Document Detail


High-dose oxytocin: 20- versus 40-minute dosage interval.
MedLine Citation:
PMID:  8290186     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether an increase in the oxytocin dosing interval would decrease the incidence of uterine hyperstimulation. METHODS: This study included 1801 consecutive pregnancies receiving high-dose oxytocin. Oxytocin was used for labor augmentation in 1167 and induction in 634 women. Twenty- and 40-minute dosage intervals were compared. The study period was based on an 80% likelihood of detecting 5 and 10% differences in the cesarean and hyperstimulation rates, respectively. Statistics were analyzed with chi 2, Fisher, and Wilcoxon rank-sum tests where appropriate. Multivariate logistic regression and analysis of covariance were used to control for confounding demographic variables. RESULTS: Comparison of the 20- and 40-minute regimens for labor induction yielded no differences in the rates of cesarean delivery for dystocia (16 versus 19%) or fetal distress (5 versus 6%). The 20-minute regimen for augmentation was associated with a significant reduction in cesarean for dystocia (8 versus 12%; P = .05). The incidence of uterine hyperstimulation was greater with the 20-minute than the 40-minute regimen for induction (40 versus 31%; P = .02), but not for augmentation (31 versus 28%). Neonatal outcomes were unaffected by the dosage interval for both augmentation and induction. CONCLUSION: A 40-minute dosing interval for high-dose oxytocin offers no clear advantage over a 20-minute interval. Both regimens were safe and efficient, with no differences in perinatal outcome. The 20-minute interval was associated with fewer cesareans for dystocia when used for labor augmentation, whereas the 40-minute interval resulted in less hyperstimulation when used for labor induction.
Authors:
A J Satin; K J Leveno; M L Sherman; D McIntire
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  83     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-02-24     Completed Date:  1994-02-24     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  234-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Wilford Hall United States Air Force Medical Center, Lackland AFB, Texas.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cesarean Section / statistics & numerical data
Drug Administration Schedule
Dystocia / epidemiology,  surgery
Female
Humans
Labor, Induced*
Multivariate Analysis
Odds Ratio
Oxytocin / administration & dosage*
Pregnancy
Time Factors
Chemical
Reg. No./Substance:
50-56-6/Oxytocin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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