High Dose Versus Low Dose Oxytocin for Augmentation of Delayed Labour in Obese Women: A Randomized Clinical Trial

Buckhound: For augmentation of delayed labour, high- or low-dose oxytocin can be used, but the evidence for promoting high-dose in obese women is weak. In obese women, labour progress is often delayed, leading to a caesarean section despite labour augmentation with synthetic oxytocin.
Objecitve: Our study aims to evaluate the effect of high dose oxytocin augmentation in spontaneously labouring obese women.
Patients and methods: We included 202 patients who were randomly assigned to two groups in a randomized controlled trial (RCT) study. Patients were divided into two groups: Group I (low dose oxytocin) were given 2 mU/minutes (min) of oxytocin, which was gradually increased by 2 mU/min every 30 minutes until adequate uterine contractions were achieved. Patients in Group II (high dose oxytocin) were given 4 mU/min of oxytocin, which was gradually increased by 4 mU/min every 30 minutes until adequate uterine contractions were achieved.
Results: Both management were equally effective in clinical data with no significant difference between the two studied groups (P>0.05).  Difference in oxytocin dose, duration of oxytocin, and uterine tachysystole between the two groups was statistically significant. The rates of caesarean section did not differ between groups (8.7% and 8.1%). The rates of instrumental vaginal births were similar. In terms of neonatal outcomes, there were no differences.
Conclusion: Except for reducing labour duration, high dose oxytocin had no advantages over low dose oxytocin in labour augmentation. Low-dose oxytocin is less likely to cause uterine hyperstimulation, making it a safer option.