Low-Dose Versus High-Dose Oxytocin Dosing for Induction and Augmentation of Labor

Low-Dose Versus High-Dose Oxytocin Dosing for Induction and Augmentation of Labor: A Randomized Control Trial

The goal of this clinical trial is to compare oxytocin infusion rates for induction and augmentation of labor in nulliparous women. The main question[s] it aims to answer are:

• Does a high dose oxytocin infusion protocol affect length of induction to delivery interval?
• Does a high dose oxytocin infusion protocol affect mode of delivery?
• Does a high dose oxytocin infusion protocol affect maternal and neonatal outcomes?

Participants will be randomized to either low- or high-dose oxytocin groups:

• The low dose group will receive an infusion to start at 2 milli-units/min and will be increased by 2 milli-units/min every 20 minutes. The maximum rate of infusion is 40 milli-units/min.
• The high dose group will receive an infusion to start at 6 milli-units/min and will be increased by 6 milli-units/min every 20 minutes. Maximum rate of infusion is 40 milli-units/min.

Inclusion Criteria:

• Women aged 18-50 years old
• Singleton gestation
• Nulliparous
• Vertex presentation
• Gestational age greater than or equal to 37 weeks
• No prior uterine surgery
• Presents for elective or medically indicated induction of labor
• Need for augmentation of labor with oxytocin

Exclusion Criteria:

• Previous cervical ripening using non-mechanical methods
• Patient unable or unwilling to provide verbal consent
• Contraindications to vaginal delivery
• Fetal demise or life-limiting anomaly
• Allergy to oxytocin
• Non-reassuring fetal heart tracing prior to inclusion
• Maternal pulmonary edema prior to inclusion
• Fetal growth restriction