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Zeynep Kamil Medical Journal
High dose versus low dose oxytocin for induction of labor of nulliparous Robson group II women at term [Zeynep Kamil Med J]
Zeynep Kamil Med J. 2023; 54(1): 7-11 | DOI: 10.14744/zkmj.2022.92408

High dose versus low dose oxytocin for induction of labor of nulliparous Robson group II women at term

Ümit Taşdemir1, Elif Gül Yapar Eyi2
1Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Turkey. Zeynep Kamil Maternity and Children’s Training and Research Hospital, İstanbul, Türkiye
2Division of Perinatology, Department of Obstetrics and Gynecology, Ankara City Hospital, Ankara, Türkiye

INTRODUCTION: Induction of labor refers to stimulation of uterine contractions before the beginning of the labor spontaneously. Labor induction procedure using oxytocin is increasing over the years. Herein, we aimed to compare the cesarean section (CS) rates in Robson Group II women by administering either high-dose or low-dose oxytocin induction protocols and to evaluate the duration of labor, fetal and maternal outcomes, and complications.
METHODS: In total of 150 nulliparas between 37and 42 weeks of gestation with singleton, viable, vertex presented and without uterine surgery, uterine anomaly history, and congenital anomalies were included to our study. The participants were divided into two groups regarding initial dose and dosing increments of oxytocin. Sixty-four patients were included in high dose group and 86 patients were included in low-dose group. Oxytocin was started at a dose of 4 miliunit (mU/min) and was increased 4 miliunit (mU/min) per 15 min until effective contractions were obtained in the high dose of oxytocin group. Oxytocin was started at a dose of 2 miliunit (mU/min) and was increased 2 miliunit (mU/min) per 15 min until effective contractions were obtained in the low dose of oxytocin group. Effective contractions are defined as over 200 montevideo unit in 10 min.
RESULTS: High-dose induction protocol did not indicate a difference in the duration of the first stage of active labor but shortened the second stage significantly (p=0.015). There was no significant difference in the CS rates, maternal, and fetal complications of two groups. High-dose induction protocol may have induced an increase in thick meconium-stained births (p=0.044), however did not promote fetal distress rates determined with cord blood gas or reduce Apgar scores.
DISCUSSION AND CONCLUSION: There was no difference between high- and low-dose induction protocols in terms of CS rates, maternal, and fetal complications. Both protocols seem safe to use in nulliparous term pregnant women.

Keywords: Cesarean section, high-dose oxytocin, labor induction, low-dose oxytocin, maternal and fetal complications.

Ümit Taşdemir, Elif Gül Yapar Eyi. High dose versus low dose oxytocin for induction of labor of nulliparous Robson group II women at term. Zeynep Kamil Med J. 2023; 54(1): 7-11

Corresponding Author: Ümit Taşdemir, Türkiye
Manuscript Language: English
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