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. 2015 Sep;28(13):1614-9.
doi: 10.3109/14767058.2014.963046. Epub 2014 Sep 29.

Factors associated with higher oxytocin requirements in labor

Heather A Frey  1 , Methodius G Tuuli, Sarah K England, Kimberly A Roehl, Anthony O Odibo, George A Macones, Alison G Cahill
Affiliations

Factors associated with higher oxytocin requirements in labor

Heather A Frey et al. J Matern Fetal Neonatal Med. 2015 Sep.

Abstract

Objective: To identify clinical characteristics associated with high maximum oxytocin doses in women who achieve complete cervical dilation.

Methods: A retrospective nested case-control study was performed within a cohort of all term women at a single center between 2004 and 2008 who reached the second stage of labor. Cases were defined as women who had a maximum oxytocin dose during labor >20 mu/min, while women in the control group had a maximum oxytocin dose during labor of ≤20 mu/min. Exclusion criteria included no oxytocin administration during labor, multiple gestations, major fetal anomalies, nonvertex presentation, and prior cesarean delivery. Multiple maternal, fetal, and labor factors were evaluated with univariable analysis and multivariable logistic regression.

Results: Maximum oxytocin doses >20 mu/min were administered to 108 women (3.6%), while 2864 women received doses ≤20 mu/min. Factors associated with higher maximum oxytocin dose after adjusting for relevant confounders included maternal diabetes, birthweight >4000 g, intrapartum fever, administration of magnesium, and induction of labor.

Conclusions: Few women who achieve complete cervical dilation require high doses of oxytocin. We identified maternal, fetal and labor factors that characterize this group of parturients.

Keywords: Labor augmentation; labor induction; labor management.

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Figures

Figure 1
Figure 1. Distribution of maximum oxytocin dosages among all women, and women with induced and augmented labor
Figure 2
Figure 2. Receiver operating characteristic curve of model including induction of labor, birth weight, magnesium administration, intrapartum fever and maternal diabetes
See this image and copyright information in PMC

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