Delayed labour progress - a study of risk factors, management and outcome
Delayed labour progress is a common and complex problem in modern intrapartum care and related with an increased risk for negative outcomes for both mother and child.
Particularly nulliparous women are affected to a delayed progress which has been found to be one of the main reasons for the rapid increase in emergency caesarean section (CS). Despite the increased use of synthetic oxytocin for labour augmentation, the CS rates are increased. There is a gap of knowledge concerning how effective Infusion with synthetic oxytocin is to treat a delayed labour progress regarding to which dosage of oxytocin should be used, both starting dose and increment dose of oxytocin.
Aim
To increase knowledge of a delayed labour progress and augmentation with synthetic oxytocin.
Research activities
Part 1: A retrospective, observational study of 1.480 deliveries undertaken in a Swedish district hospital (NU Hospital Group). Risk factors and outcome among mother and child in relation to a delayed labour progress were investigated together with the use of oxytocin for augmentation of labour during active phase and its relation of labour progress and delivery outcome. Publications: (1, 2).
Part 2: Investigating the effect of using infusion with synthetic oxytocin on a delayed labour progress. A randomized clinical trial testing a regimen of either high dose or low dose of oxytocin. Main outcome is frequency of acute caesarean Section. Data has been collected from six different delivery centres in Sweden and was completed in October 2016. The Childbirth Experiences Questionnaire (CEQ) is used to explore how the different oxytocin doses influence the women’s labour and birth experiences (included experience of pain). Analysis has started.
Publications
1. Selin L, Almström E, Wallin G, Berg M. Use and abuse of oxytocin for augmentation of labor. Acta Obstetricia et Gynecologica Scandinavica. 2009;88(12):1352-7.
2. Selin L, Wallin G, Berg M. Dystocia in labour - risk factors, management and outcome: a retrospective observational study in a Swedish setting. Acta Obstet Gynecol Scand. 2008;87(2):216-21.
3. Selin L, Wennerholm UB, Jonsson M, Dencker A, Wallin G, Wiberg-Itzel E, Almström E, Petzold M, Berg M. High-dose versus low-dose of oxytocin for labour augmentation: a randomised controlled trial.Women Birth. 2019 Aug;32(4):356-363.
4. Selin L, Berg M, Wennerholm UB, Dencker A. Dosage of oxytocin for augmentation of labor and women’s childbirth experiences: A randomized controlled trial. Acta Obstet Gynecol Scand. 2021 May;100(5):971-978.