Association of low dose oxytocin with pain intensity and delivery outcomes among primiparas who delivered vaginally with epidural block analgesia.

Abstract

Objective: This paper aimed to evaluate the influence of low-dose oxytocin (LDO) on pain intensity and delivery outcomes in primiparas who delivered vaginally with epidural block analgesia (EBA).

Methods: A total of 150 primiparas were retrospectively collected, and finally, 120 cases were included. They were divided into a control group (n = 60, received EBA) and an oxytocin group (n = 60, received EBA combined with LDO). Analgesic onset time, analgesic duration, time to flatus, and time to first bowel movement were compared. Pain intensity was assessed using the Visual Analog Scale (VAS) at pre-analgesia, cervical dilation of 3 cm, and fetal delivery. Serum levels of cortisol (Cor), norepinephrine (NE), and C-reactive protein (CRP) before and 24 hours post-delivery, postpartum bleeding, Apgar scores, delivery outcomes, and adverse reactions were compared.

Results: The oxytocin group had shorter times for gas passage and first bowel movement, as well as shorter durations of the first, second, and third stages of labor (p < 0.05). VAS scores at cervical dilation of 3 cm and fetal delivery were lower than pre-analgesia in both groups (p < 0.05), with no inter-group differences at each time point (p > 0.05). Serum Cor and NE decreased, while CRP increased at 24 hours postpartum (p < 0.05), with no inter-group differences (p > 0.05). The oxytocin group had less postpartum bleeding at 2 hours (p < 0.05), a higher natural delivery rate, and a lower incidence of uterine atony (p < 0.05), with no significant difference in Apgar scores (p > 0.05).

Conclusion: EBA with LDO shortens labor duration, promotes gastrointestinal recovery, reduces uterine atony, postpartum hemorrhage, and vaginal assistive delivery rates, without affecting analgesia or stress response.