Oxytocin and emergency caesarean section in a medium-sized hospital in Pakistan: A cross-sectional study
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Institute of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Borre, Norway
Women's Christian Hospital, Multan, Pakistan
Mirjam Lukasse   

Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South- Eastern Norway, Raveien 215, Borre, 3184, Norway
Submission date: 2020-02-17
Final revision date: 2020-05-15
Acceptance date: 2020-06-17
Publication date: 2020-08-06
Eur J Midwifery 2020;4(August):33
One of the most common complications during labour is prolonged labour (dystocia) which is associated with risks for the mother and fetus. Dystocia is usually treated with Oxytocin. Oxytocin is also used to induce labour. Oxytocin may not have the desired effect of progress and can negatively affect the fetus, thus resulting in an emergency Caesarean Section (CS). The aim of this study was to describe obstetric practice, use of oxytocin and it's association with an emergency CS.

A cross-sectional retrospective register study was conducted that included all women who gave birth during 2014 and 2015 at a hospital in a large city in Pakistan.

A total of 6652 women gave birth to 6767 newborns, 66.8% were multiparous and 33.2% primiparous women. Of the primiparous women, 78.9% had a spontaneous vaginal birth, 1.2% an elective CS and 14.4% an emergency CS. Of the multiparous women, 81.9% had a spontaneous vaginal birth, 8.0% an elective CS and 6.7% an emergency CS. Operative vaginal birth was 2.1% among primiparous and 0.2% among multiparous women. Oxytocin for induction or augmentation was administered to 60.0% of primiparous and 30.5% of multiparous women. Oxytocin during the first stage of labor was associated with an increased risk for emergency CS for both primiparous and multiparous women.

Despite the association between oxytocin and emergency CS, the CS rate was low in this hospital. The majority of the women gave birth vaginally, even with a breech presentation. Few operative vaginal births were performed.

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
Research time for ML was paid by Oslo Metropolitan University.
ML, MM, IH and SB perceived the design of the study. MM and SMcA collected the data. IH and SB cleaned the data and performed the analyses agreed upon by all authors. IH, SB, ML, SMcA and MM interpreted the results. ML, IH and SB were involved in the writing of the manuscript. All authors approved the final manuscript.
Not commissioned; externally peer reviewed.
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