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A randomised controlled trial of early versus delayed use of amniotomy and oxytocin infusion in nulliparous labour. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 103 (4): 313-318 APR 1996

Auteur·e(s) :

Cammu H, vanEeckhout E

Année de publication :

1996

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To compare routine amniotomy and early intravenous oxytocin (active management of labour) with a more selective use of amniotomy and oxytocin in women in true labour who received comparable continuous supportive midwifery care.

DESIGN: Randomised controlled trial of nulliparous clinic patients in spontaneous labour at term.

SETTING Labour and delivery ward of a university teaching hospital.

PARTICIPANTS: Three hundred and six parturients: 152 received active management of labour; 154 were more selectively managed.

INTERVENTIONS: 1. Active management: early amniotomy, early use of oxytocin. 2. Selective intervention management: no routine amniotomy and more selective use of oxytocin.

OUTCOME MEASURES: Use of oxytocin and amniotomy. Labour duration, mode of delivery.

RESULTS: Maternal characteristics were comparable in both groups. Amniotomy was more often performed (91% versus 57%, P < 0.01) and oxytocin more often used (53% versus 27%, P <0.01) in the active management group. The first stage of labour, however, was only shortened by half an hour in the active management group (254 min versus 283 min, P = 0.087). Caesarean section rate (3.9% versus 2.6%), spontaneous vaginal delivery rate (78% versus 79%) and neonatal outcome were not significantly different between groups.

CONCLUSION: Within a set-up of strict labour diagnosis and supportive midwifery care, routine amniotomy and early use of oxytocin offered no advantage over a more selective use of amniotomy and oxytocin in terms of mode of delivery and labour duration.

Sumário (português)  :

Resumen (español)  :

Remarques :

Argument (français) :

L’amniotomie de routine et l’utilisation précoce d’ocytocines n’offre aucun avantage par rapport a une utilisation plus selective en terme de délivrance et de durée du travail.
Routine amniotomy and early use of oxytocin offered no advantage over a more selective use of amniotomy and oxytocin in terms of mode of delivery and labour duration.

Argument (English):

Argumento (português):

Argumento (español):

Mots-clés :

➡ amniotomie ; ocytocine (Syntocinon) ; gestion active du travail

Auteur·e de cette fiche :

Sandrine Péneau — 19 Jan 2006