Oxytocin with calcium vs oxytocin for induction of labor in women with term premature rupture of membranes: a randomized controlled trial

IF 3.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

American Journal of Obstetrics & Gynecology Mfm Pub Date : 2024-09-20 DOI:10.1016/j.ajogmf.2024.101502

Ruixiang Cai MD, Lingyan Chen MD, Yunguang Xing BD, Yuguo Deng MD, Juan Li MD, Fangfang Guo BD, Li Liu BD, Cuihua Xie BD, Jinying Yang PhD

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引用次数: 0

Abstract

BACKGROUND

Intravenous calcium administration has shown promise in enhancing uterine contractions and reducing blood loss during cesarean delivery, but this regimen has not been compared in vaginal labor induction.

OBJECTIVE

This study aimed to determine the efficacy of oxytocin combined with calcium vs oxytocin alone for inducing labor in women with term premature rupture of membranes.

STUDY DESIGN

This single-blind, randomized controlled trial was conducted between October 2022 and May 2023 at a tertiary university hospital. Patients diagnosed with premature rupture of membranes were randomly allocated into 2 groups. The intervention group received a bolus of 10 mL of calcium gluconate followed by a continuous infusion of oxytocin via a pump (n=210), whereas the control group received only oxytocin infusion (n=218). The primary outcome was successful vaginal deliveries within 24 hours after labor induction. The secondary outcomes included the interval from labor induction to delivery, vaginal delivery blood loss, and maternal and neonatal complications.

RESULTS

Baseline characteristics, including maternal age, body mass index, and Bishop score before labor induction, were comparable between the groups. The rate of vaginal delivery within 24 hours after labor induction was statistically higher in the intervention group (79.52% vs 70.64%; P=.04). The participants in the intervention group experienced a shortened interval between labor induction and delivery (10.48 vs 11.25 hours; P=.037) and demonstrated a higher success rate in labor induction assessed by the onset of the active phase (93.80% vs 87.61%; P=.04) without increasing the cesarean delivery rate. Reduced hemorrhage was observed in the intervention group (242.5 vs 255.0 mL; P=.0015), and the maternal and neonatal outcomes were comparable between the groups.

CONCLUSION

The coadministration of calcium and oxytocin in labor induction among pregnancies with premature rupture of membranes was more efficient and safer than the administration of oxytocin alone. Our research suggests that the combination therapy of calcium and oxytocin may offer significant advantages during the process of labor induction and result in better outcomes.

Video Abstract

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Video.

查看原文本刊更多论文

用钙催产素与催产素对胎膜早破产妇进行引产：随机对照试验：催产素加葡萄糖酸钙引产。

背景：静脉注射钙剂在增强子宫收缩和减少剖宫产术失血方面显示出良好的前景，但该方案尚未在阴道引产中进行过比较：目的：确定催产素联合钙剂与单用催产素对胎膜早破（PROM）产妇引产的疗效：这项单盲随机对照试验于 2022 年 10 月至 2023 年 5 月在一家三级大学医院进行。确诊为胎膜早破的患者被随机分配到两组。干预组接受 10 毫升葡萄糖酸钙栓剂，然后通过泵持续输注催产素（n = 210），而对照组仅接受催产素输注（n = 218）。主要结果是引产后 24 小时内经阴道成功分娩。次要结果包括从引产到分娩的时间间隔、阴道分娩失血量以及产妇和新生儿并发症：两组产妇的基线特征（包括产妇年龄、体重指数、引产前主教评分）相当。干预组在引产后 24 小时内经阴道分娩的比例较高（79.52% 对 70.64%；P = 0.04）。干预组患者从引产到分娩的时间间隔缩短了（10.48 小时 vs. 11.25 小时；P = 0.037），根据活跃期的开始来评估，干预组的引产成功率更高（93.80% vs. 87.61%；P = 0.04），但剖宫产率没有增加。干预组的出血量减少（242.5 毫升对 255.0 毫升；P = 0.0015），两组产妇和新生儿的结局相当：结论：在有 PROM 的孕妇中，联合使用钙剂和催产素进行引产比单独使用催产素更有效、更安全。我们的研究表明，在引产过程中联合使用钙剂和催产素可能具有显著优势，并能获得更好的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Obstetrics & Gynecology Mfm Medicine-Medicine (all)

CiteScore

7.40

自引率

3.20%

发文量

254

审稿时长

40 days

期刊介绍： The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including: Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women. Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health. Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child. Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby. Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.