Abstract
BackgroundThere 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.MethodsFacility 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.ResultHigher 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.ConclusionsThere 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.
Highlights
There is limited evidence on effect of high and low dose oxytocin used for labor induction on perinatal outcomes
Chi-square test and logistic regression were done to see the effect of different oxytocin regimens on perinatal outcome
Majority138 (64 %) of the study participants were living in urban area with comparable distribution to the two study groups
Summary
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. Labor induction is aimed at achieving vaginal birth when the benefits of giving birth out-weigh the risk of continuing the pregnancy to the mother and perinatal outcome [1, 2]. Induction of labor (IOL) is associated with poorer perinatal outcomes when compared with spontaneous labor. Oxytocin regimen can be either high dose or low dose depending on the starting dose, the amount and rate of sequential increases in the dose of oxytocin [5]. Even though Ethiopian national guideline and other study recommends use of low dose oxytocin regimen for labor induction ([3], Management Protocol on Selected Obstetric Topics: Federal Democratic Republic Of Ethiopia, Ministry Of Health, unpublished), there are centers which are utilizing high dose oxytocin regimen one of which is Jimma university medical center (JUMC) (Segni H, Niguse D. et al.: Obstetrics management guideline in JUSH Jimma University, unpublished)
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