Lazor L Z, Philipson E H, Ingardia C J, Kobetitsch E S, Curry S L
Department of Obstetrics and Gynecology, University of Connecticut, Hartford Hospital.
Obstet Gynecol. 1993 Dec;82(6):1009-12.
To compare two low-dose oxytocin protocols in terms of fetal distress, uterine hyperstimulation, cesarean delivery rate, maximum dose of oxytocin, and length of labor.
We randomized 865 patients into 15-minute (incremental dose 1 mU/minute until 5 mU/minute, then 1 or 2 mU/minute) or 40-minute (incremental dose 1.5 mU/minute until 7 mU/minute, then 1.5 or 3.0 mU/minute) low-dose protocols. Before oxytocin use, all subjects were stratified according to parity and purpose of oxytocin, ie, for induction or augmentation of labor.
The 40-minute dosing protocol had a significantly lower maximum dose of oxytocin (augmentation, 6.5 versus 8.2 mU/minute, P < .001; induction, 11.5 versus 14.5 mU/minute, P < .001), a lower incidence of uterine hyperstimulation (augmentation, 18.8 versus 31.8%, P < .001; induction, 19.1 versus 33.0%, P < .002), and less fetal distress (augmentation, 15.5 versus 26.1%, P < .005). No significant differences were found in the cesarean rate or length of labor.
A dosing interval of 40 minutes led to lower incidences of uterine hyperstimulation and fetal distress, and decreased the maximum dose of oxytocin, without affecting the length of labor or the cesarean rate.
比较两种低剂量缩宫素方案在胎儿窘迫、子宫过度刺激、剖宫产率、缩宫素最大剂量及产程方面的差异。
我们将865例患者随机分为15分钟（递增剂量为1 mU/分钟，直至5 mU/分钟，然后为1或2 mU/分钟）或40分钟（递增剂量为1.5 mU/分钟，直至7 mU/分钟，然后为1.5或3.0 mU/分钟）低剂量方案组。在使用缩宫素前，所有受试者根据产次和使用缩宫素的目的进行分层，即引产或催产。
40分钟给药方案的缩宫素最大剂量显著更低（催产时，分别为6.5与8.2 mU/分钟，P <.001；引产时，分别为11.5与14.5 mU/分钟，P <.001），子宫过度刺激的发生率更低（催产时，分别为18.8%与31.8%，P <.001；引产时，分别为19.1%与33.0%，P <.002），胎儿窘迫情况更少（催产时，分别为15.5%与26.1%，P <.005）。剖宫产率或产程方面未发现显著差异。
40分钟的给药间隔可降低子宫过度刺激和胎儿窘迫的发生率，并减少缩宫素的最大剂量，且不影响产程或剖宫产率。
