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

Daly, Deirdre and Minnie, Karin C. S. and Blignaut, Alwiena and Blix, Ellen and Vika Nilsen, Anne Britt and Dencker, Anna and Beeckman, Katrien and Gross, Mechthild M. and Pehlke-Milde, Jessica and Grylka-Baeschlin, Susanne and Koenig-Bachmann, Martina and Clausen, Jette and Hadjigeorgiou, Eleni and Morano, Sandra and Iannuzzi, Laura and Baranowska, Barbara and Kiersnowska, Iwona and Uvnäs-Moberg, Kerstin (2020). How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries. PLoS ONE. 15 , e0227941
[Article Review/Survey]

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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.

Authors/Creators:Daly, Deirdre and Minnie, Karin C. S. and Blignaut, Alwiena and Blix, Ellen and Vika Nilsen, Anne Britt and Dencker, Anna and Beeckman, Katrien and Gross, Mechthild M. and Pehlke-Milde, Jessica and Grylka-Baeschlin, Susanne and Koenig-Bachmann, Martina and Clausen, Jette and Hadjigeorgiou, Eleni and Morano, Sandra and Iannuzzi, Laura and Baranowska, Barbara and Kiersnowska, Iwona and Uvnäs-Moberg, Kerstin
Title:How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries
Series Name/Journal:PLoS ONE
Year of publishing :2020
Volume:15
Article number:e0227941
Number of Pages:24
Publisher:PUBLIC LIBRARY SCIENCE
ISSN:1932-6203
Language:English
Publication Type:Article Review/Survey
Article category:Scientific peer reviewed
Version:Published version
Copyright:Creative Commons: Attribution 4.0
Full Text Status:Public
Subjects:(A) Swedish standard research categories 2011 > 3 Medical and Health Sciences > 303 Health Sciences > Nursing
(A) Swedish standard research categories 2011 > 3 Medical and Health Sciences > 302 Clinical Medicine > Obstetrics, Gynaecology and Reproductive Medicine
URN:NBN:urn:nbn:se:slu:epsilon-p-112329
Permanent URL:
http://urn.kb.se/resolve?urn=urn:nbn:se:slu:epsilon-p-112329
Additional ID:
Type of IDID
DOI10.1371/journal.pone.0227941
Web of Science (WoS)000556916000039
ID Code:24662
Faculty:VH - Faculty of Veterinary Medicine and Animal Science
Department:(VH) > Dept. of Animal Environment and Health
Deposited By: SLUpub Connector
Deposited On:22 Jun 2021 09:43
Metadata Last Modified:22 Jun 2021 09:51

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