There is an increased risk of uterine rupture in multiparous. I believe that syntocinon could be cautiously used in primiparous if there are no signs of obstruction or malposition of the fetal head particularly if there is evidence of inefficient contractions. Otherwise there is no clear evidence that syntocinon in second stage would improve the outcome.

Thanks Medhat.

I think to decrease the incidence of uterine hyperstimulation , precipetous labour ,fetal distress as and perineal tears . So as long as the labour is progressing normally in descend , there is no need to augement (pressure on perineum by head increase oxytocin secretion ).

30th May 2014

Oxytocin is a dangerous drug and should rarely be used in the second stage of labour.

The only indication is weak uterine contractions in the ABSENCE of:

1. Cephalo-pelvic disproportion

2. Preceding dysfunctional uterine contractions.

3. Malposition of the fetal head.

4. Prolonged labour.

5. Grand Multiparity.

In general oxytocin should be avoided in the second stafe of labour, and where necessary it should be administered cautiously and under proper supervision. The uterine contractions, progress of labour and the fetal heart rate should be monitored.

Thanks and regards to my colleagues !

Thanks Johan

Thanks for replying Junaid ! I apologise for the spelling mistake in my answer - "stafe" should read "stage".

Kind regards,

Johan (JT) Nel.