Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, PA, USA.
Am J Obstet Gynecol. 2012 Dec;207(6):471.e1-8. doi: 10.1016/j.ajog.2012.08.035. Epub 2012 Sep 7.
The purpose of this study was to determine whether there is an increase in the cesarean delivery rate in women who undergo induction when oxytocin is discontinued in the active phase of labor.
We conducted a prospective randomized controlled trial of women who underwent induction of labor at term; they were assigned randomly to either routine oxytocin use (routine) or oxytocin discontinuation (DC) once in active labor. Analysis was by intention to treat.
Two hundred fifty-two patients were eligible for study analysis: 127 patients were assigned randomly to the routine group and 125 patients were assigned randomly to the DC group. Cesarean delivery rate was similar between the groups (routine, 25.2% [n = 32] vs the DC group, 19.2% [n = 24]; P = .25). There was a higher chorioamnionitis rate and slightly longer active phase in those women who were assigned to the DC group. In adjusted analysis, the rate of chorioamnionitis was not different by randomization group but was explained by the duration of membrane rupture and intrauterine pressure catheter placement.
Discontinuation of oxytocin in active labor after labor induction does not increase the cesarean delivery rate significantly.
本研究旨在确定在活跃期停止催产素时行引产的女性中，剖宫产率是否增加。
我们对足月行引产的女性进行了前瞻性随机对照试验；将她们随机分为常规催产素使用组（常规组）或活跃期一旦使用催产素即停止（DC 组）。分析采用意向治疗。
共有 252 名患者符合研究分析条件：127 名患者被随机分配至常规组，125 名患者被随机分配至 DC 组。两组剖宫产率相似（常规组，25.2%[n=32] vs DC 组，19.2%[n=24]；P=0.25）。与常规组相比，被分配至 DC 组的女性绒毛膜羊膜炎发生率更高，活跃期略长。在调整分析中，随机分组与绒毛膜羊膜炎发生率无差异，但与胎膜破裂时间和宫内压力导管放置时间有关。
活跃期停止催产素不会显著增加剖宫产率。
