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High-Dose versus Low-Dose Oxytocin for Labor Augmentation: A Meta-Analysis of Randomized Controlled Trials.
Moraes, Francisco Cezar Aquino de; Kelly, Francinny Alves; Leite, Marianna Gerardo Hidalgo Santos Jorge; Dal Moro, Lucca; Morbach, Victória; Burbano, Rommel Mario Rodríguez.
Afiliación
  • Moraes FCA; Department of Medicine, Federal University of Pará, Belém 66073-005, PA, Brazil.
  • Kelly FA; Dante Pazzanese Institute of Cardiology, São Paulo 04012-909, SP, Brazil.
  • Leite MGHSJ; Santa Marcelina College Medical School, São Paulo 08290-005, SP, Brazil.
  • Dal Moro L; Department of Medicine, Federal University of Pará, Belém 66073-005, PA, Brazil.
  • Morbach V; Department of Medicine, Feevale University, Novo Hamburgo 93510-235, RS, Brazil.
  • Burbano RMR; Ophir Loyola Hospital, Belém 66063-240, PA, Brazil.
J Pers Med ; 14(7)2024 Jul 04.
Article en En | MEDLINE | ID: mdl-39063978
ABSTRACT
Background/

Objectives:

Although oxytocin administration is recommended for delayed labor progress, there is no consensus over the preferred optimal dose of oxytocin. We aimed to perform a meta-analysis of pregnancy outcomes comparing high-dose versus low-dose oxytocin regimens for augmentation of delayed labor.

Methods:

PubMed, Embase, and Cochrane databases were systematically searched for studies comparing high-dose with low-dose oxytocin for labor augmentation from inception up to May 2023. The outcomes assessed were cesarean rate, instrumental delivery rate, postpartum hemorrhage, neonatal death, and uterine tachysystole. Subgroup analysis was performed with randomized controlled trials (RCTs) and propensity-matched studies. Statistical analysis was performed using Rstudio. Heterogeneity was assessed with I2 statistics, and a random-risk effect was used if I2 > 50%.

Results:

Twenty-one studies met inclusion criteria, and eighteen were RCTs. A total of 14.834 patients were included, of whom 7.921 (53.3%) received high-dose and 6.913 (46.6%) received low-dose oxytocin during labor augmentation. No statistical differences were found in cesarean delivery, neonatal mortality, postpartum hemorrhage and vaginal instrumentation rate. However, uterine tachysystole incidence was significantly higher with high-dose oxytocin (95% Cl, 1.30-1.94, p = 0.3; 0.6; I2 = 9%).

Conclusions:

Labor augmentation with a low-dose oxytocin regimen is effective as with a high-dose regimen, but with significantly less uterine tachysystole events, which can lead to intrauterine and neonatal complications. Our findings suggest that a low-dose regimen may be safe and effective for labor augmentation in medical practice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pers Med Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pers Med Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza