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The study will compare 2 treatment modalities. One group will receive the routine protocol of intermittent pitocin induction for 6 hours and the second group will receive continous pitocin infusion.
The primary aim is to observe which protocol leads to the fastest delivery and evaluate the time in each group from induction to delivery.
At enrollment, after consenting to participate in the study, patients will be assigned randomly to either routine oxytocin (intermittent) treatment or continuous oxytocin treatment.
Both groups will follow our institutional oxytocin protocol. The primary dose of oxytocin is 2.0 mU/min, with an incremental increase by 5.0 mU/min every 30 minutes, until 40.0 mU/min, tittered to a target of 3-5 contractions in a 10-minute period, or active labor (dilatation > 6 cm). Women will be continuously monitored to fetal heart rate while oxytocin is administered.
In the intermittent group, oxytocin will be discontinued after 6-8 hours if the patient does not go into active labor in that period of time. The second course of oxytocin will be renewed after 8-12 hours. In the continuous group, women will receive a continuous oxytocin infusion until delivery, unless there is an indication to stop the infusion, including; category II fetal tracing, uterine tachysystole (an average of more than 5 contractions in 10 minutes for more than 30 minutes).
During oxytocin infusion, sodium levels will be monitored every four hours. In cases where the maternal sodium is below 125 mmol/L oxytocin should be stopped. The decision regarding further oxytocin administration should be made following assessment of the woman's clinical condition and circumstances after discussion with a consultant obstetrician.
Not yet recruiting
Rambam Health Care Campus
Published on BioPortfolio: 2019-07-17T10:04:57-0400
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A nonapeptide hormone released from the neurohypophysis (PITUITARY GLAND, POSTERIOR). It differs from VASOPRESSIN by two amino acids at residues 3 and 8. Oxytocin acts on SMOOTH MUSCLE CELLS, such as causing UTERINE CONTRACTIONS and MILK EJECTION.
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A hypothalamic tripeptide, enzymatic degradation product of OXYTOCIN, that inhibits the release of MELANOCYTE-STIMULATING HORMONES.
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