How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries
To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Observational study Twelve countries, eleven European and South Africa. National, regional or institutional-level regimens on ox...
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| creator | Daly, Deirdre Minnie, Karin C. S Blignaut, Alwiena Blix, Ellen Vika Nilsen, Anne Britt Dencker, Anna Beeckman, Katrien Gross, Mechthild M Pehlke-Milde, Jessica Grylka-Baeschlin, Susanne Koenig-Bachmann, Martina Clausen, Jette Aaroe Hadjigeorgiou, Eleni Morano, Sandra Iannuzzi, Laura Baranowska, Barbara Kiersnowska, Iwona Uvnäs-Moberg, Kerstin |
| description | To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Observational study Twelve countries, eleven European and South Africa. National, regional or institutional-level regimens on oxytocin for induction and augmentation labour Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67[mu]g for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused Data were obtained on 21 regimens used in 12 countries. Details on the start dose, escalation interval, escalation rate and maximum dose infused were available from 16 regimens. Starting rates varied from 0.06 IU/hour to 0.90 IU/hour, and the maximum dose rate varied from 0.90 IU/hour to 3.60 IU/hour. The total amount of IU oxytocin infused, estimated over eight hours, ranged from 2.38 IU to 27.00 IU, a variation of 24.62 IU and an 11-fold difference. Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution's mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen. |
| doi_str_mv | 10.1371/journal.pone.0227941 |
| format | Article |
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A review and analysis of regimens used in 12 countries</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SWEPUB Freely available online</source><source>Free Full-Text Journals in Chemistry</source><creator>Daly, Deirdre ; Minnie, Karin C. S ; Blignaut, Alwiena ; Blix, Ellen ; Vika Nilsen, Anne Britt ; Dencker, Anna ; Beeckman, Katrien ; Gross, Mechthild M ; Pehlke-Milde, Jessica ; Grylka-Baeschlin, Susanne ; Koenig-Bachmann, Martina ; Clausen, Jette Aaroe ; Hadjigeorgiou, Eleni ; Morano, Sandra ; Iannuzzi, Laura ; Baranowska, Barbara ; Kiersnowska, Iwona ; Uvnäs-Moberg, Kerstin</creator><creatorcontrib>Daly, Deirdre ; Minnie, Karin C. S ; Blignaut, Alwiena ; Blix, Ellen ; Vika Nilsen, Anne Britt ; Dencker, Anna ; Beeckman, Katrien ; Gross, Mechthild M ; Pehlke-Milde, Jessica ; Grylka-Baeschlin, Susanne ; Koenig-Bachmann, Martina ; Clausen, Jette Aaroe ; Hadjigeorgiou, Eleni ; Morano, Sandra ; Iannuzzi, Laura ; Baranowska, Barbara ; Kiersnowska, Iwona ; Uvnäs-Moberg, Kerstin ; Sveriges lantbruksuniversitet</creatorcontrib><description>To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Observational study Twelve countries, eleven European and South Africa. National, regional or institutional-level regimens on oxytocin for induction and augmentation labour Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67[mu]g for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused Data were obtained on 21 regimens used in 12 countries. Details on the start dose, escalation interval, escalation rate and maximum dose infused were available from 16 regimens. Starting rates varied from 0.06 IU/hour to 0.90 IU/hour, and the maximum dose rate varied from 0.90 IU/hour to 3.60 IU/hour. The total amount of IU oxytocin infused, estimated over eight hours, ranged from 2.38 IU to 27.00 IU, a variation of 24.62 IU and an 11-fold difference. Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution's mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0227941</identifier><identifier>PMID: 32722667</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Amniotic fluid ; Augmentation ; Babies ; Binding sites ; Biology and Life Sciences ; Clinical medicine ; Data collection ; Dosage ; Dosage and administration ; Drug dosages ; Education ; Gynaecology, Obstetrics and Reproductive Medicine ; Gynekologi, obstetrik och reproduktionsmedicin ; health ; Health risks ; Health sciences ; hospitals ; Induced labor ; induction ; Infusion ; Labor augmentation ; maternity care ; Mathematical analysis ; Medicine and Health Sciences ; Methods ; Midwifery ; Neonates ; Nursing ; Obstetrics, Gynecology and Reproductive Medicine ; Omvårdnad ; Oxytocin ; People and Places ; Physical Sciences ; Physiology ; receptors ; Reproduktionsmedicin och gynekologi ; Science & Technology - Other Topics ; Statistics ; trends ; Uterus ; Womens health</subject><ispartof>PloS one, 2020-07, Vol.15 (7), p.e0227941-e0227941</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Daly et al. 