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Medical News: Internal Monitoring During Induced Labor of Little Help - in OB/Gyn, Pregnancy from MedPage Today

Posted Jan 29 2010 6:25am

 

By Crystal Phend, Senior Staff Writer, MedPage Today
Published: January 28, 2010
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Action Points 


  • Note that the American College of Obstetricians and Gynecologists recommends internal tocodynamometry only in circumstances such as when induction response is limited or if the mother is obese.

Internally monitoring the progress of induced labor may not improve outcomes for mother or baby, Dutch researchers found.

Internal tocodynamometry did not reduce the rate of operative delivery compared with external monitoring (31.3% versus 29.6%, P=0.50) in a study led by Jannet J.H. Bakker, MSc, of the Academic Medical Center in Amsterdam.

Nor did it significantly reduce risk of adverse neonatal outcomes, Bakker's group reported in the Jan. 28 New England Journal of Medicine.

Some obstetrical professional associations recommend routine internal monitoring to assess contractions accurately. Others, such as the American College of Obstetricians and Gynecologists, suggest it only in special circumstances, such as when induction response is limited, or if the mother is obese.

Researchers had hoped that internal monitoring might improve doctors' ability to effectively dose labor-inducing oxytocin, leading to less distress for babies and fewer operative deliveries, the investigators noted…

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