Oxytocin infusion regimens for induction of labor at term in primigravidas

ABSTRACT

To compare induction of labor by intravenous oxytocin in regimens increasing incrementally at 15 and 30-minute intervals. In a randomized controlled trial, 62 primingravidas requiring induction of labor by oxytocin infusion were randomly allocated to incremental increases at 30-minute intervals [31 patients] or 15-minute intervals [31 patients]. The main outcomes assessed were mode of delivery, complications of labor and delivery [precipitate labor, hyperstimulation postpartum hemorrhage, perineal tears, puerperal pyrexia, and number of days in the hospital]. The 30-minute incremental regimen resulted in less precipitate labor, uterine hyperstimulation, and reduced length of stay in the hospital [difference in medians 3 days]. The induction delivery interval was longer with 30 minutes [median 8 hours] than with 15 minutes [median 5 hours] [difference in median 2 hours 95% confidence intervals in median 0-3 hours]. With the 30-minute interval, there was a reduction in the occurrence of postpartum hemorrhage, perineal tears, and puerperal pyrexia, but these differences did not reach statistical. For the indiction of labor in primigravidas, 30 minute incremental increases in the infusion rate of oxytocin were superior to a 15-minute incremental protocol in reducing the incidence of hyperstimulation and precipitous labor