Reducing oxytocin during labor to improve fetal heart rate outcomes

A Randomized Controlled Trial Evaluating the Effect of the Oxytocin Infusion Rate on Fetal Heart Rate Changes and Maternal-Fetal Outcomes During the Initiation of Combined Spinal-Epidural Labor Analgesia

Phase 4 Interventional University of Iowa · NCT03232918

This study tests if lowering the amount of oxytocin given during labor can help improve fetal heart rate patterns in healthy women having their first baby.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment730 (estimated)
Ages18 Years to 55 Years
SexFemale
SponsorUniversity of Iowa Academic / other
Locations2 sites (Iowa City, Iowa and 1 other locations)
Trial IDNCT03232918 on ClinicalTrials.gov

What this trial studies

This study investigates the impact of reducing the oxytocin infusion rate by 50% prior to the initiation of combined spinal epidural analgesia on fetal heart rate changes during labor. It aims to determine if this adjustment can decrease the incidence of nonreassuring fetal heart rate patterns, which can occur due to increased uterine tone and decreased placental blood flow. The study focuses on healthy women at term with singleton pregnancies who request neuraxial analgesia and are undergoing labor induction or augmentation. By standardizing labor analgesia and oxytocin administration, the study seeks to clarify the relationship between oxytocin dosage and fetal heart rate abnormalities.

Who should consider this trial

Good fit: Ideal candidates are healthy women at term with singleton pregnancies who are requesting neuraxial analgesia for labor induction or augmentation.

Not a fit: Patients with contraindications to neuraxial analgesia or those presenting with non-vertex fetal positions may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could lead to improved fetal heart rate outcomes and reduce the risk of fetal distress during labor.

How similar studies have performed: Previous studies on oxytocin dosing have shown mixed results, indicating that this approach is novel and may provide new insights into labor management.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Healthy nulliparous or multiparous women at term (37 \> weeks' gestation)
* Singleton pregnancy
* Request for neuraxial analgesia
* Oxytocin used for induction of labor or augmentation of labor per institutional protocols

Exclusion Criteria:

* Use of chronic analgesic medications
* Prior administration of systemic opioid labor analgesia
* Non-vertex presentation
* Contraindication to neuraxial analgesia
* Category 3 fetal heart rate tracing prior to the initiation of combined spinal epidural analgesia

Where this trial is running

Iowa City, Iowa and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Fetal Bradycardia Complicating Labor and DeliveryFetal Bradycardia During LaborFetal Heart Rate or Rhythm Abnormality Affecting Fetus
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.