Published: 2022-04-27

A comparative study of high dose vs low dose oxytocin in the augmentation of labour

Samar Rudra, Amulya Rama, Supraja Subramanian


Background: Augmentation of labour is a practice that aims to increase the duration, frequency, and intensity of uterine contractions in order to decrease the duration of labour and reduce adverse events of maternal and fetal outcomes associated with prolonged labour. Although oxytocin is the most commonly used drug for the augmentation of labour, there is no universally accepted dosage regimen as various studies have used different regimens of oxytocin as low dose and high dose, leading to clinical heterogeneity. Hence this study was taken up to study the advantages, disadvantages and complications of a widely accepted regime for this study.

Methods: 100 patients in active labour, with inadequate uterine contractions were selected. The patients were randomly selected, allotting alternate cases for high dose and low dose oxytocin. The patients were monitored through the course of labour and compared in terms of augmentation-delivery interval, mode of delivery, maternal and fetal outcome. The findings were tabulated and statistically analyzed.

Results: Majority of the patients delivered vaginally in both groups (78% of high dose and 90% of low dose group). The mean augmentation-delivery interval was 7.20 and 7.45 hours for high dose and low dose group respectively. 12% patients in high dose group experienced maternal complications, while none were encountered in low doe group. 12% neonates from high dose group and 14% from low dose group required admission to the NICU.

Conclusions: It was concluded with moderate certainty that high dose regimen of oxytocin resulted in reduction in the duration of labour, but cesarean rate, maternal and fetal complications were more. It was concluded that neither regimen has got an absolute advantage or disadvantage over the other.



Oxytocin, Labour, Augmentation-delivery interval, Maternal outcome, Fetal outcome

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Reddy AS. Induction of labor. Obstet Gynecol. 2009; 114(1):386-97.

Zhang J, Branch DW, Ramirez MM, Laughon SK, Reddy U, Hoffman M, et al. Oxytocin regimen for labor augmentation, labor progression, and perinatal outcomes. Obstet Gynecol. 2011;118(2):249-56.

WHO recommendations for augmentation of labour. Geneva: World Health Organization; 2014. Executive summary. Available at: https://www.ncbi.nlm. Accessed on 20 September 2021.

Turner MJ, Rasmussen MJ, Stronge JM. Active management of labour. Fetal and Maternal Medicine Review. Cambridge University Press; 1991;3(1):67-72.

Girault A, Blondel B, Goffinet F, Le Ray C. Frequency and determinants of misuse of augmentation of labor in France: A population-based study. PLoS One. 2021; 16(2):e0246729.

O'Driscoll K, Jackson RJ, Gallagher JT. Prevention of prolonged labour. Br Med J. 1969;2(5655):477-80.

Kenyon S, Tokumasu H, Dowswell T, Pledge D, Mori R. High-dose versus low-dose oxytocin for augmentation of delayed labour. Cochrane Database Syst Rev. 2013;(7):CD007201.

Rossen J, Østborg TB, Lindtjørn E, Schulz J, Eggebø TM. Judicious use of oxytocin augmentation for the management of prolonged labor. Acta Obstet Gynecol Scand. 2016;95(3):355-61.

Wei SQ, Luo ZC, Qi HP, Xu H, Fraser WD. High-dose vs low-dose oxytocin for labor augmentation: a systematic review. Am J Obstet Gynecol. 2010;203(4): 296-304.

Ghidini A, Wohlleb D, Korker V, Pezzullo JC, Poggi SH. Effects of two different protocols of oxytocin infusion for labor induction on obstetric outcomes: A cohort study. Acta Obstet Gynecol Scand. 2015;90(2): 321-9.

Selin L, Wennerholm UB, Jonsson M, Dencker A, Wallin G, Wiberg-Itzel E, et al. High-dose versus low-dose of oxytocin for labour augmentation: a randomised controlled trial. Women and Birth. 2019; 32(4):356-63.

Merrill DC, Zlatnik FJ. Randomized, double-masked comparison of oxytocin dosage in induction and augmentation of labor. Obstet Gynecol. 1999;94(3): 455-63.

Gupta P, Chawla I, Gupta S. Effectiveness of low dose versus high dose oxytocin regimen for induction of labour. Int J Reprod Contracept Obstet Gynecol. 2021; 10(5):1948-53.

NVS MN, More S, Himabindu N. High dose oxytocin versus low dose oxytocin for augmentation of labor: a prospective, comparative, randomized study. Int J Med Res Health Sci. 2018;7(4):6-10.

Budden A, Chen LJ, Henry A. High‐dose versus low-dose oxytocin infusion regimens for induction of labour at term. Cochrane Database Syst Rev. 2014(10):45-9.

Tesemma MG, Sori DA, Gemeda DH. High dose and low dose oxytocin regimens as determinants of successful labor induction: a multicenter comparative study. BMC Pregnan Childbirth. 2020;20(1):1-8.

Satin AJ, Hankins GD, Yeomans ER. A prospective study of two dosing regimens of oxytocin for the induction of labor in patients with unfavorable cervices. Am J Obstet Gynecol. 1991;165(4):980-4.