To investigate whether the use ofintrauterine tocodynamometry versus external tocodynamometry (IT versus ET)during labour reduces operative deliveries and improves newborn outcome. As ITprovides more accurate information on labour contractions, the hypothesis wasthat it may more appropriately guide oxytocin use than ET.
Randomised controlled trial.
Two labour wards, in a university tertiaryhospital and a central hospital.
A total of 1504 parturients with singletonpregnancies, gestational age ≥37 weeks and fetus in cephalic position: 269women with uterine scars, 889 nulliparas and 346 parous women with oxytocinaugmentation.
Participants underwent IT (n = 736)or ET (n = 768) during the active first stage of labour.
【Main outcome measures】
Primary outcome: rate of operativedeliveries. Secondary outcomes: duration of labour, amount of oxytocin given,adverse neonatal outcomes.
Operative delivery rates were 26.9% (IT)and 25.9% (ET) (odds ratio 1.05, 95% CI 0.84–1.32, P = 0.663).The ET to IT conversion rate was 31%. We found no differences in secondaryoutcomes (IT versus ET). IT reduced oxytocin use during labours with signs offetal distress, and trial of labour after caesarean section.
IT did not reduce the rate of operativedeliveries, use of oxytocin, or adverse neonatal outcomes, and it did notshorten labour duration.