Continued versus discontinued oxytocin after the active phase of labor: An updated systematic review and meta-analysis

Danni Jiang, Yang Yang, Xinxin Zhang and Xiaocui Nie

PLOS ONE, 2022, vol. 17, issue 5, 1-18

Abstract: Objective: To systematically assess the effect of discontinued vs continued oxytocin after active stage of labour is established. Methods: Pubmed, Embase, and the Cochrane Library were systematically searched to 18 April 2021. The risk ratio or mean difference with corresponding 95% confidence interval were computed to investigate the effect of intervention or control on maternal and fetus outcomes. This review was registered in the International Prospective Register of Systematic Reviews: CRD42021249635. Results: Discontinuing oxytocin when the active labour was established might decrease the risk of cesarean delivery [RR (95% CI): 0.84 (0.72–0.98), P = 0.02]. However, when we restricted our analysis to women who performed cesarean section after the active phase was reached, the difference was no longer significant [RR (95% CI): 0.82 (0.60–1.10), P = 0.19]. The incidence of uterine tachysystole [RR (95% CI): 0.36 (0.27–0.49)], postpartum hemorrhage [RR (95% CI): 0.78 (0.65–0.93)], and non-reassuring fetal heart rate [RR (95% CI): 0.66 (0.58–0.76)] were significantly lower in the oxytocin discontinuation group. We also found a possible decrease in the risk of chorioamnionitis in discontinued oxytocin group [RR (95% CI): 2.77 (1.02–5.08)]. An increased duration of active [MD (95% CI): 2.28 (2.86–41.71)] and second [MD (95% CI): 5.36 (3.18–7.54)] phase of labour was observed in discontinued oxytocin group, while the total delivery time was not significantly different [MD (95% CI): 20.17 (-24.92–65.26)]. Conclusion: After the active labor is reached, discontinuation of oxytocin could be considered a new recommendation for the improved maternal and fetal outcomes without delaying labour.

Date: 2022
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0267461

DOI: 10.1371/journal.pone.0267461

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