High-dose vs. low-dose **oxytocin** regimens compared for labor augmentation, aiming to reduce C-section risk

Delayed labor progress is a common obstetric complication, often leading to prolonged labor, maternal distress, and increased risk of cesarean section (C-section). Oxytocin, a synthetic analog of the naturally occurring hormone, is widely used to augment uterine contractions and accelerate labor when progress stalls. However, optimal dosing strategies for oxytocin augmentation remain a subject of debate, with variations in starting doses and increment protocols across clinical practices. The balance lies in achieving effective uterine contractility without causing hyperstimulation, which can lead to fetal distress or uterine rupture. This study aims to clarify whether a higher initial dose and increment of oxytocin can improve labor outcomes, specifically reducing C-section rates, compared to a lower dose regimen.

This clinical trial, registered as NCT03408054, compared two distinct oxytocin regimens for labor augmentation in women experiencing delayed labor progress. The study's primary aim was to determine if a higher dose of oxytocin could lower the chance of needing a C-section compared to a lower dose. Specifically, the study group utilized a high dose of oxytocin (20 units in 1000 ml), while the control group received a lower dose regimen. Secondary outcomes included length of labor, incidence of postpartum hemorrhage, intrauterine infection, umbilical cord gas parameters, neonatal Apgar score <5 at 5 minutes, and the need for neonatal intensive care.