Determinants of Higher Oxytocin Dose Need During Labor Induction

Author:

Khazardoust Soghra,Mahdavi Raheleh,Hantoushzadeh SedighehORCID,Ghaemi MarjanORCID,Borna Hajieh,Arman Mozhgan,Ghalandarpoor-Attar Seyedeh MojganORCID

Abstract

Background: Several guidelines have been published regarding intrapartum oxytocin infusion for labor induction or augmentation; however, many of them lack specificity. Objectives: Therefore, this study aimed to assess oxytocin dose administered during labor and evaluate its association with maternal characteristics and short-term perinatal outcomes. Methods: This retrospective cross-sectional study was conducted on 162 term pregnant women who were admitted to the labor ward for vaginal delivery in two academic hospitals during 2021 - 2022. Maternal demographic features, obstetric and medical history data, labor process details (initial Bishop score, membrane status on admission and at the time of labor induction or augmentation, latent and active phase duration, oxytocin dose, delivery mode, and neonatal outcomes) were obtained and recorded. Participants were divided into two main groups based on the intrapartum oxytocin dose, and the desired outcomes were reported and compared between the groups. Results: The median maternal age was 28 years (range: 16 - 46). The median oxytocin dose administered during labor induction was 10 mU/min (range: 2.5 - 25 mU/min). Oxytocin dose was significantly correlated with gestational age (P < 0.001), cervical dilation and effacement (P < 0.001), fetal head station (P < 0.001), cervical consistency (P < 0.001), and cervical Bishop score before labor induction (P < 0.001). The cervical dilation at the time of membrane rupture was also positively correlated with the intrapartum oxytocin dose (P = 0.013). Higher gestational age was correlated with a higher required oxytocin dose (P < 0.001). The cesarean rate was 22.8% in the study population, and it was positively correlated with intrapartum oxytocin dose (P < 0.001). Conclusions: The cervical Bishop score and its components, except for cervical position, were correlated with the intrapartum oxytocin dose. In other words, the less favorable the cervix, the higher the likelihood of requiring higher doses of oxytocin and consequently experiencing a longer duration of labor. Additionally, the cesarean rate was higher in those who needed oxytocin doses of more than 10 mU/min; however, short - term neonatal outcomes were not different.

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Briefland

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