Oxytocin For Induction Of Labor Research Articles

QMOLI- A Qualitative Assessment of Misoprostol or Oxytocin for Labour Induction

qMOLI- A Qualitative Assessment of Misoprostol or Oxytocin for Labour Induction

“Are the Maternity Nurses Knowledgeable on Oxytocin Induction During Labour? A Protocol Development for Hospitals in South India”

We conducted this study among 100 nurses who were working in the maternity ward of Hosahalli referral Hospital, and Sagar hospital in Bangalore, India, by using non-probability purposive sampling technique. The data was collected by using self-administered questionnaire. The study revealed that there is a significant relationship between knowledge level of respondents and their experience in the procedure of oxytocin induction as evidenced by P value 0.0422< alpha value 0.05. The test is Statistically Significant at 95% confidence level. Area wise analysis of knowledge score of staff nurses regarding oxytocin induction of labour has made the impression in five areas (1) the knowledge score of the samples about information of induction of labour were 70%. (2) General information about oxytocin induction (64.57%). (3) Information related to indications and contra indications of oxytocin induction (65%). (4) Information about induction of oxytocin (68.53%). (5) Nursing management during oxytocin induction (66.14%). The overall knowledge score of the participants (100 samples) is (65.50%), overall mean (28.82), median (23) SD (20.32) which revealed that only 31% of the participants have adequate knowledge on oxytocin induction during labour. A new protocol was developed for the maternity nurses on the oxytocin induction, based on the statistical findings of self-administered questionnaire for the two hospitals where the study was conducted.

772: A comparison of low and high-dose oxytocin for induction of labor in term nulliparous women

772: A comparison of low and high-dose oxytocin for induction of labor in term nulliparous women

Misoprostol Versus Oxytocin for Induction of Labour at Term and Post Term Pregnancy of Primigravida

Introduction: To compare effectiveness and safety of sublingually administered misoprostol and intravenously infused 10 units of oxytocin for labor induction at term and post term pregnant women in Gandaki Medical College Teaching Hospital (GMCTH).&#x0D; Materials and methods: This is a prospective study conducted in Department of Obstetrics and Gynaecology in Gandaki Medical College and performed on 120 patients of primigravida with cephalic presentation at term and post-term pregnancy. Patients were given 50µg sublingual misoprostol 6 hourly (two doses) and 5 units of oxytocin in 500ml RL started from 10 drops up to 60 drops till effective contraction occur with maximum of 10 units oxytocin. Maternal and fetal outcomes were observed. Collected data were analyzed using SPSS and MS Excel.&#x0D; Results: There were no significant differences between the groups concerning time duration between inductions to delivery time, indications of caesarean section, different modes of delivery and for the Apgar score at one and five minutes.&#x0D; Conclusion: Both oxytocin and misoprostol are effective and safe for induction of labour.

Assessing risk of neurodevelopmental disorders after birth with oxytocin: a systematic review and meta-analysis.

Experts have raised concerns that oxytocin for labor induction and augmentation may have detrimental effects on the neurodevelopment of children. To investigate whether there is the reason for concern, we reviewed and evaluated the available evidence by searching databases with no language or date restrictions up to 9 September 2018. We included English-language studies reporting results on the association between perinatal oxytocin exposure and any cognitive impairment, psychiatric symptoms or disorders in childhood. We assessed the quality of studies using the Newcastle-Ottawa Quality Assessment Scales. Independent risk estimates were pooled using random-effects meta-analyses when at least two independent datasets provided data on the same symptom or disorder. Otherwise, we provided narrative summaries. Two studies examined cognitive impairment, one examined problem behavior, three examined attention-deficit/hyperactivity disorder (ADHD) and seven focused on autism spectrum disorders (ASD). We provided narrative summaries of the studies on cognitive impairment. For ADHD, the pooled risk estimate was 1.17; 95% confidence interval (CI) 0.77-1.78, based on a pooled sample size of 5 47 278 offspring. For ASD, the pooled risk estimate was 1.10; 95% CI 1.04-1.17, based on 8 87 470 offspring. Conclusions that perinatal oxytocin increases the risks of neurodevelopmental problems are premature. Observational studies of low to high quality comprise the evidence-base, and confounding, especially by the genetic or environmental vulnerability, remains an issue. Current evidence is insufficient to justify modifying obstetric guidelines for the use of oxytocin, which state that it should only be used when clinically indicated.

