High dose and low dose oxytocin regimens as determinants of successful labor induction: a multicenter comparative study

Tesemma, Melese Gezahegn; Sori, Demisew Amenu; Gemeda, Desta Hiko

doi:10.1186/s12884-020-02938-4

Cited by 10 publications

(12 citation statements)

References 16 publications

(34 reference statements)

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“…It was found that oxytocin regimen didn’t show significant association with induction success and adverse maternal outcome in another article of the same project unlike adverse perinatal outcome that increase with high dose oxytocin [ 13 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Arbaminch general hospital has 1500 births per year, Kuyu general hospital about 1350 births per year and Shenen gibe general hospital has nearly 1400 births per year. The methodology used in the current study is similar to that of another study related to the same project which has been published in BMC Pregnancy and Childbirth [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

“…Pregnant women with singleton gestations who undergo induction of labor at term and beyond were included. Pregnant mothers with Intra Uterine Fetal Death (IUFD), critically ill pregnant mothers, pregnant mothers with lethal congenital anomaly, pregnancies complicated by cord prolapse, induced pregnancy for whom cesarean section (CS) was done for non-obstetric indication like social reason were excluded from the study[ 13 ].…”

Section: Methodsmentioning

confidence: 99%

“…Initial dose of 6mU/min increased by 6mU/min every 20 min up to a maximum dose of 92.8 mU/min [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

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Perinatal outcomes of high dose versus low dose oxytocin regimen used for labor induction and factors associated with adverse perinatal outcome in four hospitals of Ethiopia: a multicenter comparative study

Tesemma

Sori

Gemeda

2021

BMC Pregnancy Childbirth

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Background There is limited evidence on effect of high and low dose oxytocin used for labor induction on perinatal outcomes. We compared perinatal outcomes among pregnant mothers who received the two different oxytocin regimens and identified risk factors associated with adverse perinatal outcomes. Methods Facility based comparative cross-sectional study was conducted in four hospitals of Ethiopia over eight month’s period during 2017/2018 year with 216 pregnant women who received high and low dose oxytocin for labor induction. Socio-demographics, reproductive characteristics of mothers and perinatal outcomes data were collected and entered into Epi-data version 3.1 and then exported to SPSS version 20 for cleaning and analysis. Chi-square test and logistic regression were done to see the effect of different oxytocin regimens on perinatal outcome. The result was presented using 95 % confidence interval of crude and adjusted odds ratios. P-value < 0.05 was used to declare statistical significance. Result Higher adverse perinatal outcomes (29 % vs. 13.9 %, p = 0.005) and higher non-reassuring fetal heart rate pattern (23.1 % vs. 7.4 %, p = 0.001) was observed among mothers who received high dose oxytocin compared to mothers who received low dose oxytocin. Using high oxytocin dose [AOR = 2.4, 95 % CI: 1.1, 5.5], caesarean birth [AOR = 9.3, 95 %CI: 3.8, 22.5], instrumental birth [AOR = 7.7, 95 % CI: 2.1, 27.8], and antepartum hemorrhage [AOR = 17.8, 95 %CI: 1.9, 168.7] were risk factors of adverse perinatal outcomes. Conclusions There was significance difference in the occurrence of adverse perinatal outcomes among pregnant mothers who received high and low dose of oxytocin. Using high dose oxytocin, antepartum hemorrhage, caesarean birth and instrumental birth were associated with increased risk of adverse perinatal outcomes. We recommend using low dose oxytocin for better perinatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Initial dose of 6mU/min increased by 6mU/min every 20 min up to a maximum dose of 92.8 mU/min [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Perinatal outcomes of high dose versus low dose oxytocin regimen used for labor induction and factors associated with adverse perinatal outcome in four hospitals of Ethiopia: a multicenter comparative study

Tesemma

Sori

Gemeda

2021

BMC Pregnancy Childbirth

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“…If a woman gave birth vaginally with or without the aid of an instrument after labor induction ( 31 ).…”

Section: Methodsmentioning

confidence: 99%

Proportion and Outcome of Induction of Labor Among Mothers Who Delivered in Teaching Hospital, Southwest Ethiopia

