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Table 1 International guidelines for the administration of oxytocin

From: Inter-institutional variations in oxytocin augmentation during labour in German university hospitals: a national survey

 

HSE (Ireland)

NICE (Great Britain)

NFOG (Denmark, Sweden, Finland, Iceland, Norway)

ACOG (USA)

Empiric study on German university units (n = 35)

International Units (U)

10

/

5

30

6

Oxytocin solution

1 l NaCl

/

500 ml NaCl

500 ml Ringer lactate

500 ml NaCl

Oxytocin concentration (mU/ml)

10

/

10

60

12

Start dosage (mU/h)

60–300

/

360

120

120

Maximum dosage (mU/h)

1800

4–5 contractions/ 10 min

2400

9000

1200

Escalation dosage (mU/h)

60–300

/

180

120

120

Time interval (min)

15–30

30

15

30

20

Monitoring

CTG

CTG

CTG

CTG

CTG

Criteria for oxytocin administration

20 min CTG, stable fetal status, preceding amniotomy

CTG, preceding amniotomy

CTG, preceding amniotomy

Stable fetal and maternal status, continuous monitoring

CTG, monitoring of obstetric situation

Indication

Slow labour, reduced contraction frequency

Slow labour, reduced contraction frequency

in-effective contractions

Induction and augmentation of labour

Labour augmentation

Contra-indications

Fetal distress, hyperactive uterus, uterus scar, fetal malposition

Hyperactive uterus

Hyperactive uterus, shoulder dystocia

Hyperactive uterus, water intoxication, fetal distress, no monitoring possible

Pathological CTG, hyperactive uterus, shoulder dystocia

Case-specific variations

Multipara, uterus scar, pre-term labour, twin pregnancy, maternal heart insufficiencies

Multipara, regional analgesia

Sensitivity is individual for every women and the administration should be adapted accordingly, uterus scar

After amniotomy reduction of oxytocin dosage, guideline for: singletons, vertex, in term, without uterus scars

Uterus scar, twin pregnancy (multipara, pre-term)