Continuous oxytocin versus intermittent oxytocin for induction of labor: a randomized study

Objective: To assess whether intermittent usage of oxytocin infusion increases the duration of the active phase of labor and reduces maternal and neonatal complications or not.Materials and Methods: A prospective randomized controlled study was conducted of 200 consenting women with singleton pregnancy in the vertex position undergoing labor induction or augmentation at the Zeynep Kamil Maternity and Children’s Training and Research Hospital. Participants with cervical dilation of 3 cm were randomized to either continued or intermittent oxytocin infusion when cervical dilation reached 5 cm. The primary outcome measures were the duration of the active phase of labor, defined as the period of labor from 5 cm of cervical dilation to vaginal delivery. Secondary outcomes were the duration of oxytocin infusion, mode of delivery, hyperstimulation, abnormalities in fetal heart rate, perineal tears, and neonatal outcomes.Results: The median duration of the active phase for the women with a vaginal delivery was longer in the intermittent oxytocin group than the continued oxytocin group, but it was not statistically significant (median, 6.91 vs. 7.58 h, p = .37). There was a significant difference in the duration of oxytocin infusion (median, 12.38 h in the intermittent group vs. 15.79 h in the continued group, p = .005). The incidence of uterine hyperstimulation was significantly greater in the continued group (21.1%) than the intermittent oxytocin group (3.8%) (p=.001).Conclusions: Intermittent usage of oxytocin infusion seems to make labor less complicated without lengthening duration of labor.

Comparative study of misoprostol and oxytocin in induction of labor in full-term pregnancy complicated with premature rupture of membranes

Objective To investigate effect of the application of misoprostol and oxytocin in full-term pregnancy induced labor with premature rupture of membranes. Methods From March 2016 to June 2017, 95 pregnant women in term pregnancy induced labor with premature rupture of membranes in General Hospital of Taiyuan Iron&Steel (Group) CO.LTD were selected as the research objects, and they were randomly divided into study group and control group, the control group was given oxytocin, the study group was given misoprostol for induction of labor, then the effect, the total production process, delivery time, labor time, maternal and infant outcomes, the occurrence of adverse reactions of the two groups were observed. Results The total effective rate of pregnant women of the study group and the control group were 95.83%, 78.72%, respectively, the difference was statistically significant(χ2=7.136, P 0.05). Conclusion Compared with oxytocin, misoprostol for full-term pregnancy with fetal membranes induction effect is more significant, which can shorten the birth process, improve maternal and child outcomes.So it is worthy of clinical promotion. Key words: Pregnancy; Term birth; Fetal membranes, premature rupture; Labor, induced; Misoprostol; Oxytocin; Pregnancy outcome

The behaviour of pelvic floor muscles during uterine contractions in spontaneous and oxytocin-induced labour

Term pregnant women were divided into oxytocin infusion and control groups. The electrical activities of pelvic floor muscles (PFM) were recorded at rest and during contractions electromyographically. The beginning and the end of each contraction were marked on the recorded electromyographic trace. A trace was regarded as ‘negative’ if no increase in electrical activity was observed and ‘positive’ if increased electrical activity was observed during the contractions. To evaluate the relative frequency of the areas of electrical activity during uterine contractions (UC) a ‘positive electrical activity percentage’ was used and calculated as: (total count of positive electrical activity areas)/(total count of UC) × 100. Positive and negative electrical activity percentages were compared. The percentages were significantly different between the groups (p <.01). Positive traces increased in 56.1 and 18.8% in study and control groups, respectively, (p < .01). Multiparous women showed more positive traces than nulliparous women, both in oxytocin-treated and spontaneous labour groups (p < .01). The rate of performed episiotomies was higher in the oxytocin-infused labours (p = .01). During physiological labour contractions the predominant behaviour of PFM seemed to be a relative silent status compared to a more contractile status caused by oxytocin administration. Contracted muscles may produce a counterpressure against expulsive UC leading to obstetrical injuries of these muscles and clinically higher rates in episiotomy decisions. This is the first report of behaviour of PFM during labour contractions and further prospective studies are needed to assess the role of oxytocin administration on PFM and associated clinical consequences.Impact statementWhat is already known on this subject? The physiological functions of pelvic floor muscles depend on the coordinated actions of these muscles and rely also on unique interactions between the somatic and autonomic nervous systems. Oxytocin is commonly used for the induction and augmentation of uterine contractions and such an induced labour may be more painful for the woman.What do the results of this study add? Pelvic floor muscles tend to contract more frequently during uterine contractions as labour progresses. This difference was more pronounced in labours which were treated with oxytocin infusion.What are the implications of these findings for clinical practice and/or further research? This is the first report of electrophysiological behaviour of pelvic floor muscles during labour contractions in spontaneous and oxytocin-induced labour. Oxytocin administration seems to interfere with the coordination of uterine and pelvic floor muscle contractions. This study may be of interest for researchers to investigate the effect of the worldwide liberal use of oxytocin for induction of labour on pelvic floor muscle damage during parturition.

