Oxytocin Use in Grand-Multiparous Patients: Safety and Complications Academic Article uri icon

abstract

  • Debate continues over whether grand multiparity should be viewed as a high-risk obstetrical designation. To determine whether a combination of high parity and oxytocin during labor predisposes to peripartum complications, 11,075 grand multiparas delivering in the years 1989 to 1997 were included in a retrospective cohort study. Intravenous oxytocin was used to augment labor in 424 of these women; the remaining grand multiparas served as a control group. Simple grand multiparas, having six to nine births, totaled 326; the remaining 62 women were great grand multiparas, having had 10 or more births. Fetal heart rate and uterine contractions were monitored in all instances. Oxytocin was started at about 0.5 mU/min, and the dose rose to a maximum of 8 mU/min until there were three regular contractions in 10 minutes. Intravenous oxytocin was given to 4.3% of the simple grand multiparous women and 2.4% of the great-grand multiparous women. There were no substantial clinical differences between the study and control groups, and maternal complications were comparably frequent. Vacuum delivery was more frequent in women given oxytocin augmentation. No other significant group differences in maternal or peripartum complications were apparent. The rate of vacuum delivery was increased in both simple grand multiparous (parity = 6-9) and great grand multiparous women (parity = ≥10). These findings suggest that intravenous oxytocin, given to speed labor, is a safe practice in grand multiparous women and does not significantly increase the risk of peripartum complications. Vacuum delivery, however, took place more often than expected in this retrospective study when oxytocin was administered.

publication date

  • January 1, 2002