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Objectives To determine total oxytocin dosing in pregnancies with Class III obesity compared to women with normal BMI, with the aim to develop a protocol for labour induction specific to high BMI patients. Methods A retrospective study of primiparous, term, singleton pregnancies with a pre-pregnancy BMI of ≥40kg/m2 (cases) or ≤25kg/m2 (controls), were matched by provider, age, and year of delivery. Primary outcomes included oxytocin rate, total dose and duration. Secondary outcomes included mode of delivery, last cervical dilation, neonatal birthweight >4000g, and maternal and neonatal morbidity composite scores. Statistical analysis using SPSS v.26 software generated ANOVA models and receiver/operator curves. Results 334 patients were included. Cases had a higher total oxytocin dose (15.5U vs. 7.0U, p 4000g did not affect statistical significance. There were no differences in maternal morbidity score. Neonatal morbidity score was lower in cases than controls. Conclusions During labour induction of primiparous women with class III obesity, allowing for increases in total oxytocin, oxytocin duration, and maximum oxytocin rate results in a 62% vaginal birth rate with no increase in maternal or neonatal morbidity. Based on these findings, there is validity for a trial of high dose oxytocin protocols in this population. |
