Objective: Term prelabour rupture of membrane (PROM) occurs in 8% of term deliveries, but it is unclear when to initiate induction. Our objective was to assess the optimal timing of oxytocin induction in the management of term PROM in terms of maternal and neonatal outcomes.
Methods: A retrospective cohort study was performed at a single tertiary care center from 2010 to 2020. All singleton pregnancies with PROM beyond 37 weeks gestation, without regular uterine contractions, were included. Eligible women were divided into three groups according to the timing of oxytocin induction (≤12; 12-24; ≥24 h) following PROM.
Results: Of 9,443 women presented with the term PROM, 1676 were included. They were classified according to the timing of oxytocin induction initiation following PROM: 1,127 within 12 h; 285 within 12-24 h; 264 after 24 h. There were no significant differences in baseline demographic characteristics between groups. Women who presented at our emergency department were induced earlier delivered significantly sooner than those who received oxytocin later (45 vs. 28.2 vs. 23.2 h, respectively, < .001. Maternal infection rate was similar and unrelated to oxytocin starting time. Induction at <12 h from PROM was associated with reduced rate of antibiotic administration compared with other timings (26.8% vs. 38.6% vs. 33.33%, respectively; < .001), and the same was found for neonatal composite adverse outcomes (RR = 1.27, = .0307).
Conclusion: In term PROM, early induction (within 12 h of PROM) may be recommended to reduce the time-do-delivery interval and increase the delivery rate within 24 h. It may be of economic significance and improve women satisfaction. Furthermore, early induction may also improve neonatal outcomes, without worsening maternal outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/14767058.2023.2215997 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A systematic review and meta-analysis of randomized trials comparing carbetocin to oxytocin in prevention of postpartum hemorrhage after cesarean delivery in low-risk women.
J Obstet Gynaecol Res
January 2025
Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
Objectives: To evaluate the efficacy and safety of Carbetocin compared to oxytocin in prevention of postpartum hemorrhage (PPH) after low-risk cesarean delivery (CD).
Search Strategy: Screening of Medline, Web Of Science, Scopus, Google scholar, and clinical trials registry till January 2024 using the key words related to carbetocin, blood loss, PPH, Cesarean section and their MeSH terms was done.
Selection Criteria: This study included all RCTs conducted on women with low risk for developing PPH after CD and compared the administration of carbetocin to oxytocin without any language limitation.
Rational approach to fetal heart rate monitoring and management during the second stage of labor.
Eur J Obstet Gynecol Reprod Biol
December 2024
Direttore UOC Ostetricia e Ginecologia, Azienda Ospedaliera Universitaria di Parma, Professore Ordinario di Ginecologia e Ostetricia, Direttore della Scuola di Specializzazione in Ostetricia e Ginecologia, Presidente del CdS OstetriciaUniversità di Parma, Italy. Electronic address:
Second stage of labor is considered to be associated with an increased risk of intrapartum fetal hypoxic injury. This is due to a combination of several risk factors such as -the increased frequency, strength and duration of uterine contractions due to higher number and affinity of myometrial oxytocin receptors; -the Ferguson's reflex which leads to a reflex release of endogenous oxytocin in response of the distension of the cervix by descending fetal head in late stages of labor; maternal expulsive efforts with the Valsalva manoeuvre that may reduce maternal oxygenation, as well as reduce the venous return and maternal cardiac output due to increased intrathoracic pressure, winch may lead to reduced placental oxygenation; - and increased fetal intracranial pressure due to head compression leading to a potential decrease in fetal cerebral oxygenation. In addition, the umbilical cord often forms one or more loops around the fetal neck, which may get tightened as the head descends leading to an acute and intermittent cessation of fetal oxygenation.
View Article and Find Full Text PDFSituations in Which Oxytocin Was Administrated by Paramedics in Out-of-Hospital Births: A Retrospective Analysis over Six Years in the Polish Population.
J Clin Med
November 2024
Department of Emergency Medical Service, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Postpartum haemorrhage (PPH) is a leading cause of maternal mortality worldwide, particularly in low- and middle-income countries, complicating 1% to 10% of deliveries. Despite improvement in prevention and management, variations in PPH definitions and measurement methods contribute to challenges in accurately assessing its incidence, with up to 90% of PPH-related deaths in high-income countries deemed avoidable through timely intervention. Oxytocin is the primary drug administered during labour or miscarriage, causing an increase in uterine muscle tone, which reduces bleeding and the risk of complications.
View Article and Find Full Text PDFStress and parental behaviors.
Neurosci Res
December 2024
Neuroscience Institute, New York University Langone Medical Center, New York, NY, USA; Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA; Department of Neuroscience and physiology, New York University Langone Medical Center, New York, NY, USA. Electronic address:
In nearly all mammalian species, newborn pups are weak and vulnerable, relying heavily on care and protection from parents for survival. Thus, developmentally hardwired neural circuits are in place to ensure the timely expression of parental behaviors. Furthermore, several neurochemical systems, including estrogen, oxytocin, and dopamine, facilitate the emergence and expression of parental behaviors.
View Article and Find Full Text PDFPostpartum Hemorrhage in Humanitarian Settings: Implementation Insights from Using Heat-Stable Carbetocin and Tranexamic Acid.
Int J MCH AIDS
September 2024
United Nations Population Fund, Humanitarian Response Division, Switzerland.
Article Synopsis
- Maternal mortality due to postpartum hemorrhage (PPH) is a significant issue in low-resource settings, and this study examines healthcare providers' perspectives on the effectiveness and challenges of using heat-stable carbetocin (HSC) and tranexamic acid (TXA) for prevention and treatment of PPH.
- The research involved semi-structured interviews and focus group discussions with 64 healthcare workers in South Sudan and Uganda, focusing on a PPH intervention package that included training, readiness kits, and a community support platform.
- Results indicated providers view HSC favorably for preventing bleeding and recognize TXA as effective but noted limited experience with it; challenges included medication confusion and record-keeping issues, while
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!