How Much Oxytocin?
A team in Dundee did a telephone survey of 33 maternity units in Scotland asking about their usc of oxytocin: the amount of fluid they used, the minimum and maximum dose, how frequently the dose was increased and by how much. Two years ago the Royal College of Obstetricians and Gynaecologists published guidelines saying that it should be given in the smallest possible volume by an accurate pump starting at 1-4 mU/minute. The dose should not be increased more often than every 30 minutes, until there were 3 contractions every 10 minutes. The maximum rate should be 12 mU/minute and the total dose should not exceed 5 IU. The survey found a huge variation: 19 of the 22 units would use more than the maximum dose of 5 IU recommended in the RCOG guidelines. Only 5 units used a low dose “physiological” regime (i.e. aiming for something like normal labour) despite good research evidence that it is effective and more likely to avoid hyper-stimulation of the uterus, whereas 17 used a “pharmacologi