Yosef

Getachew

2021

Front. Public Health

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Background: Despite the induction of labor (IOL) having had some undesired consequences, it also has several benefits for maternal and perinatal outcomes. This study aimed to assess the proportion and outcome of IOL among mothers who delivered in Teaching Hospital, southwest Ethiopia.Methods: A retrospective cross-sectional study was conducted from June 10 to June 20, 2019, among 294 mothers who gave birth between November 30, 2018, and May 30, 2019, by reviewing their cards using a structured checklist to assess the prevalence, outcome, and consequences of induction of labor. A binary logistic regression analysis was computed to look for the association between outcome variables and independent variables.Results: The prevalence of labor induction was 20.4%. The most commonly reported cause of induction was preeclampsia (41.6%). The factors associated with IOL were mothers aged 25–34 years [AOR = 2.55, 95% CI (1.18–5.50)] and ≥35 years [AOR = 10.6, 95% CI (4.20–26.9)], having no history of antenatal care [AOR = 2.12, 95% CI (1.10–4.07)], and being Primipara AOR = 2.33, 95% CI (1.18–3.24)]. Of the 60 induced mothers, 23.3% had failed induction. The proportion of mothers with dead fetal outcomes and maternal complications was 5 and 41.7%, respectively. The unfavorable Bishop Score before induction [AOR = 1.85, 95% CI (1.32–4.87)] and induction using misoprostol [AOR = 1.48, 95% CI (1.24–5.23)] were the factors associated with failed induction of labor.Conclusion: The prevalence of induced labor was considerably higher than rates in other Ethiopian studies; however, the prevalence of induction failure was comparable to other studies done in Ethiopia. The study found that Bishop's unfavorable score before induction and induction using misoprostol was the factor associated with unsuccessful induction. Therefore, the health professionals should confirm the favorability of the cervical status before the IOL to increase the success rate of induction of labor.

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Optimal starting dosing regimen of intravenous oxytocin for labor induction based on the population kinetic‐pharmacodynamic model of uterine contraction frequency

Yu,

Chen,

Zhao

et al. 2024

Pharmacotherapy

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BackgroundIntravenous oxytocin is commonly used for labor induction. However, a consensus on the initial dosing regimen is lac with conflicting research findings and varying guidelines. This study aimed to develop a population kinetic‐pharmacodynamic (K‐PD) model for oxytocin‐induced uterine contractions considering real‐world data and relevant influencing factors to establish an optimal starting dosing regimen for intravenous oxytocin.MethodsThis retrospective study included pregnant women who underwent labor induction with intravenous oxytocin at Peking University Third Hospital in 2020. A population K‐PD model was developed to depict the time course of uterine contraction frequency (UCF), and covariate screening identified significant factors affecting the pharmacokinetics and pharmacodynamics of oxytocin. Model‐based simulations were used to optimize the current starting regimen based on specific guidelines.ResultsData from 77 pregnant women with 1095 UCF observations were described well by the K‐PD model. Parity, cervical dilation, and membrane integrity are significant factors influencing the effectiveness of oxytocin. Based on the model‐based simulations, the current regimens showed prolonged onset times and high infusion rates. This study proposed a revised approach, beginning with a rapid infusion followed by a reduced infusion rate, enabling most women to achieve the target UCF within approximately 30 min with the lowest possible infusion rate.ConclusionThe K‐PD model of oxytocin effectively described the changes in UCF during labor induction. Furthermore, it revealed that parity, cervical dilation, and membrane integrity are key factors that influence the effectiveness of oxytocin. The optimal starting dosing regimens obtained through model simulations provide valuable clinical references for oxytocin treatment.

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High dose and low dose oxytocin regimens as determinants of successful labor induction: a multicenter comparative study

Cited by 10 publications

References 16 publications

Perinatal outcomes of high dose versus low dose oxytocin regimen used for labor induction and factors associated with adverse perinatal outcome in four hospitals of Ethiopia: a multicenter comparative study

Perinatal outcomes of high dose versus low dose oxytocin regimen used for labor induction and factors associated with adverse perinatal outcome in four hospitals of Ethiopia: a multicenter comparative study

Proportion and Outcome of Induction of Labor Among Mothers Who Delivered in Teaching Hospital, Southwest Ethiopia

Optimal starting dosing regimen of intravenous oxytocin for labor induction based on the population kinetic‐pharmacodynamic model of uterine contraction frequency

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