Recommandations pour l'administration d'oxytocine au cours du travail spontané. Chapitre 6 : risques et effets indésirables fœtaux, et pédiatriques de l'administration de l'oxytocine au cours du travail spontané

There might be five sorts of fetal and neonatal risks and adverse effects linked to the use of oxytocin during spontaneous labor: (1) failure to adapt to extra-uterine life, (2) neonatal jaundice, (3) neonatal hyponatremia, (4) sucking impairment through the neonatal period, (5) pervasive developmental disorder in children. Numerous methodological challenges prevent authors from establishing a causal connection between exposure to oxytocin and those five adverse effects: lack of power in randomized trials, inclusion in randomized trials of laboring women different from those included in population-based studies, while those same population-based studies highlight adverse effects associated with oxytocin but not necessarily within the recommended conditions of administration (either regarding therapeutic indications, dosis or preparation of this drug). Nevertheless, due to the current high frequency of oxytocin use during spontaneous labor in France, our expert group recommends that prescribing physicians remain cautious. Exercising caution regarding oxytocin use includes drafting oxcytocin administration protocols during spontaneous labor in every maternity ward, having each ward aware of its own rate of oxcytocin use and carefully analyzing oxytocin administration while reviewing cases of newborns failing to adapt to extra-uterine life.