Background: One of the most widely utilised substances toaugmentlabour is oxytocin. However, there is no universal agreement on the best dosage schedule. High-dose and low-dose oxytocin protocols differ in initiation dose and escalation rates, and their relative efficacy and safety remain debated. With rising caesarean section rates, evaluating the impact of oxytocin dosage on labour outcomes is clinically important, particularly in the Indian population.
Methods: This prospective comparative observational study was conducted in the Department of Obstetrics and Gynaecology, Durgapur Steel Plant Hospital, West Bengal, over a period of two years (2020-2022). A total of 100 term pregnant women requiring labour augmentation were enrolled and divided into two groups of 50 each. Group HD received a high-dose oxytocin regimen (starting dose 5 mU/min with 5 mU/min increments every 30 minutes), while Group LD received a low-dose regimen (starting dose 2.5 mU/min with 2.5 mU/min increments every 30 minutes). Maternal outcomes included mode of delivery, induction success, induction-to-delivery interval, and complications. Neonatal outcomes assessed were birth weight, Apgar scores, and NICU admission. Statistical analysis was performed using SPSS version 21.0.
Results: The groups were similar in terms of baseline parameters such as first Bishop score, gestational age, and maternal age. The high-dose group had a significantly higher mean Bishop score at 6 hours (8.91 vs 6.14; p<0.01). 72% of the high-dose group and 54% of the low-dose group experienced successful induction (p<0.01). Caesarean section rates were significantly lower in the high-dose group (28% vs 46%; p<0.01). The mean induction-to-delivery interval was significantly shorter with high-dose oxytocin (4.05 vs 9.21 hours; p<0.01). Maternal and neonatal complications, including postpartum haemorrhage, tachysystole, Apgar scores, and NICU admissions, were comparable between the groups.
Conclusion: With no increase in maternal or neonatal morbidity, high-dose oxytocin for labour augmentation is linked to better cervical ripening, a shorter induction-to-delivery interval, and a higher rate of successful vaginal deliver.
International Journal of Clinical Obstetrics and Gynaecology
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