[Association between oxytocin augmentation intervals and the risk of postpartum haemorrhage]

J Gynecol Obstet Biol Reprod (Paris). 2016 Sep;45(7):708-15. doi: 10.1016/j.jgyn.2015.12.005. Epub 2016 Feb 10.
[Article in French]

Abstract

Objective: To study the association between the duration of oxytocin augmentation intervals and the risk of postpartum haemorrhage (PPH) among primiparous women in spontaneous labour.

Materials and methods: Retrospective cohort including primiparous women in spontaneous labour who received oxytocin during labour (n=454). Oxytocin augmentation intervals were dichotomized in intervals<20minutes and≥20minutes. Obstetrical and neonatal issues were analyzed according to the duration oxytocin augmentation intervals. The association between oxytocin augmentation intervals and PPH was analyzed using univariate and multivariate analysis.

Results: Oxytocin augmentation intervals were shorter than 20minutes for 43.8% of the study population. The rate of PPH was higher (9.1% vs 3.5%; P=0.014), and the use of sulprostone was more frequent (6.5% vs 3.5%; P=0.013) if oxytocin augmentation intervals were shorter than 20minutes in comparison with intervals≥20minutes. The association between oxytocin augmentation intervals and PPH remains significant after adjustment on other PPH risk factors (adjusted OR=3.48, 95% CI [1.45-8.34]). The rate of adverse neonatal issue, defined by arterial pH at birth≤7.10 and/or 5minutes score d'Apgar≤7, was higher if oxytocin augmentation intervals were<20minutes (12.1% vs 4.3%; P=0.002).

Conclusion: Our study demonstrated an increased risk of PPH for primiparous women in spontaneous labour who received oxytocin with augmentation intervals shorter than 20minutes.

Keywords: Augmentation intervals; Hémorragie du post-partum; Intervalles d’augmentation; Oxytocin; Oxytocine; Postpartum haemorrhage.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Labor, Obstetric / drug effects*
  • Middle Aged
  • Oxytocics / administration & dosage*
  • Oxytocics / adverse effects*
  • Oxytocin / administration & dosage*
  • Oxytocin / adverse effects*
  • Postpartum Hemorrhage / chemically induced*
  • Pregnancy
  • Retrospective Studies
  • Young Adult

Substances

  • Oxytocics
  • Oxytocin