Oxytocin augmentation in grandmultiparous parturients: to give or not to give?
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OBJECTIVE: The present editorial was aimed to determine policies toward the use of oxytocin for labor augmentation among grandmultiparous (above 5 deliveries) parturients (GMPs). STUDY DESIGN: A questionnaire regarding attitudes toward oxytocin augmentation during labor among GMPs was distributed to all chairpersons of Ob/Gyn departments throughout the country; 20/23 chairpersons responded to the national survey. RESULTS: In all, 85% (17/20) of the chairpersons allowed the use of oxytocin for augmentation of labor in GMPs. Those answering positively to this question did not choose to limit the use of oxytocin for any level of parity. Moreover, 58% (11/19) of them did not obligate the concurrent use of intrauterine pressure catheter while using oxytocin augmentation in these patients. Only 22% (4/18) of the medical centers surveyed limited the maximal dose of Oxytocin among GMPs. The limited dose of oxytocin ranged from 8 to 16 micro/min. Alternatives for oxytocin augmentation in GMPs were breast stimulation (30%), and surgical induction (15%). Nevertheless, 50% of the chairpersons found no other suitable alternative for labor augmentation among GMPs. CONCLUSION: Oxytocin seems like an accepted method for labor augmentation among grandmultiparous women. Moreover, the vast majority of chairpersons did not mandate additional safety measures such as internal uterine catheter or limited dose regimens in these patients.
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