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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


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1619-3997
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Volume 41, Issue 5

Issues

Effect of maternal body mass index on oxytocin treatment for arrest of dilatation1)

Shelly Soni / Niraj Chivan / Wayne R. Cohen
Published Online: 2013-03-21 | DOI: https://doi.org/10.1515/jpm-2013-0024

Abstract

To determine whether the effectiveness of oxytocin treatment of arrest of dilatation differed in obese compared to lean women, we did a retrospective analysis of 118 subjects in spontaneous labor whose arrest of dilatation was treated with oxytocin. Cases were stratified by maternal body mass index (BMI): Group A, <25 kg/m2; Group B, 25.0–29.9 kg/m2; Group C, 30.0–34.9 kg/m2; and Group D, ≥35 kg/m2. Groups were comparable in maternal age, parity, gestational age, birth weight, and the frequency of infection. Full dilatation was reached in about 90% of Group A and B, 72% of Group C, and 39% of Group D, the most obese women (P<0.001). The cesarean rate was directly related to maternal BMI, 11.4%, 22.9%, 34.3%, and 69.6% in Groups A through D, respectively (P<0.001). Significantly more oxytocin was used in group D than in the other groups during the first 3h of infusion in attempting to overcome the arrest (P=0.003). We conclude that oxytocin treatment of arrest of dilatation was less effective in obese than in lean women. This effect was most prominent in women with a BMI >35 kg/m2, who were, despite having received more oxytocin than those in the leaner groups, less than half as likely to attain full dilatation and more than twice as likely to deliver by cesarean.

Keywords: Arrest of dilatation; labor; obesity; oxytocin

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About the article

Corresponding author: Wayne R. Cohen, MD, 4841 North Valley View Rd. Tucson, 85718 AZ, USA, Tel.: +1 646 270 5518, Fax: +1 520 505 4213


Received: 2013-01-29

Accepted: 2013-02-25

Published Online: 2013-03-21

Published in Print: 2013-09-01


This paper was presented in abstract form at the Annual Clinical Meeting of the American Congress of Obstetricians and Gynecologists, San Diego, CA, May 7, 2012.


Citation Information: Journal of Perinatal Medicine, Volume 41, Issue 5, Pages 517–521, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2013-0024.

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