Oxytocin titration to achieve preset active contraction area values does not improve the outcome of induced labour

Abstract

The value of controlling oxytocin titration in induction of labour by a present uterine activity, assessed as active contraction area, was examined in a randomized study in 60 nulliparae and 54 multiparae. Each parity group was divided into two groups according to the cervical score (less than or equal to 5 and greater than 5) and within those four groups the women were randomly allocated to oxytocin titration against a present frequency of 6-7 uterine contractions every 15 min, or to a preset uterine activity equivalent to the 75th centile for spontaneous labour. The length of labour was slightly, but not significantly, longer in the frequency group. The mode of delivery, Apgar scores at 1 and 5 min and cord artery blood pH values were similar with the two modes of oxytocin titration. The mean maximum dose rate of oxytocin infusion was not significantly different except in the nulliparous group with a poor cervical score. The given mean total dose of oxytocin was similar in the different groups when controlled for parity and cervical score. The results suggest that oxytocin titration to achieve uterine activity values equivalent to the 75th centile of those observed in spontaneous labour does not confer any advantage compared with the traditional practice of titrating the oxytocin infusion to achieve a preset frequency of uterine contractions.