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Objectives: To determine the outcome of early versus delayed Oxytocin augmentation in nulliparous women on
the duration of labor and other obstetric and neonatal outcomes.
Study Design:Aprospective randomized trial.
Place and Duration of study: The study was conducted at Pakistan Railways Hospital, for the duration of 1 year
with effect from January 2010 January, 2011. It is 400 bedded teaching hospital affiliated with IIMC-T of Riphah
International University, Islamabad
Materials and Methods: In healthy nulliparous women with normal pregnancy,the progress of labor was
thoroughly monitored and documented every 23 hours. If there was still no progress 1 hour after amniotomy, the
woman was randomly allocated to either labor augmentation by oxytocin infusion or to postponement of oxytocin
augmentation for 3 hours (expectant group, n = 158). Women whose labors had progressed satisfactory (1
cm/hour) after amniotomy were not randomized. Participants were managed according to a standard protocol
entailing continuous documentation of the progress of labour, the amount of oxytocin administered, and
obstetrical and neonatal outcomes. Oxytocin infusion was started at 6 mU/minute and was raised by 6
mU/minute every 30 minutes until efficient contractions were established in the early oxytocin group. In the
expectant group, if no progress occurred after 3 hours, the women were reassessed regarding the need for
oxytocin augmentation. Data were analyzed with SPSS 15.0. The MannWhitney U test was used to compare
means. Proportions of events were compared with Fisher's exact test or chi-square analysis. Statistical
significance was set at a P value of <0.05.
Results: The caesarean section rate was 9% in the early oxytocin group and 10.7% in the expectant group (OR
0.8, 95% CI 0.51.4), and instrumental vaginal delivery 17% in the early oxytocin versus 12% in the expectant
group (OR 1.5, 95% CI 0.972.4). Early initiation of oxytocin resulted in a mean decrease of 85 minutes in the
randomization to delivery interval.
Conclusion: Early administration of oxytocin did not change the rate of caesarean section or instrumental
vaginal delivery but shortened labor duration significantly in women with a 2-hour arrest in cervical dilatation. No
other clear benefits or harms were seen between early and delayed administration of oxytocin.
Azra Saeed Awan, Umber Bakhtiar, Ghazala Amin. (2011) Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial, Journal of Islamic International Medical College, Volume-6, Issue-1.
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