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How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries.

Daly, D., Minnie, K.C.S., Blignaut, A., Blix, E., Nilsen, A.B.V., Dencker, A., Beeckman, K., Gross, M.M., Pehlke-Milde, J., Grylka-Baeschlin, S., Koenig-Bachmann, M., Clausen, J.A., Hadjigeorgiou, E., Morano, S., Iannuzzi, L., Baranowska, B., Kiersnowska, I. and Uvna¨s-Moberg, K., 2020. How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries. PLoS One, 15 (7), e0227941.

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DOI: 10.1371/journal.pone.0227941

Abstract

Objective To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Design Observational study Setting Twelve countries, eleven European and South Africa. Sample National, regional or institutional-level regimens on oxytocin for induction and augmentation labour Methods Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67μg for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused Results Data were obtained on 21 regimens used in 12 countries. Details on the start dose, escalation interval, escalation rate and maximum dose infused were available from 16 regimens. Starting rates varied from 0.06 IU/hour to 0.90 IU/hour, and the maximum dose rate varied from 0.90 IU/hour to 3.60 IU/hour. The total amount of IU oxytocin infused, estimated over eight hours, ranged from 2.38 IU to 27.00 IU, a variation of 24.62 IU and an 11-fold difference. Conclusion Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution’s mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen.

Item Type:Article
ISSN:1932-6203
Additional Information:Funding: This article is based upon work funded by the COST Action IS1405 BIRTH: "Building Intrapartum Research Through Health - An interdisciplinary whole system approach to understanding and contextualising physiological labour and birth" (http://www.cost.eu/COST_Actions/isch/IS1405), supported by EU COST (European Cooperation in Science and Technology).
Group:Faculty of Health & Social Sciences
ID Code:34405
Deposited By: Symplectic RT2
Deposited On:05 Aug 2020 11:42
Last Modified:14 Mar 2022 14:23

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