CONTINUATION VERSUS DISCONTINUATION OF OXYTOCIN INFUSION THROUGHOUT THE ACTIVE PHASE OF LABOR AND ITS EFFECT ON THE COURSE OF INDUCED LABOR

Abstract

Background: Oxytocin is an effective commonly used drug for induction of labor, However it is associated with several maternal and neonatal adverse effect. So, controlled dosage is recommended. Objective: To determine the effect of continuation or discontinuation of the infusion of oxytocin on the duration of the active phase of labor and maternal and neonatal complications. Patients and Methods: This was a randomized controlled trial study conducted in the Obstetrics and Gynecology Department of Dikirnis General Hospital from (August 2018 to September 2019). The women participated in this study was divided in 2 groups, each group consists of 100 women [40 of them were nulliparous and 60 were multiparous]: Group (A) received continuous oxytocin infusions throughout labor until the end of labor. Group (B) received oxytocin infusion which was discontinued once the active phase of labor was established (cervix ≥ 6 cm, uterine contraction at a rate of 3-5 per 10 minutes). Results: The active phase of labor was longer by 53 minutes in the discontinued group (primigravida) versus the continued group (primigravida) and was longer by 75 minutes in the discontinued group B (multigravida) versus the continued group A (multigravida). The incidence of intrapartum fetal distress and uterine hyperstimulation were non-significantly greater in the continued than the discontinued group. The mode of delivery, incidence of cesarean deliveries, postpartum hemorrhage, cervical tear and NICU admission were higher in the continued group versus the discontinued group. Conclusion: The duration of active phase of labor prolonged after discontinuing oxytocin infusion. The new protocol may improve labor outcomes and significantly decrease the rate of uterine hyperstimulation, intrapartum fetal distress and decrease cesarean delivery.