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Review article - Peer-reviewed, 2020

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

Daly, Deirdre; Minnie, Karin C. S.; Blignaut, Alwiena; Blix, Ellen; Vika Nilsen, Anne Britt; Dencker, Anna; Beeckman, Katrien; Gross, Mechthild M.; Pehlke-Milde, Jessica; Grylka-Baeschlin, Susanne; Koenig-Bachmann, Martina; Clausen, Jette Aaroe; Hadjigeorgiou, Eleni; Morano, Sandra; Iannuzzi, Laura; Baranowska, Barbara; Kiersnowska, Iwona; Uvnas-Moberg, Kerstin

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 1.67 mu g 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.

Published in

PLoS ONE
2020, volume: 15, number: 7, article number: e0227941
Publisher: PUBLIC LIBRARY SCIENCE

Authors' information

Daly, Deirdre
Trinity College Dublin
Minnie, Karin C. S.
North West University - South Africa
Blignaut, Alwiena
North West University - South Africa
Blix, Ellen
Oslo Metropolitan University (OsloMet)
Vika Nilsen, Anne Britt
Western Norway University of Applied Sciences
Dencker, Anna
University of Gothenburg
Beeckman, Katrien
University of Antwerp
Gross, Mechthild M.
Hannover Medical School
Pehlke-Milde, Jessica
Zurich University of Applied Sciences
Grylka-Baeschlin, Susanne
Zurich University of Applied Sciences
Koenig-Bachmann, Martina
Health University of Applied Sciences Tyrol
Clausen, Jette
University College Copenhagen
Hadjigeorgiou, Eleni
Cyprus University of Technology
Morano, Sandra
University of Genoa
Iannuzzi, Laura
Bournemouth University
Baranowska, Barbara
Medical Centre of Postgraduate Education
Kiersnowska, Iwona
Medical University of Warsaw
Swedish University of Agricultural Sciences, Department of Animal Environment and Health

UKÄ Subject classification

Nursing
Obstetrics, Gynecology and Reproductive Medicine

Publication Identifiers

DOI: https://doi.org/10.1371/journal.pone.0227941

URI (permanent link to this page)

https://res.slu.se/id/publ/112329