Document Detail

Active-phase labor arrest: a randomized trial of chorioamnion management.
MedLine Citation:
PMID:  8190435     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether leaving the membranes intact in active-phase arrest would affect the cesarean delivery rate or the incidence of maternal morbidity secondary to infection. METHODS: We conducted a randomized trial of healthy, spontaneously laboring women at term with an intact chorioamnion and active-phase arrest (defined as 1 cm or less of cervical change over 2 hours in the active phase of labor). Patients were assigned to either oxytocin augmentation with intact chorioamnion or oxytocin augmentation with amniotomy and internal monitoring of the fetal heart rate and uterine contractions. RESULTS: The intact group (n = 58) and the amniotomy group (n = 60) were similar with respect to maternal age, race, parity, labor epidural usage, gestational age, cervical dilatation at randomization, number of vaginal examinations, and infant birth weight. Four patients in the intact group and five in the amniotomy group underwent cesarean delivery (P = 1.0). No patient in the intact group and three in the amniotomy group were diagnosed with chorioamnionitis (P = .24). Endometritis did not occur in the intact group, whereas four cases occurred in the amniotomy group (P = .12). There were no cases of maternal infection in the intact group, versus seven in the amniotomy group (P = .01). The interval between randomization and vaginal delivery was 44 minutes longer in the intact group than in the amniotomy group (P = .11). CONCLUSION: In women with active-phase arrest of labor and intact membranes, oxytocin augmentation with elective amniotomy and internal monitoring increases maternal infectious morbidity.
D J Rouse; C McCullough; A L Wren; J Owen; J C Hauth
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  83     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-06-21     Completed Date:  1994-06-21     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  937-40     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, University of Alabama at Birmingham.
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MeSH Terms
Amnion / surgery*
Cesarean Section
Chorioamnionitis / etiology
Endometritis / etiology
Fetal Monitoring
Labor, Induced / adverse effects,  methods
Obstetric Labor Complications / therapy*
Oxytocin / therapeutic use
Pregnancy Outcome
Puerperal Infection / etiology
Reg. No./Substance:

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