The Effect of Early Oxytocin Augmentation in Labor: A Meta-Analysis

@article{Wei2009TheEO,
  title={The Effect of Early Oxytocin Augmentation in Labor: A Meta-Analysis},
  author={Shuqin Wei and Zhongcheng Luo and Hairong Xu and William D Fraser},
  journal={Obstetrics \& Gynecology},
  year={2009},
  volume={114},
  pages={641-649}
}
OBJECTIVE: To estimate the effects of early augmentation with oxytocin for slow progress of labor on the delivery method and on indicators of maternal and neonatal morbidity. DATA SOURCES: We conducted electronic database searches of PubMed, MEDLINE, EMBASE, and the Cochrane Library for articles published through February 2009 using the keywords “oxytocin,” “augmentation,” “active management of labor,” “cesarean section,” and “labor.” Primary authors were contacted directly if the data sought… Expand

Paper Mentions

Interventional Clinical Trial
In UKM Medical Centre (UKMMC), delayed oxytocin augmentation at two hours following amniotomy is the routine obstetric practice in spontaneous or induced labour with intact membranes… Expand
ConditionsDelivery Delayed, Mode of Delivery, Post Partum Hemorrhage, (+1 more)
InterventionOther
High-dose vs low-dose oxytocin for labor augmentation: a systematic review.
TLDR
High-dose oxytocin for labor augmentation is associated with a decrease in cesarean section and shortened labor, and there was no evidence of an increase in maternal or neonatal morbidity. Expand
Labor stimulation with oxytocin: effects on obstetrical and neonatal outcomes
TLDR
Findings provide further evidence to health professionals and midwives on the use of oxytocin during labor and suggest that under normal conditions, women should be informed of the possible effects of labor stimulation with Oxytocin. Expand
Outcome measures in studies on the use of oxytocin for the treatment of delay in labour: a systematic review.
TLDR
It is recommended that, in future randomised trials of oxytocin use for delay in labour, some women-centred and health-focussed outcome measures should be used, which may instil a more salutogenic culture in childbirth. Expand
Accelerated Titration of Oxytocin in Nulliparous Women with Labour Dystocia: Results of the ACTION Pilot Randomized Controlled Trial.
  • J. Dy, J. Rainey, +7 authors Shuqin Wei
  • Medicine
  • Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
  • 2018
TLDR
This pilot study demonstrated that a large, multicentre RCT is not only feasible, but also necessary to assess the effectiveness and safety of an AOT protocol for labour augmentation with regard to CS rate and indicators of maternal and perinatal morbidities. Expand
The sequence of intrapartum interventions: a descriptive approach to the cascade of interventions
TLDR
The temporal sequence of intrapartum interventions varied in association with parity, cervical dilation, labor duration and mode of birth, and increased as interventions increased. Expand
Comparison of Low-Dose Oxytocin and Dinoprostone for Labor Induction in Postterm Pregnancies: A Randomized Controlled Prospective Study
TLDR
Both oxytocin and dinoprostone seem to have similar obstetric outcomes in postterm pregnancies with an unfavorable cervix, except for a significant superiority of oxytocIn for delivery in a shorter period. Expand
Management of Spontaneous Labour at Term in Healthy Women.
  • Lily Lee, J. Dy, H. Azzam
  • Medicine
  • Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
  • 2016
TLDR
This guideline is designed to provide guidance in the management of first and second stage dystocia to increase the likelihood of a vaginal birth and optimize birth outcomes. Expand
Oxytocin augmentation of labour in women with epidural analgesia for reducing operative deliveries.
TLDR
To determine whether augmentation of women using epidural analgesia with oxytocin will decrease the incidence of operative deliveries and thereby reduce fetal and maternal morbidity, the Cochrane Pregnancy and Childbirth Group's Trials Register was searched. Expand
Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women
TLDR
The findings show that admission to hospital early in labor played a key role in increasing the number of interventions used and was associated with increased risk of cesarean birth. Expand
Comparison between amniotomy, oxytocin or both for augmentation of labor in prolonged latent phase: a randomized controlled trial
TLDR
Labor augmentation by combined amniotomy and oxytocin among women with a prolonged latent phase at term seems superior compared to either of them alone. Expand
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References

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High-dose oxytocin decreases the time from admission to vaginal delivery, but does not appear to decrease the incidence of cesarean sections when compared with low-dose therapy. Expand
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The program studied for the active management of labor reduces the incidence of dystocia and increases the rate of vaginal delivery without increasing maternal or neonatal morbidity. Expand
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Patients undergoing active management of labor had shortened labors and were more likely to be delivered within 12 hours, differences that persisted despite the use of epidural analgesics. Expand
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This study demonstrates that pulsatile administration of oxytocin is similar in efficacy to the standard continuous oxytoc in infusion and requires a lower total amount and rate of Oxytocin administered, which may afford a greater margin of safety. Expand
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A high starting dose of oxytocin infusion is as safe but more effective for augmentation of labour in nulliparous women, compared to a low starting dose. Expand
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TLDR
It is demonstrated that pulsatile administration of oxytocin is similar in efficacy to the standard continuous oxytoc in infusion and requires a lower total amount and rate of Oxytocin administered, which may afford a greater margin of safety. Expand
Active‐Phase Labor Arrest: A Randomized Trial of Chorioamnion Management
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In women with active‐phase arrest of labor and intact membranes, oxytocin augmentation with elective amniotomy and internal monitoring increases maternal infectious morbidity. Expand
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The use of high-dose oxytocin regimen benefits both nulliparous and multiparous women requiring labor augmentation by significantly lowering both the time necessary to correct the labor abnormality and the need for cesarean section. Expand
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The use of high dose oxytocin is associated with significantly shorter labor without any adverse fetal and maternal effects. Expand
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TLDR
Although induction failed less frequently with the high-dose regimen, cesarean for fetal distress was performed more frequently, and high- dose oxytocin to augment ineffective spontaneous labor minimized the number of cESareans done for dystocia. Expand
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