Induction of labor with pulsatile oxytocin by a computer-controlled pump

• HIT Description: Decision support and computerized medication dosing. More info...
  
• Purpose of Study: Investigate the safety and efficacy of a computer-controlled pulsatile oxytocin infusion protocol that adjusts the oxytocin dose rate on the basis of uterine activity.
  
• Years of study: Not Available
  
• Study Design: RCT
  
• Outcomes: Impact on health care effectivness/quality, Impact on health care access
  

• Settings: Three hundred fifty-eight women in labor participated in the trial.
• Intervention: Three interventions for the induction of labor with oxytocin were studied: aggressively managed continuous infusion manually, conservatively managed continuous infusion manually, and computer-controlled pulsatile infusion.
• Evaluation Method: Measures of doses of oxytocin, labor induction, rates of cesarean section, hyperstimulation, blood gases, and Apgar scores.
• Quality of Care and Patient Safety Outcome: Mean doses of oxytocin in the group receiving pulsed oxytocin were approximately 20% of the dose rates in the continuous infusion protocols. All protocols effectively established labor in the majority of patients, although nulliparous women with unfavorable Bishop scores were more likely to fail to establish labor within a 24-hour period when treated with the aggressive continuous protocol. There were no differences in the rates of cesarean section, hyperstimulation, blood gases, or Apgar scores among the three treatment groups.