Rationale:
The use of oxytocin for labor augmentation is high, and studies indicate frequent misuse of the medication. Early oxytocin stimulation compared to expectant management may shorten labor but does not improve other outcomes. However, oxytocin use can lead to uterine hyperstimulation, which has been associated with an increased risk of operative deliveries, lower Apgar scores, and a higher likelihood of neonatal admissions to intensive care units.
References:
- The Labor Progression Study: The use of oxytocin augmentation during labor following Zhang's guideline and the WHO partograph in a cluster randomized trial Dalbye et al
Acta Obstet Gynecol Scand. 2019 Sep;98(9):1187-1194. doi: 10.1111/aogs.13629. Epub 2019 Jun 14. - Effects of oxytocin-induced uterine hyperstimulation during labor on fetal oxygen status and fetal heart rate patterns. Simpson & James Am J Obstet Gynecol. 2008 Jul;199(1):34.e1-5. doi: 10.1016/j.ajog.2007.12.015. Epub 2008 Mar 14.
- Outcome in obstetric care related to oxytocin use. Oscarsson et al A population‐based study. Acta Obstet Gynecol Scand. 2006;85(9):1094‐1098.
- Oxytocin and dystocia as risk factors for adverse birth outcomes: a cohort of low‐risk nulliparous women. Bernitz et al. Midwifery. 2014;30(3):364‐370.
- De-medicalization of birth by reducing the use of oxytocin for augmentation among firsttime mothers - a prospective intervention study Gaudernack et al 2018 BMC Pregnancy Childbirth. 2018 Mar 27;18(1):76. doi: 10.1186/s12884-018 1706-4.
- Discontinuing Oxytocin Infusion in the Active Phase of Labor: A Systematic Review and Metaanalysis. Saccone et al Obstet Gynecol. 2017 Nov;130(5):1090-1096. doi: 10.1097/AOG.0000000000002325.
- High-dose versus low-dose of oxytocin for labour augmentation: a randomised controlled trial. Selin et al Women Birth.Aug;32(4):356-363. doi: 10.1016/j.wombi.2018.09.002. Epub 2018 Oct 16.
- Early versus delayed oxytocin augmentation in nulliparous women with prolonged labour--a randomised controlled trial. Dencker et al BJOG. 2009 Mar;116(4):530-6. doi: 10.1111/j.1471-0528.2008.01962.x.