Continued versus discontinued oxytocin stimulation in the active phase of labour (CONDISOX): Double blind randomised controlled trial

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To determine whether discontinuing oxytocin stimulation in the active phase of induced labour is associated with lower caesarean section rates. International multicentre, double blind, randomised controlled trial. Nine hospitals in Denmark and one in the Netherlands between 8 April 2016 and 30 June 2020. 1200 women stimulated with intravenous oxytocin infusion during the latent phase of induced labour. Women were randomly assigned to have their oxytocin stimulation discontinued or continued in the active phase of labour. Delivery by caesarean section. A total of 607 women were assigned to discontinuation and 593 to continuation of the oxytocin infusion. The rates of caesarean section were 16.6% (n=101) in the discontinued group and 14.2% (n=84) in the continued group (relative risk 1.17, 95% confidence interval 0.90 to 1.53). In 94 parous women with no previous caesarean section, the caesarean section rate was 7.5% (11/147) in the discontinued group and 0.6% (1/155)in the continued group (relative risk 11.6, 1.15 to 88.7). Discontinuation was associated with longer duration of labour (median from randomisation to delivery 282v201 min; P<0.001), a reduced risk of hyperstimulation (20/546 (3.7%)v70/541 (12.9%); P<0.001), and a reduced risk of fetal heart rate abnormalities (153/548 (27.9%)v219/537 (40.8%); P<0.001) but rates of other adverse maternal and neonatal outcomes were similar between groups. In a setting where monitoring of the fetal condition and the uterine contractions can be guaranteed, routine discontinuation of oxytocin stimulation may lead to a small increase in caesarean section rate but a significantly reduced risk of uterine hyperstimulation and abnormal fetal heart rate patterns. ClinicalTrials.govNCT02553226.

OriginalsprogEngelsk
Artikelnummern716
TidsskriftThe BMJ
Vol/bind373
Antal sider9
ISSN0959-8146
DOI
StatusUdgivet - apr. 2021

Bibliografisk note

Funding Information:
Funding: The study was funded by the Randers Regional Hospital Research Fund, Aarhus University, Health Research Fund of Central Denmark Region, Dagmar Marshall Foundation, Danish Regions Medical Foundation, Aase and Ejnar Danielsen Foundation, A.P. Moeller Foundation for the Advancement of Medical Science, and Soren Segels and Johanne Wiibroe Segels Research Fund. The funders had no role in the design of the study, the data collection, the data analysis, interpretation of data, or writing of the manuscript.

Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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