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AUGMENTED LABOR

From the Department of Obstetrics and Gynecology, Lenox Hill Hospital, 100 East 77th St, New York, NY 10021.

Oxytocin was administered to 3831 women to pharmacologically augment labor that was not progressing satisfactorily. Results were excellent in cases of posterior occiput, abnormal descent patterns, secondary arrest of the active phase of labor, prolonged latent phase with a favorable cervix and in protracted labor during the active phase. Contraindications to the use of oxytocin have been listed in detail and a strong plea made that these be adhered to. Methodology of administration has also been outlined and certain observations made describing some pitfalls associated with oxytocin therapy. There were no maternal deaths in this series of 3831 patients, but there were 2 ruptured uteri; from 1 an unrecognized hydrocephalic baby was delivered and the other was related to forceps rotation and extraction. Duration of labor was essentially the same in both the augmented and control groups, but when forceps were necessary they were easier and lower than in the control group. In the augmented group, the cesarean section rate was about 30% lower despite the fact that practically all problem cases were in this group. Perinatal mortality and morbidity were decreased in the oxytocin augmented group. Augmenting labor with oxytocin is concluded to be both safe and beneficial as long as: a) contraindications are strictly adhered to, b) labor is monitored adequately, c) the environment is safe and d) refinements in the technic of administering oxytocin are used.