The use and abuse of oxytocin.

Key content: Oxytocin is a well‐established drug with a long history of use.The generation of intrauterine pressure is a result of myometrial activity, but is attenuated by a softening cervix.The introduction of active management regimens have not changed the outcome of labour as we envisaged.Too many babies suffer asphyxia as a result of misuse of oxytocin.Some form of education programme must be developed to warn of the dangers of this very useful drug.Better training and education programmes must be in place for midwives and obstetricians for labour management and cardiotography interpretation. Learning objectives: To outline the history of the development of oxytocin.To understand the mechanism of intrauterine pressure development.To understand the methods of intrauterine pressure measurement and assessment.To understand the development of principles of active management with a discussion of the subsequent studies analysing the results of such labour management.To outline the medicolegal aspects of labour augmentation, with particular reference to oxytocin use.To discuss possible implications for the future. Ethical issues: Should all women be given the information that oxytocin augmentation of slow labour may reduce the duration of labour by several hours but does not change the mode of delivery, whilst carrying a risk of causing fetal asphyxia?Should women sign informed consent before their labours are augmented?Should augmentation of labour only be undertaken under the direct supervision of a senior clinician? [ABSTRACT FROM AUTHOR]