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Oxytocin augmentation successfully corrects dystocia in most slowly-progressing first labors, although its use has been suggested as a cause of increased perinatal morbidity. We examined this potential relationship in a large series of first labors.
Three aspects of perinatal outcome asphyxial neonatal death, asphyxial seizures and abnormal neonatal neurological behaviour, were analyzed in a consecutive cohort of 23889 spontaneous singleton cephalic nulliparous labors at term (≥37 weeks) from 1998 to 2008, in respect of oxytocin acceleration in a dosage range of 6-40 mU/min.
In total, 13242 (55%) nulliparas received oxytocin augmentation and 10647 did not. There were no significant differences in respect of any of the three outcome measures between the oxytocin-treated and untreated cohorts; in addition, the incidences of low Apgar (<7 at 1 min) and low cord blood pH (where sampled) did not differ. Mean birthweight and epidural usage did not differ between the oxytocin and non-oxytocin-acccelerated groups, although mean spontaneous labor duration was different (oxytocin: 8.5 hours; no oxytocin 5.4 hours). No case of uterine rupture occurred.
In this cohort of spontaneous singleton cephalic first labours at term, correction of slow progress with oxytocin augmentation as part of an Active Mangement of Labor protocol conferred no discernible extra maternal or perinatal morbidity.