Oxytocin Use in the Second Stage of Labor for First-Time Mothers at 37 Weeks or More A Randomized Controlled Trial

What this Trial Is About

Researchers are studying the use of oxytocin during the second stage of labor, a critical time when the cervix is fully dilated and the baby is pushed out. Although oxytocin is commonly used during the first stage of labor to help with contractions and cervical dilation, its benefits and risks in the second stage are not well established. This trial aims to better understand the effects of continuing oxytocin during this stage, especially considering potential risks like uterine tachysystole, postpartum hemorrhage, and maternal hyponatremia. Participants in this randomized controlled trial will be assigned to either continue or discontinue oxytocin during the second stage of labor. For those continuing oxytocin, the drug will be administered intravenously according to hospital protocols, starting at 2 milliunits per minute and adjusted every 20 minutes to achieve adequate contractions, with a maximum of 40 milliunits per minute. Those discontinuing oxytocin will receive routine maintenance IV fluids instead. The study uses standard intravenous pumps and follows established oxytocin dosing procedures. Throughout labor and delivery admission, researchers will monitor the duration of the second stage of labor as the primary outcome. Secondary outcomes include rates of operative delivery, postpartum hemorrhage, estimated blood loss, chorioamnionitis, endometritis, severe perineal laceration, and neonatal morbidity. These assessments will help determine the impact and safety of oxytocin use during this labor stage. Participants will be observed closely during their hospital stay for all related outcomes and safety measures.

The Role of Oxytocin in the Second Stage of Labor