Obesity is considered one of the biggest public health concern of the 21st century and
increases the risk of many comorbid medical conditions. Obesity in pregnancy places women at
higher risk of obstetrical complications during pregnancy, delivery and postpartum. In
particular, obese pregnant women have more difficulty going into labor, a longer labor
course, and even with pharmacologic treatment, have a higher chance of requiring cesarean
delivery.
When pregnant women need help going into labor, they commonly receive a medication called
Pitocin on the labor and delivery floor. Pitocin is the brand name and is a synthetic analog
to the naturally produced oxytocin, a hormone secreted by mother when they naturally go into
labor. This medication has been used widely around the world. There is emerging evidence that
obese women need more oxytocin to go into labor compared to their lean cohorts. There are
many studies to support the use of different oxytocin dosages and are currently supported by
the American College of Obstetricians and Gynecologists. Despite these evidences, a low dose
oxytocin regimen is universally used in the United States, regardless of patient
characteristics.
This study is a double blinded randomized controlled trial. Both lean and obese cohorts will
be recruited for the study. The investigators will randomly place both cohorts into the low
or the high dose oxytocin regimen treatment group. The investigators, patients and providers
will be blinded and will not know the specific assignments. The purpose of this study is to
evaluate the effect of high dose oxytocin in the obese cohort. The hypothesis is that obese
patient will have shorter time to delivery with the high dose oxytocin regimen without
incurring any additional risks or adverse outcomes.