SAFETY AND EFFICACY OF LOW DOSE OXYTOCIN VERSUS HIGH DOSE OXYTOCIN IN AUGMENTATION OF LABOR IN PRIMIGRAVID WOMEN: RANDOMIZED CLINICAL TRIAL
Ahmed Samy, Hisham Haggag, MD, Ahmed k Abd Eltawab*
Departments of Obstetrics and Gynecology, Faculty of Medicine, Cairo University *Faculty of Medicine, Fayoum University
Objective: Our study aimed to comparatively explore which is more effective and safer in augmentation of labor; low dose oxytocin or high dose oxytocin regimens. Study Design: A randomized clinical study. Patients and Methods: we included 200 primigravid women who were in active labor and needed oxytocin augmentation at the obstetrics and gynecology hospital, faculty of medicine, Cairo University from January 2015 to April 2015. We randomly assigned those patients into two groups, either low dose oxytocin regimen with a starting dose of 2.5 mU/min or high-dose oxytocin regimen initially started at a dose of 5 mU/min. Labor duration, mode of delivery, maternal and neonatal complications were evaluated. Results: high dose oxytocin was associated with a significant shortening of labor duration; (augmentation to delivery interval AD; high dose: 307.8±39.5 min versus low dose: 233.6±53.9 min; p=0.0010) and (augmentation to full cervical dilatation, AFD; High dose 272±32.7 versus Low dose: 296.2±48.6; p=0.009). A slightly significant difference in the duration of second stage labor was noted in the high dose oxytocin regimen, but no difference was found in the duration of third stage labor between the two groups. No significant difference was found between the high dose and low dose oxytocin groups regarding the mode of delivery. No difference in maternal and fetal outcomes except for four cases of neonatal sepsis and two cases of neonatal sepsis in low dose group and high dose group respectively were occurred. Conclusion High dose oxytocin effectively reduces the duration of the first stage of labor in both (oxytocin augmentation to delivery interval and oxytocin augmentation to full cervical dilatation) as compared to low dose group.