A one year case control study on oxytocin use in labor and its effect on maternal: fetal outcomes

Devendra Singh Kushwah, Beenu Kushwah


Background: Oxytocin is a drug commonly administered drug to a pregnant lady during labor, nowadays even without an indication, in the hope that the progress of labor can be improved and the need for cesarean delivery may be reduced. This study emphasizes the need for using safeguards like use of checklists before starting oxytocin augmentation, therefore ensuring its rational use to minimize maternal and neonatal complications when augmenting labor with oxytocin, including rigorous indications, use of minimal useful dose and careful efficacy evaluation.

Methods: This is a retrospective, Case-Control, descriptive and analytical study. Study population included women delivering in labor room of Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa, from July 2015 to June 2016, then after data were compiled and assessed in department of pharmacology G.R. Medical College, Gwalior.

Results: Results show that the use of oxytocin in labor stimulation can be detrimental to both the mother and the newborn, since they indicate that the use of oxytocin is associated with increased cesarean section rates both in primiparous and multiparous. Furthermore, it was also observed, a significant association between stimulation with oxytocin and low Apgar scores at 1 and 5 minutes both, of the newborns.

Conclusions: Therefore, it may conclude that stimulation with oxytocin should not be used without any indication, but only in very specific cases, in which its use is particularly necessary. These results provide to health professionals a better understanding of the effects of the use of oxytocin during labor, which can be useful for decision-making in clinical practice.


Apgar score, Labour augmentation, Oxytocin

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Holmgren S, Silfver KG, Lind C, Nordström L. Oxytocin augmentation during labor: how to implement medical guidelines into clinical practice. Sex Reprod Healthc. 2011;2(4):149-52.

Tracy SK, Sullivan E, Wang YA, Black D, Tracy M. Birth outcomes associated with interventions in labour amongst low risk women: a population-based study. Women Birth. 2007;20(2):41-8.

Blix E, Pettersen SH, Eriksen H, Røyset B, Pedersen EH, Øian P. Use of oxytocin augmentation after spontaneous onset of labor. Tidsskr Nor Laegeforen. 2002;122(14):1359-62.

Selin L, Almström E, Wallin G, Berg M. Use and abuse of oxytocin for augmentation of labor. Acta Obstet Gynecol Scand. 2009;88(12):1352-7.

Herbst A, Wolner-Hanssen P, Ingemarsson I. Risk factors for acidemia at birth. Obstet Gynecol. 1997;90(1):125-30.

Liston WA, Campbell AJ. Dangers of oxytocin-induced labour to fetuses. Br Med J. 1974;3(5931):606-7.

Klink F, Grosspietzsch R, Klitzing LV, Oberheuser F. Uterine contraction intervals and transcutaneous levels of fetal oxygen pressure. Obstet Gynecol. 1981;57(4):437-40.

Vanner T, Gardosi J. Intrapartum assessment of uterine activity. Baillieres Clin Obstet Gynaecol. 1996;10(2):243-57.

Johnson N, van Oudgaarden E, Montague I, McNamara H. The effect of oxytocin-induced hyperstimulation on fetal oxygen. Br J Obstet Gynaecol. 1994;101(9):805-7.

Simpson KR, James DC. Effects of oxytocin-induced uterine hyperstimulation during labor on fetal oxygen status and fetal heart rate patterns. Am J Obstet Gynecol. 2008;199(1):34.e1-5.

Jonsson M, Nordén-Lindeberg S, Ostlund I, Hanson U. Acidemia at birth, related to obstetric characteristics and to oxytocin use, during the last two hours of labor. Acta Obstet Gynecol Scand. 2008;87(7):745-50.

Hayes BC, McGarvey C, Mulvany S, Kennedy J, Geary MP, Matthews TG, King MD. A case-control study of hypoxic-ischemic encephalopathy in newborn infants at >36 weeks gestation. Am J Obstet Gynecol. 2013;209(1):29.e1-19.

Insel TR. The challenge of translation in social neuroscience: a review of oxytocin, vasopressin, and affiliative behavior. Neuron. 2010;65(6):768-79.

Bell AF, White-Traut R, Rankin K. Fetal exposure to synthetic oxytocin and the relationship with prefeeding cues within one hour postbirth. Early Hum Dev. 2013;89(3):137-43.

Carter CS. Developmental consequences of oxytocin. Physiol Behav. 2003;79(3):383-97.

Handlin L. Human-Human and Human-Animal Interaction. Some Common Physiological and Psychological Effects. Doctoral Thesis, Swedish University of Agricultural Sciences, Skara, 2010.

Gordon I, Zagoory-Sharon O, Leckman JF, Feldman R. Oxytocin and the development of parenting in humans. Biol Psychiatry. 2010;68(4):377-82.

Institute for Safe Medical Practices. High alert medications. [Accessed February 20, 2014]; Available at:

Fraser W, Vendittelli F, Krauss I, Breart G. Effects of early augmentation labour with amniotomy and oxytocin in nulliparous women: a metaanalysis. Br J Obstet Gynaecol. 1998;105:189-94.

Sadler LC, Davison T, McCowan LM. A randomised controlled trial and meta-analysis of active management of labour. BJOG. 2000;107:909-15.

Thornton JG, Lilford RJ. Active management of labour: current knowledge and research issues. BMJ. 1994;309:366-9.

Frigoletto FD Jr, Lieberman E, Lang JM, Cohen A, Barss V, Ringer S, et al. A clinical trial of active management of labor. N Engl J Med. 1995;333:745-50.

Rogers R, Gilson GJ, Miller AC, Izquierdo LE, Curet LB, Qualls CR. Active management of labor: does it make a difference? Am J Obstet Gynecol. 1997;177:599-605.

Combs CA, Murphy EL, Laros RK. Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol. 1991;77:69e76.

Grotegut CA, Paglia MJ, Johnson LN, et al. Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. Am J Obstet Gynecol. 2011;204:56.e1e6.

Sheiner E, Sarid L, Levy A. Obstetric risk factors and outcome of pregnancies complicated with early postpartum hemorrhage: a population-based study. J Matern Fetal Neonatal Med. 2005;18:149-54.

Sosa CG, Althabe F, Belizan JM. Use of oxytocin during early stages of labor and its effect on active management of third stage of labor. Am J Obstet Gynecol. 2010;204:238.e1-5.

Raba G, Baran P. Obstetric outcomes in oxytocin-related and spontaneous deliveries-analysis of 2198 cases. Ginekol Pol. 2009;80(7):507-11.

Selo-Ojeme D, Rogers C, Mohanty A, Zaidi N, Villar R, Shangaris P. Is induced labour in the nullipara associated with more maternal and perinatal morbidity? Arch Gynecol Obstet. 2011;284(2):337-41.

Hidalgo-Lopezosa P, Rodríguez-Borrego MA, Muñoz- Villanueva MC. Are Birth plans associated with improved maternal or neonatal outcomes? MCN Am J Matern Child Nurs. 2013;38(3):150-6.

Lewis LS, Pan HY, Heine RP, Brown HL, Brancazio LR, Grotegut CA. Labor and pregnancy outcomes after adoption of a more conservative oxytocin labor protocol. Obstet Gynecol. 2014 May;123(1):66S.