Pulsatile versus continuous administration of oxytocin for induction and augmentation of labor: two randomized controlled trials - 28/02/12
, Sarah E. Crawshaw, RM, PhD a, Paul Seed, CStat a, Andrew H. Shennan, MD a, Philip N. Baker, DM, FMedSci b
Reprints: Rachel M. Tribe, PhD, Division of Women's Health, King's College London, 10th Floor North Wing, St. Thomas' Hospital Campus, Westminster Bridge, London, SE1 7EH, UKRésumé |
Objective |
To determine whether pulsatile oxytocin infusion improves delivery outcome in women requiring induction or augmentation of labor.
Study Design |
Two related randomized controlled trials undertaken in 2 inner-city United Kingdom university hospitals (ISRCTN72773405; www.isrctn.org/). Women were randomly assigned to a pulsatile or continuous infusion protocol. Primary outcome: cesarean section rate (induction trial); operative delivery rate (augmentation trial).
Results |
For induction, cesarean section rates were similar in women receiving pulsatile (n = 264, 38.3%) vs continuous infusion of oxytocin (n = 257; 37.7%; risk ratio, 1.01; 95% confidence interval, 0.81–1.26; P = .903), but associated with increased “infusion to time of delivery” intervals (P < .001) in the pulsatile group. For augmentation, pulsatile infusion resulted in higher operative delivery rates (70.1%, n = 251) vs continuous infusion (62.7%, n = 249; risk ratio, 1.12; 95% confidence interval, 0.99–1.27; P = .077) and increased neonatal morbidity.
Conclusion |
For induction, pulsatile infusion of oxytocin is effective, but conferred little clinical benefit. Pulsatile infusion is not recommended for augmentation.
Le texte complet de cet article est disponible en PDF.Key words : labor, pregnancy, syntocinon
Plan
| Sponsored by a grant from the GlaxoSmithKline Giving Committee administered by Tommy's, the baby charity (registered charity number 1060508). |
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| The authors report no conflict of interest. |
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| Cite this article as: Tribe RM, Crawshaw SE, Seed P, et al. Pulsatile versus continuous administration of oxytocin for induction and augmentation of labor: two randomized controlled trials. Am J Obstet Gynecol 2012;206:230.e1-8. |
Vol 206 - N° 3
P. 230.e1-230.e8 - mars 2012 Retour au numéro
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