Reducing Emergency Births by Modification in Oxytocin Utilization

Background: The purpose of our study was to explore the correlation between the amount of oxytocin use and emergency vacuum, forceps, cesarean births and neonatal intensive care unit (NICU) response to fetal distress. In 2004, we restricted the criteria for oxytocin utilization for labor induction and augmentation.

Methods: This retrospective study was carried out at a large private university tertiary care hospital- affiliated, and included data from the years 2005 to 2007. We utilized hospital data from vital statistics, labor and delivery, central pharmacy and NICU. Information obtained included maternal characteristics, annual birth data, indication and numbers of emergency vacuum, forceps and cesarean births, oxytocin utilization, and number of NICU responses to fetal distress.

Results: The total number of deliveries during the studied period equaled14,184. The oxytocin utilization showed a reduction from 93.3% to 78.9%. The number of patients who did not receive oxytocin during labor increased from 6.7% to 21.1%. The correlation between the reduction of oxytocin utilization with the reduction of emergency cesarean births (10.9% to 5.07%), vacuum briths (9.1% to 8.5%), and forceps birth (4% to 2.3%) including NICU responses to fetal distress (P = 0.0001) revealed a significant statistical difference. The overall cesarean section rate did not indicate a significant increase 29.4% to 29.8% (P = 0.14) nor did the patient’s characteristics differ.

Conclusion: In our population, reducing oxytocin appears to strongly correlate with a reduction in the number of emergency vacuum, forceps, cesarean births and NICU responses to fetal distress.