OBJECTIVE: To investigate the use of oxytocin for augmentation of labor and its relation to labor progress and delivery outcome. DESIGN AND SETTING: A retrospective observational study undertaken in a Swedish hospital during 2000-2001. SAMPLE: Singleton pregnancies at > or = 37 weeks of gestation with cephalic presentation and spontaneous onset of labor. METHODS: Data were collected from 1,263 clinical records. The partogram was used to diagnose labor dystocia (LD). MAIN OUTCOME MEASURES: Prevalence of oxytocin administration, LD and operative delivery. RESULTS: Oxytocin was administered to 55% of the women (75% of primiparas and 38.1% of multiparas); a majority did not meet LD criteria. LD frequency was 19.8% (32.7% in primiparas and 7.4% in multiparas). Oxytocin was started both 'too early' and 'too late' in relation to the diagnosis of LD. Cesarean section (CS) was performed on 17.1% of primiparous and 2.4% of multiparous oxytocin recipients with LD, compared to 2.3 and 1.5%, respectively, of oxytocin recipients without diagnosed LD. CONCLUSIONS: Oxytocin augmentation was undertaken in an unstructured manner; some women were inadequately treated and others were treated unnecessarily. Oxytocin recipients with LD underwent operative delivery to a higher extent than oxytocin recipients without LD, suggesting that the main reason for CS was the underlying problem of LD rather than the oxytocin augmentation itself.
OBJECTIVE: To investigate the use of oxytocin for augmentation of labor and its relation to labor progress and delivery outcome. DESIGN AND SETTING: A retrospective observational study undertaken in a Swedish hospital during 2000-2001. SAMPLE: Singleton pregnancies at > or = 37 weeks of gestation with cephalic presentation and spontaneous onset of labor. METHODS: Data were collected from 1,263 clinical records. The partogram was used to diagnose labor dystocia (LD). MAIN OUTCOME MEASURES: Prevalence of oxytocin administration, LD and operative delivery. RESULTS:Oxytocin was administered to 55% of the women (75% of primiparas and 38.1% of multiparas); a majority did not meet LD criteria. LD frequency was 19.8% (32.7% in primiparas and 7.4% in multiparas). Oxytocin was started both 'too early' and 'too late' in relation to the diagnosis of LD. Cesarean section (CS) was performed on 17.1% of primiparous and 2.4% of multiparous oxytocin recipients with LD, compared to 2.3 and 1.5%, respectively, of oxytocin recipients without diagnosed LD. CONCLUSIONS:Oxytocin augmentation was undertaken in an unstructured manner; some women were inadequately treated and others were treated unnecessarily. Oxytocin recipients with LD underwent operative delivery to a higher extent than oxytocin recipients without LD, suggesting that the main reason for CS was the underlying problem of LD rather than the oxytocin augmentation itself.
Authors: Olufemi T Oladapo; João Paulo Souza; Meghan A Bohren; Özge Tunçalp; Joshua P Vogel; Bukola Fawole; Kidza Mugerwa; A Metin Gülmezoglu Journal: Reprod Health Date: 2015-05-26 Impact factor: 3.223