Start of induction of labour with oxytocin in the morning or in the evening. A randomised controlled trial

  • Bakker J
  • De Vos R
  • Pel M
 et al. 
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Abstract

OBJECTIVE: The objective of this study was to compare outcomes of induced labour with intravenous oxytocin with a start in the evening versus in the morning. DESIGN: Randomised controlled trial. SETTING: Labour wards of three hospitals in Amsterdam, the Netherlands. PARTICIPANTS: Women with an indication for induction of labour with intravenous oxytocin. METHODS: Included women were randomized to either the evening group with a start of induction of labour at 21:00 hours, or the morning group with a start at 07:00 hours. MAIN OUTCOME MEASURES: Primary outcome was duration of labour. Secondary outcomes were instrumental delivery rate, adverse neonatal outcome defined as an Apgar score below 7 after 5 minutes, number and indications of paediatric consults and neonatal admissions, duration of second stage, number of intrapartum infections and necessity of pain relief. RESULTS: We randomised 371 women. Mean duration of labour was not significantly different (primiparae: morning 12 hours and 8 minutes versus evening 11 hours and 22 minutes, P value 0.29; multiparae: morning 7 hours and 34 minutes versus evening 7 hours and 46 minutes, P value 0.70). There were no significant differences in instrumental deliveries rates, number of infections or patient satisfaction. Unexpectedly, neonatal outcome was better in women induced in the evening. CONCLUSION: Induction of labour with intravenous oxytocin in the evening is equally effective as induction in the morning.

Author-supplied keywords

  • Circadian rhythm
  • Duration of labour
  • Induced labour
  • Oxytocin

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Authors

  • J. J. Bakker

  • R. De Vos

  • M. Pel

  • C. Wisman

  • J. M. Van Lith

  • B. W.J. Mol

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