Augmentation of Labour by a Standard Protocol in Papua New Guinea

Abstract

A study to investigate a policy of routine augmentation of dystocic labour by standard protocol encompassing definitions of delay in the first and second stages, dosage and administration of oxytocin, specific contra-indications and monitoring progress of augmented labour. During the 5 months of the study 3,261 women were confined at Port Moresby General Hospital. In 329 of these labour was augmented by a standard regime. Amongst the 161 primigravidae thus augmented there were 8 (5%) caesarean sections and 34 (21.1%) assisted deliveries. Of the 166 multigravidae augmented there were 4 (2.4%) caesarean sections and 20 (12.1%) assisted deliveries. These figures can be compared against a total caesarean rate of 2.4% and an assisted delivery rate of 3% in 1988. Analysis of case controls did not show a significant difference in perinatal outcome for those who were augmented. We conclude that a standard management protocol for augmentation of labour in all cases of delay in the first and second stages of labour, excluding those with specific contra-indications is safe and substantiates further the ascertion that active management of labour is a reasonable alternative to caesarean section for dystocia.