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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
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Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 2

Category: Labor

Poster Session 2

(653) Association between oxytocin rest and mode of delivery in low-risk nulliparas at term

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  
Objective:
“Oxytocin rest” is a practice of temporarily discontinuing oxytocin during labor when a regular contraction pattern has not been achieved to allow for myometrial oxytocin receptor re-sensitization. Data are lacking on the clinical utility of this practice. We aimed to evaluate the association between oxytocin rest and mode of delivery and maternal outcomes.

Study Design:
This was a secondary analysis of the MFMU ARRIVE trial, a multi-center randomized controlled trial of induction versus expectant management in low-risk term nulliparas. Participants who received oxytocin in labor were included in this analysis. The exposure was oxytocin rest, defined as a stop in oxytocin during labor. The primary outcome was mode of delivery. Secondary outcomes were chorioamnionitis, maximum cervical dilation achieved, and a composite maternal morbidity. Multivariable modeling estimated the association between oxytocin rest and outcomes with odds ratios and 95% confidence intervals reported. A sensitivity analysis excluded those with cesarean for non-reassuring fetal status.

Results:
Of 3,257 participants included, 365 (11%) experienced an oxytocin rest with a median duration of 1.4 hours (interquartile range 0.7-3.0 hours) and most (61%) occurring in the latent phase (n=224). Baseline characteristics differed by oxytocin rest (Table 1). Oxytocin rest was associated with higher odds of cesarean delivery (37% vs. 22.6%; aOR 1.83, 95% CI 1.44-2.32), and decreased odds of reaching 5 or 10 cm dilation (Table 2). Oxytocin rest was not associated with maternal morbidity. Findings were similar in the sensitivity analysis.

Conclusion:
In low-risk nulliparas who received oxytocin, undergoing an oxytocin rest was associated with cesarean delivery, and decreased odds of achieving active labor or complete dilation. Findings may reflect that oxytocin rest was used more often in those with dysfunctional labor without improving chances of vaginal delivery. Prospective study is needed to better elucidate potential benefits or risks of oxytocin rest.