Oxytocin administration for induction and augmentation of labour in Polish maternity units– an observational study
Abstract Background: There is not enough data regarding practices and protocols that healthcare personnel follow and the amount of oxytocin that women receive during labour. Empirical evidence indicates that compliance with the guidelines improves the quality of healthcare and reduces adverse effects. The study aimed to evaluate practices of oxytocin provision for labour induction and augmentation in Polish maternity units. Methods: The article presents a prospective observational study. Data collection took place in two selected maternity units between January 15 and July 31, 2019 (n=545). The analysis included the total amount and cumulative dose of oxytocin during labour. We analysed the relationship between the cumulative dose of oxytocin and short term perinatal outcomes (mode of delivery, use of epidural anaesthesia, Apgar scores, birth weight and postpartum blood loss). The study examines the compliance of oxytocin supply during labour with national guidelines in the following five criteria: medium, start dose, escalation rate, interval, the continuation of infusion after established labour. Results: The average total amount of oxytocin administrated to women before birth was 7.329µg following labour induction and 3.952µg following labour augmentation. The actual administration of oxytocin deviated both from the unit and national guidelines in 93.6% of all observed labours (mainly because of continuation of infusion after established labour). We found no statistically significant correlation between the cumulative dose of oxytocin administered and mode of delivery, immediate postpartum blood loss or Apgar scores. There was no observed effect of cumulative dose oxytocin on short-term perinatal outcomes. Hospitals with similar protocols did not differ significantly in terms of total oxytocin amount, rates of induction and augmentation - the only observed difference was the mode of delivery. Conclusions: There was no practical effect of cumulative dose oxytocin on short-term perinatal outcomes. In the study, we observed significant discrepancies between protocols and practice.