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Study Compares Methods of Measuring Contractions

Results don't support routine internal method for monitoring women in induced, augmented labor

WEDNESDAY, Jan. 27 (HealthDay News) -- In women going through induced or augmented labor, monitoring contractions with an intrauterine pressure catheter doesn't reduce the rate of operative delivery compared to external monitoring, according to research published in the Jan. 28 issue of the New England Journal of Medicine.

Jannet J.H. Bakker, of the Academic Medical Center in Amsterdam, Netherlands, and colleagues analyzed data from 1,456 women who had labor induced or augmented. Women were randomized to internal tocodynamometry or external monitoring. The primary outcome was rate of operative deliveries, defined as Caesarean section or instrumented vaginal delivery.

The researchers found that the operative delivery rate wasn't significantly different between the internal or external groups (31.3 versus 29.6 percent). Adverse neonatal outcomes, including Apgar score of less than seven at five minutes or neonatal hospital stay of longer than 48 hours, weren't significantly different between the groups, either (14.3 versus 15 percent).

"Internal tocodynamometry has serious risks, including placental or fetal-vessel damage, infection, and anaphylactic reaction. We did not observe any complications of internal monitoring in our study, but it was not powered to detect these events, which in previous studies had an estimated incidence of one in 300 patients and one in 1400," the authors conclude. "The results of our trial do not support the routine use of internal tocodynamometry for monitoring contractions in women with induced or augmented labor."

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