Outcomes after Internal versus External Tocodynamometry for Monitoring Labor

• Published in: The New England journal of medicine Vol. 362; no. 4; pp. 306 - 313
• Main Authors: Bakker, Jannet J.H, Verhoeven, Corine J.M, Janssen, Petra F, van Lith, Jan M, van Oudgaarden, Elisabeth D, Bloemenkamp, Kitty W.M, Papatsonis, Dimitri N.M, Mol, Ben Willem J, van der Post, Joris A.M
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 28.01.2010
• Subjects: Adult; Antibiotics; Apgar score; Biological and medical sciences; Cesarean section; Cesarean Section - statistics & numerical data; Childbirth & labor; Confidence intervals; Delivery. Postpartum. Lactation; Extraction, Obstetrical - statistics & numerical data; Female; Fetuses; General aspects; Gynecology; Gynecology. Andrology. Obstetrics; Health risk assessment; Humans; Induced labor; Kaplan-Meier Estimate; Labor, Induced; Labor, Obstetric; Medical sciences; Midwifery; Neonates; Obstetrics; Oxytocin; Pregnancy; Pregnancy Outcome; Statistics, Nonparametric; Uterine Monitoring - instrumentation; Uterine Monitoring - methods; Uterus; Vagina; Netherlands; Medicine; Prognosis; Surveillance; Internal; External; Evolution; Delivery; Labor; Comparative study
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa0902748

In this multicenter, randomized trial, internal tocodynamometry was compared with external monitoring of uterine activity in women with induced or augmented labor. The use of internal tocodynamometry did not reduce the rate of operative deliveries or improve other maternal or neonatal outcomes. Internal tocodynamometry was compared with external monitoring of uterine activity in women with induced or augmented labor. The use of internal tocodynamometry did not reduce the rate of operative deliveries or improve other maternal or neonatal outcomes. The monitoring of uterine contractions by means of internal tocodynamometry during induction or augmentation of labor is advocated by professional societies in obstetrics and gynecology. Induction or augmentation is necessary in approximately 20% of all deliveries, and internal monitoring is thought to quantify the frequency, duration, and magnitude of uterine activity more accurately than does external tocography. 1 – 3 The American College of Obstetricians and Gynecologists (ACOG) and the Society of Obstetricians and Gynaecologists of Canada (SOGC) advise the use of internal tocodynamometry in selected circumstances, such as when the mother is obese, when one-on-one nursing care is not available, or . . .