One hundred twenty-three women were randomized to receive either of two regimens of oxytocin for labor induction. Sixty-one received a low-dose regimen, with oxytocin increases at intervals of not less than 60 minutes. Patients with unripe cervices received prolonged low-dose oxytocin priming before membrane rupture. Sixty-two others received a traditional protocol, with oxytocin increased every 20 minutes as required. Both groups had amniotomy when deemed safe and feasible. Oxytocin was adjusted for uterine hyperstimulation or abnormal fetal heart rate patterns in 29 and 58% of low-dose and traditional protocol subjects, respectively (P.001, odds ratio 3.6). No significant increase in time to delivery was seen with low-dose oxytocin infusion. Cesarean delivery and cesareans for fetal distress were more frequent in the traditional protocol group. This study demonstrates that a continuous low-dose protocol for oxytocin induction of labor is effective in establishing active labor and achieving vaginal delivery in women with both ripe and unripe cervices. It is also associated with fewer episodes of uterine hyperstimulation requiring adjustments of oxytocin infusion than is the traditional protocol of this institution.
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