Less oxytocin, better delivery for mom and baby: study

Using lower levels of oxytocin, a drug given to pregnant women to induce labour, can lead to a safer delivery with fewer complications for both mother and baby, a new study suggests.

Researchers at the University ofTexas studied 200 pregnant women —100 before a set of guidelines governing the use of oxytocin were adopted by Salt Lake City's St. Marks hospitalon March 1, 2005, and 100 after they were put in place. The protocols were created to ensure a more conservative approach toadministeringthe drugand to lower the amounts given to patients.

Use of oxytocin has side-effects such as uterine hyperstimulation and can lead to fetal distress, according to the study.

The study was published in the November issuesof the American Journal of Obstetrics and Gynecology.

The authors found that in babies delivered after the adoption of the guidelines, the birth weight increased. There was no difference between the two groups in the length of the labour.

The rates of caesarean deliveries were also lower among women receiving less oxytocin, as were caesarean deliveries due to the infants' heart rate abnormalities.

As for adverse outcomes in babies, 31 were reported among the women who had higher doses of oxytocin and 18 among the women receiving lower doses.

"In practice, the institution of this protocol neither prolonged labour nor increased the need for operative intervention, despite a significant reduction in the maximum infusion rate of oxytocin," reads the study.

In fact, when the hospital's guidelines were appliedin all 125 obstetric facilities in Hospital Corporations of America hospitals, there was a significant drop in caesarean rates. The rate of caesarean births in 220,000 deliveries fell to 21 per centin 2006 (a year after the guidelines were implemented) from 23.6 per cent in 1995.

Apgar scores improve

And Apgar scores of the babies delivered post-guidelines improved. Apgar tests provide a post-birth assessment of a baby's health based on its colour, reflexes, heart rate, muscle tone and breathing.

"We feel justified only in saying that this protocol appears to improve newborn outcomes," the authors state.

In an editorial that accompanies the study, its authors call for a more tailored approach in administering oxytocin to pregnant women.

"For patients receiving oxytocin, the response of the uterus and the fetus is far more important than the overall amount or rate of oxytocin infusion," they write. "As clinicians, our focus needs to shift to this response factor rather than focusing only on the infusion pump setting or drug concentration."