ABSTRACT
Oxytocin Augmentation There are no trials to evaluate the timing and dosing of oxytocin in labor in women making normal progress in labor.
For women making slow progress in the first stage of spontaneous labor, treatment with oxytocin as compared with no treatment or delayed oxytocin treatment does not result in any discernable difference in the number of cesarean sections performed, in one meta-analysis. In addition there are no detectable adverse effects for mother or baby (50). The use of oxytocin is associated with a reduction in the time to delivery of approximately 2 hours, which might be important to some women. However, if the primary goal of this treatment is to reduce cesarean section rates, then doctors and midwives may have to look for alternative options. Two comparisons were made in this meta-analysis: (i) the use of oxytocin versus placebo or no treatment and (ii) the early use of oxytocin versus its delayed use. There were no significant differences in the rates of cesarean section or instrumental vaginal delivery in either comparison. Early use of oxytocin resulted in an increase in uterine hyperstimulation associated with fetal heart changes. However, the early use of oxytocin versus its delayed use resulted in no significant differences in a range of neonatal and maternal outcomes. Use of early oxytocin resulted in a statistically significant reduction in the mean duration in labor of approximately 2 hours but did not increase the normal delivery rate in both this meta-analysis (50) and a recent RCT (51).