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S</creatorcontrib><creatorcontrib>Blignaut, Alwiena</creatorcontrib><creatorcontrib>Blix, Ellen</creatorcontrib><creatorcontrib>Vika Nilsen, Anne Britt</creatorcontrib><creatorcontrib>Dencker, Anna</creatorcontrib><creatorcontrib>Beeckman, Katrien</creatorcontrib><creatorcontrib>Gross, Mechthild M</creatorcontrib><creatorcontrib>Pehlke-Milde, Jessica</creatorcontrib><creatorcontrib>Grylka-Baeschlin, Susanne</creatorcontrib><creatorcontrib>Koenig-Bachmann, Martina</creatorcontrib><creatorcontrib>Clausen, Jette Aaroe</creatorcontrib><creatorcontrib>Hadjigeorgiou, Eleni</creatorcontrib><creatorcontrib>Morano, Sandra</creatorcontrib><creatorcontrib>Iannuzzi, Laura</creatorcontrib><creatorcontrib>Baranowska, Barbara</creatorcontrib><creatorcontrib>Kiersnowska, Iwona</creatorcontrib><creatorcontrib>Uvnäs-Moberg, Kerstin</creatorcontrib><creatorcontrib>Sveriges lantbruksuniversitet</creatorcontrib><title>How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries</title><title>PloS one</title><description>To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Observational study Twelve countries, eleven European and South Africa. National, regional or institutional-level regimens on oxytocin for induction and augmentation labour Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67[mu]g for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused Data were obtained on 21 regimens used in 12 countries. 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Daly, Deirdre</au><au>Minnie, Karin C. S</au><au>Blignaut, Alwiena</au><au>Blix, Ellen</au><au>Vika Nilsen, Anne Britt</au><au>Dencker, Anna</au><au>Beeckman, Katrien</au><au>Gross, Mechthild M</au><au>Pehlke-Milde, Jessica</au><au>Grylka-Baeschlin, Susanne</au><au>Koenig-Bachmann, Martina</au><au>Clausen, Jette Aaroe</au><au>Hadjigeorgiou, Eleni</au><au>Morano, Sandra</au><au>Iannuzzi, Laura</au><au>Baranowska, Barbara</au><au>Kiersnowska, Iwona</au><au>Uvnäs-Moberg, Kerstin</au><aucorp>Sveriges lantbruksuniversitet</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries</atitle><jtitle>PloS one</jtitle><date>2020-07-28</date><risdate>2020</risdate><volume>15</volume><issue>7</issue><spage>e0227941</spage><epage>e0227941</epage><pages>e0227941-e0227941</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Observational study Twelve countries, eleven European and South Africa. National, regional or institutional-level regimens on oxytocin for induction and augmentation labour Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67[mu]g for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused Data were obtained on 21 regimens used in 12 countries. Details on the start dose, escalation interval, escalation rate and maximum dose infused were available from 16 regimens. Starting rates varied from 0.06 IU/hour to 0.90 IU/hour, and the maximum dose rate varied from 0.90 IU/hour to 3.60 IU/hour. The total amount of IU oxytocin infused, estimated over eight hours, ranged from 2.38 IU to 27.00 IU, a variation of 24.62 IU and an 11-fold difference. Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution's mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32722667</pmid><doi>10.1371/journal.pone.0227941</doi><tpages>e0227941</tpages><orcidid>https://orcid.org/0000-0003-3045-9894</orcidid><orcidid>https://orcid.org/0000-0003-2723-9604</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-07, Vol.15 (7), p.e0227941-e0227941 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2428044498 |
| source | Public Library of Science (PLoS) Journals Open Access; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; SWEPUB Freely available online; Free Full-Text Journals in Chemistry |
| subjects | Amniotic fluid Augmentation Babies Binding sites Biology and Life Sciences Clinical medicine Data collection Dosage Dosage and administration Drug dosages Education Gynaecology, Obstetrics and Reproductive Medicine Gynekologi, obstetrik och reproduktionsmedicin health Health risks Health sciences hospitals Induced labor induction Infusion Labor augmentation maternity care Mathematical analysis Medicine and Health Sciences Methods Midwifery Neonates Nursing Obstetrics, Gynecology and Reproductive Medicine Omvårdnad Oxytocin People and Places Physical Sciences Physiology receptors Reproduktionsmedicin och gynekologi Science & Technology - Other Topics Statistics trends Uterus Womens health |
| title | How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries |
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