Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 3: Interventions associated with oxytocin administration during spontaneous labor
Résumé
Objectives: The objective of our work was to determine the effects of co-interventions used during labor with oxytocin or for labor dystocia.
Methods: We searched for reports of the interventions we sought to study published between 1987 and 2015, looking especially for meta-analyses and randomized trials via the Medline database and the Cochrane Library. We limited our research to studies of spontaneous labor in singleton pregnancies at term.
Results: In the absence of labor dystocia, active management of labor is not recommended (Grade B). It is recommended that amniotomy should not be performed routinely during the first stage of labor (Grade B). In cases of labor dystocia during the active phase, an amniotomy is recommended before the administration of oxytocin (professional consensus). The encouragement of continuous support during labor is recommended (Grade B). No scientific evidence justifies the recommendation of any of the following methods for the sole purpose of limiting oxytocin use during labor: maternal position during the first or second stages of labor (grade C), immersion in a water during the first stage (grade B), intravenous infusion, oral hydration, or solid food (grade B), antenatal preparation with hypnosis sessions (grade C), use of relaxation techniques (grade C), acupuncture or acupressure (Grade B), or the use of muscle-relaxant agents (professional consensus).
Conclusions: Few of the co-interventions studied appear to modulate recourse to oxytocin.
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