Comparison of Oral Misoprostol and Oxytocin for Labour Induction in Prelabour Rupture of Membranes at Term

Comparison of Oral Misoprostol and Oxytocin for Labour Induction in Prelabour Rupture of Membranes at Term

Automatic &amp; Safe Oxytocin Induction of Labor

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.

Safety and effectiveness of labour induction after caesarean section using balloon catheter or oxytocin.

Induction of labour after previous caesarean section (CS) is a challenge for obstetricians due to the increased risk of uterine rupture. Common methods for labour induction are balloon catheters and oxytocin as they are considered safe. However, the effectiveness remains unclear as currently available data are limited. Therefore, we aimed to determine safety and effectiveness of balloon catheter or oxytocin for labour induction after CS. We included 179 consecutive women with a previous CS and labour induction in this retrospective study. We performed labour induction using a balloon catheter in case of a Bishop score of <6 and intact membranes, or oxytocin in the case of a Bishop score of >6 and/or premature rupture of membranes. The primary outcome was the rate of successful vaginal deliveries. We adjusted for multiple factors that may have impacted on the rate of vaginal delivery as well. The secondary outcomes were the rate of maternal and neonatal morbidities. We detected a vaginal delivery success rate of 45.8% in the catheter and of 63.9% in the oxytocin group. We identified previous vaginal birth as an independent predictive factor for successful vaginal delivery in both groups. Induction using oxytocin was a negative predictive factor for neonatal admissions. Multivariate analysis showed that post-term pregnancy decreased the likelihood of vaginal delivery. We did not detect any factors predicting uterine rupture or uterine dehiscence, which occurred with similar frequency in both groups. Finally, the neonatal admission rate was less likely with higher gestational age and oxytocin as an induction method, whereas previous vaginal birth increased the risk. Our study indicates that induction of labour with balloon catheter or oxytocin seems to be safe in women with previous CS. Labour induction using a balloon catheter in women with previous CS and unfavourable cervix has a disappointingly low success rate. We identified factors influencing vaginal delivery success rates. Women with previous CS and indications for labour induction should be informed about vaginal birth success rates and the alternative of elective repeat CS needs to be discussed.

High-dose compared with low-dose oxytocin for induction of labour of nulliparous women at term

Background: The optimal oxytocin infusion regimen to induce labour with the lowest caesarean section rate, instrumental delivery rate and length of active labour is unclear. We compared the effect of a low-dose to high-dose oxytocin regimen to induce labour. Materials and methods: We conducted a retrospective study of nulliparous women induced at term in a single tertiary centre from 2009 to 2015. The oxytocin induction protocol changed from a high to low-dose regimen in November 2012, affording us the opportunity to compare outcomes 3 years prior to, and following the change in protocol. Main outcome measures were caesarean section rate, instrumental delivery rate and length of active labour. Results: Four thousand eight hundred and eighty-five participants were included, 2211 were induced via the low-dose regimen, and 2674 using the high-dose regimen. There was no difference in caesarean section rate (adjusted OR 0.99; 95% CI 0.87–1.13) or instrumental delivery rates once adjusted for regional anaesthesia (adjusted OR 1.16; 95% CI 0.99–1.36) between the different regimens. Surprisingly, the length of labour was longer in the high-dose oxytocin group (adjusted mean difference 0.60 h; 95%CI 0.81–0.12). There were significantly more postpartum haemorrhage ≥1000 ml (10.5% versus 7.8%, p < .001) and regional anaesthesia use (55.8% versus 52.1%, p = .03) in the low-dose cohort. There were no differences in neonatal outcomes. Conclusion: Outcomes between high- and low-dose oxytocin induction regimens are relatively comparable with similar caesarean section and instrumental delivery rates. Therefore, either regimen is acceptable for use for induction of labour.

