Duration of Oxytocin and Rupture of the Membranes Before Diagnosing a Failed Induction of Labor.
Duration of Oxytocin and Rupture of the Membranes Before Diagnosing a Failed Induction of Labor.
- 2016
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSION: Based on when neonatal morbidity increased, in an otherwise uncomplicated induction of labor with rupture of membranes, a latent phase after initiation of oxytocin of at least 12 hours for nulliparous women and 15 hours in multiparous women is a reasonable criterion for diagnosing a failed induction. METHODS: This is a retrospective cohort study using data from the Consortium of Safe Labor study, including 9,763 nulliparous and 8,379 multiparous women with singleton, term pregnancies undergoing induction at 2 cm dilation or less with rupture of membranes before 6 cm dilation after which the latent phase ended. Outcomes were evaluated according to duration of oxytocin and rupture of membranes. OBJECTIVE: To compare maternal and neonatal outcomes based on length of the latent phase during induction with rupture of membranes before 6 cm dilation. RESULTS: At time points from 6 to 18 hours of oxytocin and rupture of membranes, the rates of nulliparous women remaining in the latent phase declined (35.9-1.4%) and the rates of vaginal delivery for those remaining in the latent phase at these time periods decreased (54.1-29.9%) Nulliparous women remaining in the latent phase for 12 hours compared with women who had exited the latent phase had significantly increased rates of chorioamnionitis (12.1% compared with 4.1%) and endometritis (3.6% compared with 1.3%) and increased rates of neonatal intensive care unit admission (8.7% compared with 6.3%). Similar patterns were present for multiparous women at 15 hours.
English
0029-7844
*Extraembryonic Membranes
*Labor, Induced
*Labor, Obstetric
*Oxytocics/ad [Administration & Dosage]
*Oxytocin/ad [Administration & Dosage]
Adult
Chorioamnionitis/ep [Epidemiology]
Endometritis/ep [Epidemiology]
Female
Humans
Infant, Newborn
Intensive Care, Neonatal/sn [Statistics & Numerical Data]
Labor, Obstetric/de [Drug Effects]
Parity
Pregnancy
Retrospective Studies
Time Factors
Treatment Failure
Young Adult
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Maternal-Fetal Medicine
Journal Article
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
CONCLUSION: Based on when neonatal morbidity increased, in an otherwise uncomplicated induction of labor with rupture of membranes, a latent phase after initiation of oxytocin of at least 12 hours for nulliparous women and 15 hours in multiparous women is a reasonable criterion for diagnosing a failed induction. METHODS: This is a retrospective cohort study using data from the Consortium of Safe Labor study, including 9,763 nulliparous and 8,379 multiparous women with singleton, term pregnancies undergoing induction at 2 cm dilation or less with rupture of membranes before 6 cm dilation after which the latent phase ended. Outcomes were evaluated according to duration of oxytocin and rupture of membranes. OBJECTIVE: To compare maternal and neonatal outcomes based on length of the latent phase during induction with rupture of membranes before 6 cm dilation. RESULTS: At time points from 6 to 18 hours of oxytocin and rupture of membranes, the rates of nulliparous women remaining in the latent phase declined (35.9-1.4%) and the rates of vaginal delivery for those remaining in the latent phase at these time periods decreased (54.1-29.9%) Nulliparous women remaining in the latent phase for 12 hours compared with women who had exited the latent phase had significantly increased rates of chorioamnionitis (12.1% compared with 4.1%) and endometritis (3.6% compared with 1.3%) and increased rates of neonatal intensive care unit admission (8.7% compared with 6.3%). Similar patterns were present for multiparous women at 15 hours.
English
0029-7844
*Extraembryonic Membranes
*Labor, Induced
*Labor, Obstetric
*Oxytocics/ad [Administration & Dosage]
*Oxytocin/ad [Administration & Dosage]
Adult
Chorioamnionitis/ep [Epidemiology]
Endometritis/ep [Epidemiology]
Female
Humans
Infant, Newborn
Intensive Care, Neonatal/sn [Statistics & Numerical Data]
Labor, Obstetric/de [Drug Effects]
Parity
Pregnancy
Retrospective Studies
Time Factors
Treatment Failure
Young Adult
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Maternal-Fetal Medicine
Journal Article