Healthcare· 2026Q1· Review
Early Versus Delayed Oxytocin Augmentation in Nulliparous Women with Spontaneous Dysfunctional Labour: A Systematic Review and Meta-Analysis
- 0citations
- Q1SCImago
- 2026year
Short summary
Administering oxytocin early to nulliparous women with slow labor progress did not change C-section rates but shortened labor by 2 hours, though evidence certainty is low.
AI-generated from the title and abstract; the full text is not read.
Key points
- Early oxytocin augmentation did not significantly alter cesarean delivery rates (RR 0.86, 95% CI 0.63–1.16) in nulliparous women with slow labor progress.
- Labor was shorter by approximately 2 hours with early oxytocin (MD -2.17 h, 95% CI -3.54 to -0.80), but with substantial heterogeneity.
- Uterine hyperstimulation was more frequent with early oxytocin (RR 2.51, 95% CI 1.04–6.06), but this finding was not robust.
- No differences were found for instrumental delivery, spontaneous delivery, Apgar < 7, neonatal admission, or hemorrhage.
- The certainty of evidence for most outcomes was rated as low or very low.
AI-generated from the title and abstract; the full text is not read.
Abstract
Background: The timing of oxytocin for slow labour progress rests on custom rather than evidence, and existing syntheses pool clinically distinct populations. Objectives: We restricted this systematic review to nulliparous women in established active-phase labour with a trial-specified diagnosis of slow progress, comparing early versus delayed or withheld intravenous oxytocin. Methods: Cochrane review CD007123 was updated by searching MEDLINE, Embase and CENTRAL; counts were recomputed from primary reports. Results: Three trials (1102 women) were eligible. Early oxytocin did not alter caesarean delivery (three trials, 1102 women; risk ratio [RR] 0.86, 95% confidence interval [CI] 0.63–1.16), an interval excluding neither benefit nor harm. Uterine hyperstimulation, defined differently in the two contributing trials, was more frequent with early oxytocin (two trials, 472 women; RR 2.51, 95% CI 1.04–6.06), but 92% of the weight came from one trial and the association did not survive Hartung–Knapp or leave-one-out analysis. No difference was demonstrated for instrumental or spontaneous delivery, Apgar < 7, neonatal admission or haemorrhage. Labour was shorter by two hours (two trials, 1042 women; mean difference −2.17 h, 95% CI −3.54 to −0.80), with substantial heterogeneity. Certainty was low or very low. Conclusions: Early oxytocin may shorten labour; its effects on caesarean delivery and other outcomes remain uncertain.
The authors' abstract, as published at the source. Healthcare, 2026 · DOI ↗
Continue with a free account
Ask the paper: 3 free questions a day about this paper; save it, get its citation, new summaries every day for your field. Takeaways are Premium.
Continue free on the webSign in with Google or Apple; no card needed. You come back to this paper.
On your phone:
Field: Obstetrics and Gynecology
Obstetrics and GynecologyMedicine