Induction of labour in term premature rupture of membranes; oxytocin versus sublingual misoprostol; a randomised clinical trial

Premature rupture of the membranes (PROM) occurs in about 8–10% of pregnancies and its most important complication is chorioamnionitis, so labour induction has an important role in this situation. This study was performed to compare oxytocin and sublingual Misoprostol for labour induction in PROM cases with term pregnancy. A total of 270 pregnant women who had spontaneous rupture of membrane and unripe cervix were enrolled. The first group underwent Oxytocin infusion according to low-dose standard protocol and the second group received 25 μg sublingual Misoprostol every 4 h. Time interval from induction to the beginning of active phase of labour was similar in both groups. Second stage of labour was significantly shorter in misoprostol group (p < .05). Although, some maternal side-effects were significantly higher in misoprostol group (p < .001), but 5 minute Apgar score was significantly better in this group. In conclusion, sublingual misoprostol was associated with better neonatal outcomes was more effective than oxytocin for labour induction in PROM cases.Impact statementWhat is already known on this subject: PROM occurs in about 8–10% of pregnancies; about 60% of these cases are term pregnancies. Most experts recommend early induction of labour in term PROM cases with an eye towards avoiding increased morbidity and mortality. Oxytocin is the most frequently used agent that is administered intravenously for the purpose of labour induction. Misoprostol is an alternative to oxytocin and is simpler to use, as it is administered via the oral, buccal, sublingual, rectal and vaginal routes rather than intravenously.What do the results of this study add: Time interval from induction to the beginning of active phase of labour was similar in both groups. Second stage of labour was significantly shorter in the misoprostol group. Although, some maternal side-effects were significantly higher in misoprostol group, the 5 minute Apgar score was significantly better in this group.What are the implications of these finding for clinical practice and/or further research: Sublingual misoprostol for induction of labour in PROM cases is more effective than oxytocin and its neonatal outcomes are better. Due to its easy prescription and better labour outcomes, sub lingual misoprostol may be a better choice for labour induction in PROM cases.

Amniotomy plus intravenous oxytocin for induction of labour

Reason for withdrawal from publication This review is no longer going to be prepared by the team and the protocol has been withdrawn from publication in the Cochrane Library.

Oxytocin for labour induction or augmentation as a risk factor for autism: systematic literature review

Introduction: Some studies have shown a potential association between oxytocin use during labour and autism spectrum disorder in children (ASD). We performed a systematic review of recent studies examining this association. Methods: Boolean operators (AND/OR) were used to search MEDLINE using the following search criteria: Autistic Disorder or Autism Spectrum Disorder or Autism and Labour Induction or Labour Augmentation. Articles published in English in 2013 or later were considered. Additional studies were identified by reviewing citations. Only studies conducted on people were included. Studies not accounting for potential confounding factors were excluded. Results: Four retrospective cohort studies met the inclusion criteria. One showed an association between labour induction and augmentation and ASD, one showed a weak association between labour augmentation in boys and ASD, and one showed no association between labour induction or augmentation and ASD. The largest study showed a weak association between labour induction and ASD, which was not significant when siblings were analyzed separately. Discussion and conclusions: Recently published studies do not support the hypothesis of a causal relationship between oxytocin use during labour and ASD. Benefits of medically indicated induction or augmentation of labour outweigh the theoretical risk of ASD.

Intracervical Foley Catheter With and Without Oxytocin for Labor Induction: A Randomized Controlled Trial.

To evaluate whether adding oxytocin to preinduction cervical ripening with a Foley catheter increases the rate of delivery within 24 hours. This was a randomized, multicenter, parallel trial of women with a singleton pregnancy at 24 weeks of gestation or greater undergoing labor induction. Women were randomly allocated to an intracervical Foley catheter followed by oxytocin or Foley with concurrent oxytocin infusion. Nulliparous and multiparous women were randomized and analyzed separately based on parallel design. The primary outcome was Foley placement to delivery at 24 hours or less. A sample size of 100 nulliparous women and 75 multiparous women per group would be required to detect a 20% increase in baseline 24-hour delivery rate with 80% power for each parity group. From January 2015 through July 2016, 323 patients were enrolled: 184 nulliparous women and 139 multiparous women. Nulliparous women who received concurrent Foley and oxytocin delivered more frequently within 24 hours of Foley placement than did the Foley followed by oxytocin group (64% compared with 43%, P=.003, relative risk 1.51, 95% confidence interval [CI] 1.14-2.00). Multiparous women who received concurrent Foley and oxytocin delivered more frequently within 24 hours than the Foley followed by oxytocin group (87% compared with 72%, relative risk 1.22, 95% CI 1.02-1.45). Median time to delivery was shorter in both nulliparous women (20.9 compared with 26.1 hours, P<.001) and in multiparous women, (14.9 compared with 18.6 hours, P=.01) who received concurrent Foley and oxytocin compared with Foley followed by oxytocin. There were no significant differences in the rates of cesarean delivery, postpartum hemorrhage, chorioamnionitis, or neonatal intensive care unit admission between the randomization groups. Induction with concurrent oxytocin infusion added to Foley significantly increases the rate of delivery within 24 hours in both nulliparous and multiparous compared with Foley followed by oxytocin. ClinicalTrials.gov, https://clinicaltrials.gov/, NCT02273115.

