Intrauterine versus external tocodynamometry in monitoring labour: a randomised controlled clinical trial.
Caesarean section
contractions
intrauterine pressure catheter
labour
oxytocin
tocodynamometry
trial of labour after caesarean section
vacuum extraction
vaginal birth after caesarean section
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
accepted:
21
05
2020
pubmed:
4
6
2020
medline:
15
12
2020
entrez:
4
6
2020
Statut:
ppublish
Résumé
To investigate whether the use of intrauterine tocodynamometry versus external tocodynamometry (IT versus ET) during labour reduces operative deliveries and improves newborn outcome. As IT provides more accurate information on labour contractions, the hypothesis was that it may more appropriately guide oxytocin use than ET. Randomised controlled trial. Two labour wards, in a university tertiary hospital and a central hospital. A total of 1504 parturients with singleton pregnancies, gestational age ≥37 weeks and fetus in cephalic position: 269 women with uterine scars, 889 nulliparas and 346 parous women with oxytocin augmentation. Participants underwent IT (n = 736) or ET (n = 768) during the active first stage of labour. Primary outcome: rate of operative deliveries. duration of labour, amount of oxytocin given, adverse neonatal outcomes. Operative delivery rates were 26.9% (IT) and 25.9% (ET) (odds ratio 1.05, 95% CI 0.84-1.32, P = 0.663). The ET to IT conversion rate was 31%. We found no differences in secondary outcomes (IT versus ET). IT reduced oxytocin use during labours with signs of fetal distress, and trial of labour after caesarean section. IT did not reduce the rate of operative deliveries, use of oxytocin, or adverse neonatal outcomes, and it did not shorten labour duration. IT (versus ET) reduced oxytocin use in high-risk labours but did not influence operative delivery rate or adverse neonatal outcomes.
Identifiants
pubmed: 32491233
doi: 10.1111/1471-0528.16343
doi:
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1677-1686Subventions
Organisme : Special Grant funding provided by the Government of Finland
Pays : International
Organisme : Suomen Kulttuurirahasto
ID : 00180293
Pays : International
Informations de copyright
© 2020 Royal College of Obstetricians and Gynaecologists.
Références
Caldeyro R, Alvarez R, Reynolds SRM. Better understanding of uterine contractility through simultaneous recording with an internal and a seven channel external method. Surg Gynecol Obstet 1950;91:641-50.
Bakker PCAM, Kurver PHJ, Kuik DJ, Van Geijn HP. Elevated uterine activity increases the risk of fetal acidosis at birth. Am J Obstet Gynecol 2007;196:313.e1-6.
Simpson KR, James DC. Effects of oxytocin-induced uterine hyperstimulation during labor on fetal oxygen status and fetal heart rate patterns. Am J Obstet Gynecol 2008;199:34.e1-5.
Bakker JJH, Verhoeven CJM, Janssen PF, Van Lith JM, Van Oudgaarden ED, Bloemenkamp KWM, et al. Outcomes after internal versus external tocodynamometry for monitoring labor. N Engl J Med 2010;362:306-13.
Chia YT, Arulkumaran S, Soon SB, Norshida S, Ratnam SS. Induction of labour: does internal tocography result in better obstetric outcome than external tocography. Aust N Z J Obstet Gynaecol 1993;33:159-61.
Chua S, Kurup A, Arulkumaran S, Ratnam SS. Augmentation of labor: does internal tocography result in better obstetric outcome than external tocography? Obstet Gynecol 1990;76:164-7.
Panayotopoulos N, Salamalekis E, Vitoratos N, Loghis C, Kassanos D. Monitoring of uterine activity in cases of labor augmentation, and newborn outcome. Prenat Neonatal Med 1998;3:464-7.
Bakker JJH, Janssen PF, van Halem K, van der Goes BY, Papatsonis DNM, van der Post JAM, et al. Internal versus external tocodynamometry during induced or augmented labour. Cochrane Database Syst Rev 2013;(8):CD006947.
Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2) - a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG 2010;117:5-19.
Hofmeyr GJ, Say L, Gülmezoglu AM. WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG 2005;112:1221-8.
Devarajan S, Talaulikar VS, Arulkumaran S. Vaginal birth after caesarean. Obstet Gynaecol Reprod Med 2018;28:110-5.
Vlemminx MWC, de Lau H, Oei SG. Tocogram characteristics of uterine rupture: a systematic review. Arch Gynecol Obstet 2016;295:1-10.
FIGO News. Guidelines for the use of fetal monitoring. Int J Gynaecol Obstet 1987;25:159-67.
Arulkumaran S, Ingemarsson I, Ratnam SS. Oxytocin titration to achieve preset active contraction area values does not improve the outcome of induced labour. Br J Obstet Gynaecol 1987;94:242-8.
Bidgood KA, Steer PJ. A randomized control study of oxytocin augmentation of labour. I. Obstetric outcome. Br J Obstet Gynaecol 1987;94:518-22.
Steer PJ, Carter MC, Choong K, Hanson M, Gordon AJ, Pkadhan P. A multicentre prospective randomized controlled trial of induction of labour with an automatic closed-loop feedback controlled oxytocin infusion system. BJOG 1985;92:1127-33.
Rhoades JS, Cahill AG. Defining and managing normal and abnormal first stage of labor. Obstet Gynecol Clin North Am 2017;44:535-45.
Rood KM. Complications associated with insertion of intrauterine pressure catheters: an unusual case of uterine hypertonicity and uterine perforation resulting in fetal distress after insertion of an intrauterine pressure catheter. Case Rep Obstet Gynecol 2012;2012:1-3.
Wilmink FA, Wilms FF, Heydanus R, Mol BWJ, Papatsonis DNM. Fetal complications after placement of an intrauterine pressure catheter: a report of two cases and review of the literature. J Matern Neonatal Med 2008;21:880-3.
Harbison L, Bell L. Anaphylactoid syndrome after intrauterine pressure catheter placement. Obstet Gynecol 2010;115:407-8.
Mirza FG, Thaker HM, Flejter WL, D'Alton ME. Fetomaternal hemorrhage following placement of an intrauterine pressure catheter: report of a new association. Case Rep Obstet Gynecol 2015;2015:1-3.
Gee SE, Ma'ayeh M, Ward C, Buhimschi C, Klebanoff M, Rood K. Intrauterine pressure catheter use is associated with an increased risk of postcesarean surgical site infections. Am J Perinatol 2020;37:557-61.
Vlemminx MWC, Rabotti C, Van Der Hout-Van Der Jagt MB, Oei SG. Clinical use of electrohysterography during term labor: a systematic review on diagnostic value, advantages, and limitations. Obstet Gynecol Surv 2018;73:303-24.
Euliano TY, Nguyen MT, Darmanjian S, McGorray SP, Euliano N, Onkala A, et al. Monitoring uterine activity during labor: a comparison of 3 methods. Am J Obstet Gynecol 2013;208:66.e1-6.