Implementation of a conservative checklist-based protocol for oxytocin administration: maternal and newborn outcomes

Steven Clark, Michael Belfort, George Saade, Gary Hankins, Darla Miller, Donna Frye, Janet Meyers

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Objective: The purpose of this study was to examine the effects of a conservative and specific checklist-based protocol for oxytocin administration on maternal and newborn outcome. The protocol was based on maternal and fetal response to oxytocin rather than infusion rate. Study Design: This was a retrospective chart review and data extraction of the last 100 patients receiving oxytocin before implementation of the protocol and the first 100 patients receiving oxytocin after protocol implementation. Results: The 2 groups were demographically similar. For the pre- and postprotocol groups, the mean time of infusion to delivery was 8.5 ± 5.3 hours versus 8.2 ± 4.5 hours (NS), the maximum oxytocin infusion rate was 13.8 ± 6.3 mU/min versus 11.4 ± 6.1 mU/min (P = .003) and the cesarean delivery rate was 15% versus 13% (NS). Every index of newborn outcome was improved in the post-protocol group, but these differences did not individually reach statistical significance. However, newborns with any index of adverse outcome were significantly fewer in the post protocol group (31 vs 18, P = .049). System wide implementation of this program was associated with a decline in the rate of primary cesarean delivery from 23.6% in 2005 to 21.0% in 2006. Conclusion: Implementation of a specific and conservative checklist-based protocol for oxytocin infusion based on maternal and fetal response results in a significant reduction in maximum infusion rates of oxytocin without lengthening labor or increasing operative intervention. Cesarean delivery rate declined system-wide following implementation of this protocol. Newborn outcome also appears to be improved.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume197
Issue number5
DOIs
StatePublished - Nov 2007

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Oxytocin
Checklist
Mothers
Newborn Infant

Keywords

  • cesarean delivery
  • medication safety
  • oxytocin

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Implementation of a conservative checklist-based protocol for oxytocin administration : maternal and newborn outcomes. / Clark, Steven; Belfort, Michael; Saade, George; Hankins, Gary; Miller, Darla; Frye, Donna; Meyers, Janet.

In: American Journal of Obstetrics and Gynecology, Vol. 197, No. 5, 11.2007.

Research output: Contribution to journalArticle

Clark, Steven ; Belfort, Michael ; Saade, George ; Hankins, Gary ; Miller, Darla ; Frye, Donna ; Meyers, Janet. / Implementation of a conservative checklist-based protocol for oxytocin administration : maternal and newborn outcomes. In: American Journal of Obstetrics and Gynecology. 2007 ; Vol. 197, No. 5.
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