OXYTOCIN AUGMENTATION ARREST DISORDERS IN THE PRESENCE OF THICK MECONIUM - INFLUENCE ON NEONATAL OUTCOME

The objective of this report was to study the effect of oxytocin augme ntation in arrest disorders in the presence of thick meconium on mecon ium aspiration and fetal acidosis. We evaluated 3,321 singleton, term deliveries with cephalic presentation at our institution. Eight percen t (253/3,321) had thick meconium in labor, and these patients comprise d the study sample. Of the 253 women with thick meconium, 84 had an ar rest disorder in the active phase of labor with normal fetal heart rat e tracing at the time of diagnosis. Seventy-four percent (62/84) of th e women with arrest were treated with oxytocin(group 1) and 26% (22/84 ) delivered by cesarean section without augmentation (group 2). There was a significant (p < 0.05) increase in the incidence of meconium asp iration (14.5 vs. 4.5%) and low (<7.20) cord arterial pH (27.8 vs. 4.5 %) in patients who received oxytocin compared to those who did not. Of the women who received oxytocin, 36 delivered vaginally, and 2 neonat es had meconium aspiration. The remaining 26 women had cesarean sectio ns following oxytocin augmentation and had a significantly higher (p < 0.05) frequency of meconium aspiration (26.9 vs. 4.5%) and low cord a rterial pH (38.5 vs. 4.5%) compared to women who had cesarean sections without oxytocin augmentation. The findings suggest that oxytocin aug mentation in arrest disorders in the presence of thick meconium may be associated with a higher risk of meconium aspiration and low umbilica l cord arterial pH.