| 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) |