Significance of internal tocography and intrapartal tocolysis in the management of labor

Geburtshilfe und Frauenheilkunde
A Hohlbein, J Heinrich

Abstract

The quantitation of uterine activity in 5,611 deliveries shows the following frequency of tocographic alarm criteria: high amplitude of labour greater than or equal to 11 kPa (82.5 Torr), 3.1%; high frequency of labour greater than or equal to 6 labours/10 min 4.6%; total contraction area greater than or equal to 40 kPa-min (300 Torr-min/10 min) 5.4%; high uterine basal tonus greater than or equal to 4 kPa (30 Torr) 0.9%; irregularity of labour 3.5%. In 70% the uterine hyperactivity is the reason for pathological FHF-patterns which induced an intravenous bolus injection of 25 micrograms Partusisten or an automatic continuous infusion before operative delivery. A second retrospective report covers 8,895 deliveries with a rate of 26.9% betamimetic treatments (preterm 41.5%) and only 8.1% pathological FHF-patterns. The low incidence of acidosis in the umbilical arteria (pHNA less than 7.10) of 2.6% in preterm and 0.6% in term newborn is caused by our obstetrical management including elective foetal monitorings and consistently realized betamimetic treatment during labour.

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