Oxytocin does not reduce caesarean section rate

Clinical question: 
How effective is oxytocin for the treatment of slow progress in the first stage of spontaneous labour in low-risk women?
Bottom line: 
Oxytocin did not reduce the need for caesarean sections. It did not reduce the need for forceps deliveries or increase the number of normal deliveries when compared with no treatment or delayed oxytocin treatment. Oxytocin seemed to shorten labour by nearly two hours on average. The uptake of epidurals was no different. It did not seem to cause harm to the mother or baby.
Caveat: 
Early use of oxytocin resulted in an increase in uterine hyperstimulation associated with foetal heart changes. Sample size was too small to determine if its use had an effect on foetal mortality.
Context: 
Slow progress in the first stage of spontaneous labour is associated with an increased caesarean section rate and foetal and maternal morbidity. Oxytocin has long been advocated as a treatment for slow progress in labour but it is unclear to what extent it improves the outcomes for that labour and whether it actually reduces the caesarean section rate or maternal and foetal morbidity. Low risk referred to women with singleton pregnancies at term.
Review CD#: 
CD007123
PEARLS No: 
326
Date: 
September, 2011
Authored by: 
Brian R McAvoy