Transcervical Foley Bulb (TFB) and Risk of Subsequent Preterm Delivery [32O

INTRODUCTION: To evaluate if the use of a transcervical Foley balloon (TFB) for induction of labor (IOL) increases the risk of preterm delivery in subsequent pregnancies. METHODS: This was a retrospective cohort study evaluating methods of induction and subsequent pregnancy outcomes. RESULTS: 151 women were identified to have a term IOL followed by a subsequent pregnancy within a 10-year span meeting study's criteria. Patients were in the study group if a TFB was used alone or in combination with prostaglandins and/or oxytocin for IOL while the control group did not include TFB. Age, race, BMI (in first pregnancy and subsequent pregnancy), tobacco use, previous LEEP, previous D&amp;C, indication for IOL, and birth weight (in first pregnancy and subsequent pregnancy) were all not significantly different between the groups. Bishop score was significantly higher in the control group (p=0.003). Mode of delivery for the initial pregnancy was significantly different between the two groups (p=0.019) with a higher rate of cesarean section in the study group. Mean gestational age at delivery of the subsequent pregnancy was 39 and 39.1 weeks for the control and study groups respectively (p=0.747). CONCLUSION: The use of TFB for IOL did not have an impact on gestational age of subsequent pregnancy when compared to other modes of induction. The cesarean section rate was higher in the TFB group in the initial pregnancy, which was likely related to the lower bishop score and increased difficulty of IOL which required the TFB in addition to the other methods to begin with.

Outcome of misoprostol and oxytocin in induction of labour.

Background:Induction of labour is the process of initiating the labour by artificial means from 24 weeks of gestation. The main aim of this study is to find out the maternal and foetal outcomes after induction of labour with misoprostol and oxytocin beyond 37 weeks of gestation.Methods:This was a hospital-based observational study carried out at Paropakar Maternity and Women’s Hospital, Nepal. Misoprostol of 25 µg was inserted in posterior fornix of vagina or oxytocin infusion was started from 2.5 units on whom induction was decided. Maternal and foetal/neonatal outcomes were observed. Collected data were analysed using SPSS and MS Excel.Results:General induction rate was found to be 7.2%. In this study, post-term pregnancy was found to be the most common reason for induction of labour. Analysis of onset of labour led to the finding that mean onset of labour was much rapid in oxytocin (6.6 h) than misoprostol (13.6 h). However, there is similarity in induction–delivery interval in both groups. Overall, the rate of normal delivery and caesarean section was found to be 64.9% and 33.2%, respectively. Similarly, normal delivery within 12 h was seen in 18.4% of the patients given with misoprostol and 43.5% in oxytocin group. Foetal distress was found as the most common reason for caesarean section. The overall occurrence of maternal complication was found to be similar in misoprostol and oxytocin groups, nausea/vomiting being the most common (36.7%) complication followed by fever (24.1%). Besides this, the most common neonatal complication found in overall cases was meconium stained liquor (49.2%).Conclusion:It was found that misoprostol was used most frequently for induction of labour compared to oxytocin. The onset of labour was found to be rapid in oxytocin than misoprostol. However, the occurrence of side effects was found to be similar in both misoprostol and oxytocin groups.

Effectiveness and safety of induction of labor for term breech presentations

To assess the effectiveness and safety of induction of labor for breech presentations. Retrospective comparative hospital-based study of a continuous series of term breech deliveries from 2000 to 2010. The condition of term breech newborns delivered vaginally after induction of labor was compared to that of their counterparts delivered vaginally after spontaneous labor. During the study period, 96women with term fetuses in breech presentations had labor induced and 501 in spontaneous labor had attempted vaginal deliveries. Compared with spontaneous labor, induction was not associated with a significantly higher rate of cesarean delivery during labor (20.8 vs 14.8%, P=0.14), nor with poorer neonatal condition, defined either as moderate acidosis (pH<7.15; 21.6 vs 19.8%, P=0.71) or composite neonatal morbidity (2.1 vs 0.6%, P=0.16). Our data indicate that, compared with spontaneous labor, neither cervical ripening nor oxytocin induction of labor is associated with either a poorer neonatal prognosis or an excess rate of obstetric complications in term breech births, and that the success rate of induction is satisfactory.

43: The intracervical foley catheter with and without oxytocin for labor induction: a randomized trial

43: The intracervical foley catheter with and without oxytocin for labor induction: a randomized trial