{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:37:22Z","timestamp":1780731442230,"version":"3.54.1"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,6,21]],"date-time":"2013-06-21T00:00:00Z","timestamp":1371772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Evidence suggests that a high dose of oxytocin for nulliparous women at 37\u201342\u00a0weeks of gestation with confirmed delay in labour increases spontaneous vaginal birth. We undertook a pilot study to test the feasibility of this treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Pilot double\u2010blind randomised controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Three teaching hospitals in the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 94 consenting nulliparous women at term with confirmed delay in labour were recruited, and 18 were interviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women were assigned to either a standard (2\u00a0mU\/min, increasing every 30\u00a0minutes to 32\u00a0mU\/minute) or a high\u2010dose regimen (4\u00a0mU\/minute, increasing every 30\u00a0minutes to 64\u00a0mU\/minutes) oxytocin by computer\u2010generated randomisation. Simple descriptive statistics were used, as the sample size was insufficient to evaluate clinical outcomes. The constant comparative method was used to analyse the interviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcomes measures<\/jats:title><jats:p>The main outcome measures: number of women eligible; maternal and neonatal birth; safety; maternal psychological outcomes and experiences; health\u2010related quality of life outcomes using validated tools and data on health service resource use; incidence of suspected delay of labour (cervical dilatation of &lt;2\u00a0cm after 4\u00a0hours, once labour is established); and incidence of confirmed delay of labour (progress of &lt;1\u00a0cm on repeat vaginal examination after a period of 2\u00a0hours).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We successfully developed systems to recruit eligible women in labour and to collect data. Rates of spontaneous vaginal birth (10\/47 versus 12\/47, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.2, 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.6\u20132.5) and caesarean section (15\/47 versus 17\/47, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.1, 95%\u00a0<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.6\u20132.0) were increased, and rates of instrumental birth were reduced (21\/47 versus 17\/47, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.8, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.5\u20131.3). No evidence of increased harm for either mother or baby was found. The incidences of suspected delay (14%) and confirmed delay (11%) in labour were less than anticipated. Of those who did not go on to have delayed labour confirmed, all except one woman gave birth vaginally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A pilot trial assessing the efficacy of high\u2010dose oxytocin was feasible, but uncertainty remains, highlighting the need for a large definitive trial. The implementation of national guidance of suspected and confirmed delay in labour is likely to reduce intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12331","type":"journal-article","created":{"date-parts":[[2013,6,21]],"date-time":"2013-06-21T05:13:10Z","timestamp":1371791590000},"page":"1403-1412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Standard\u2010 or high\u2010dose oxytocin for nulliparous women with confirmed delay in labour: quantitative and qualitative results from a pilot randomised controlled trial"],"prefix":"10.1111","volume":"120","author":[{"given":"S","family":"Kenyon","sequence":"first","affiliation":[{"name":"School of Health and Population Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Armstrong","sequence":"additional","affiliation":[{"name":"SAPPHIRE Group Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Johnston","sequence":"additional","affiliation":[{"name":"Maternal and Fetal Medicine Birmingham Women's NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Walkinshaw","sequence":"additional","affiliation":[{"name":"Maternal and Fetal Medicine Liverpool Women's NHS Foundation Trust Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Petrou","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit Division of Health Sciences Warwick Medical School University of Warwick Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Howman","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit School of Cancer Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Cheed","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit School of Cancer Sciences University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Markham","sequence":"additional","affiliation":[{"name":"Service User Northampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"McNicol","sequence":"additional","affiliation":[{"name":"SAPPHIRE Group Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Willars","sequence":"additional","affiliation":[{"name":"SAPPHIRE Group Department of Health Sciences University of Leicester Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Waugh","sequence":"additional","affiliation":[{"name":"Obstetrics and Maternal Medicine NUTH NHS Foundation Trust Newcastle Upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The HOLDS Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,21]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"2001","volume-title":"RCOG Clinical Effectiveness Support Unit. 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