Please use this identifier to cite or link to this item: https://www.um.edu.mt/library/oar/handle/123456789/88540
Title: Optimisation of oxytocin use during labour
Authors: Falzon, Rebecca Marie (2021)
Keywords: Oxytocin
Labor (Obstetrics) -- Malta
Medical protocols -- Malta
Issue Date: 2021
Citation: Falzon, R.M. (2021). Optimisation of oxytocin use during labour (Master's dissertation).
Abstract: Both endogenous and exogenous oxytocin play a key role in the various stages of labour. Misusing this high-alert drug could lead to several maternal and foetal adverse outcomes. A suspected local overuse of oxytocin led to particular interest in this topic. This study aimed to investigate the local use of oxytocin, audit its use against local protocols and compare to international guidelines. The effects of such use on the mother and foetus were assessed. A cohort prospective observation study was performed. The study was carried out at the Obstetrics wards, Mater Dei Hospital, Malta. A three-month collation of data was statistically analysed using IBM SPSS Version 27 One-way ANOVA, Pearson Correlation and Chi- Squared Test. 305 births were analysed. Statistical significance was obtained for the following correlations; a lower 1-minute Apgar Score, a longer first and second stage of labour with oxytocin use, a lower Apgar Score with prolonged second stage of labour; higher incidence of ventouse deliveries with a prolonged second stage of labour; and a shorter duration of labour with higher parity. Disparities pertaining to the rate of the infusion being doubled sooner than the recommended time interval in the local protocol or starting the infusion at a higher rate than that recommended were observed in 7.7 % of the oxytocin group. Another deviation related to the higher than recommended use of maximum oxytocin units as per local protocol, which was observed in 4.3% of the oxytocin group. The local oxytocin protocol was generally coherent with international guidelines, key differences being lesser detail in specific domains such as the management of uterine tachysytsole and absence of rates and regimens for nulliparous and multiparous mothers. The study highlights the need for optimising the use of oxytocin in the management of labour in view of the general lack a general consensus on recommended dose, regimen and administration rates. Further studies are recommended in order to approach standardisation.
Description: M.Pharm.(Melit.)
URI: https://www.um.edu.mt/library/oar/handle/123456789/88540
Appears in Collections:Dissertations - FacM&S - 2021
Dissertations - FacM&SPha - 2021

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