Abstract
Aims: To prevent fetal damage by excess oxytocin administration of manually controlled infusion, by automatic and safe increasing infusion setting with monitoring uterine contraction and fetal heart rate. Methods: Starting infusion level was 2 milliU/ml, as oxytocin sensitivity of a pregnant uterus is unknown, to avoid hyper contraction and fetal bradycardia caused by unexpected excess oxytocin sensitivity. The infusion automatically increased with automatic monitoring of uterine contraction curve, then the increasing stopped when contraction reached to normal labor level, where the infusion level maintained, which continued until delivery, if there is no trouble. However, the infusion continued until expiring all fluid in case of insensitive uterus, where the induction was performed in another day. The infusion stopped automatically when contraction was too strong, or fetal heart rate is abnormal. Thus, oxytocin sensitive case is protected from excess contraction and fetal asphyxia. Results: Normal vaginal delivery was achieved in 28/33 cases (85%), which was more than manually controlled infusion. No case was abnormal in successful oxytocin infusion. Conclusion: The automated technique will be applied to oxytocin labor induction.
Highlights
The infusion automatically increased with automatic monitoring of uterine contraction curve, the increasing stopped when contraction reached to normal labor level, where the infusion level maintained, which continued until delivery, if there is no trouble
It was necessary to start from very low dose oxytocin testing the sensitivity level looking for suitable oxytocin dose to develop normal contraction, oxytocin was gradually increased studying the reaction of myometrium with uterine contraction curve in this study
Oxytocin increasing stopped when normal contraction curve appeared, the contraction is induced by appropriate dose oxytocin until delivery, while whole oxytocin infusion stopped automatically, if the contraction is too strong, or fetal monitor detects abnormal fetal heart rate (FHR)
Summary
The author was afraid of fetal damage, looking at fetal bradycardia in manually controlled oxytocin infusion in 1960s-1970s, and invented automatic and safe induction with oxytocin infusion. The past experience of oxytocin induction developed excessive uterine contraction and fetal heart rate (FHR) bradycardia under 100 bpm in oxytocin sensitive case, where fetal damage or demise was concerned (Figure 1). It was necessary to start from very low dose oxytocin testing the sensitivity level looking for suitable oxytocin dose to develop normal contraction, oxytocin was gradually increased studying the reaction of myometrium with uterine contraction curve in this study. Oxytocin increasing stopped when normal contraction curve appeared, the contraction is induced by appropriate dose oxytocin until delivery, while whole oxytocin infusion stopped automatically, if the contraction is too strong, or fetal monitor detects abnormal FHR
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