An Oxytocin Checklist

This checklist is one of the most commonly used for oxytocin protocols. In research*, its use was associated with a significant reduction in NICU admissions and primary cesarean rates.

Criteria for continuation of oxytocin: In each 30 minute segement, each of the following elements must be seen:

  1. At least one acceleration of 15 BPM x 15 seconds in 30 minutes or moderate variability for 10 of the previous 30 minutes.
  2. No more than one late deceleration.
  3. No more than two variable decelerations exceeding 60 seconds in duration and decreasing greater than 60 BPM from the baseline.
  4. No more than five uterine contractions in 10 minutes for any 20 minute interval in the segment.
  5. No two contractions greater than 120 seconds in duration.
  6. If IUPC is in place, MVU must calculate less than 300 mm Hg and the baseline resting tone must be less than 25 Hg.

 

* Clark SL, Meyers JA, Frye DK, Garthwaite T, Lee AJ, Perlin JB. Recognition and response to electronic fetal heart rate patterns: impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor. Am J Obstet Gynecol. 2015 Apr;212(4):494.e1-6

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