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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Evaluation of outcomes after implementation of an induction-of-labor protocol
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Evaluation of outcomes after implementation of an induction-of-labor protocol

机译：实施引产协议后的结果评估

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Objective The purpose of this study was to determine whether adherence to an induction of labor (IOL) protocol decreases the rate of failed IOL (FIOL). Study Design We performed a 1-year retrospective chart review around the implementation of a hospital IOL protocol and compared maternal and neonatal outcomes from deliveries managed per protocol (n = 369) with those deliveries that were not (n = 230). Women at least 24 weeks' gestation with cervical dilation up to 2 cm who underwent an indicated IOL were included. Protocol-adherent (PA) inductions had amniotomy within 24 hours of starting oxytocin, intrauterine pressure catheter placement in latent labor, Montevideo units titrated to 200-300 or to adequate cervical change, and oxytocin administered for at least 12 hours after amniotomy before FIOL was diagnosed (defined as delivery by cesarean during latent labor as a result of failure to enter active labor). The primary outcome was the rate of FIOL. Control for possible confounders was made by stratification and multivariate modeling. Results FIOL rates were lowest in the PA group, which remained significant after stratification on parity and multivariate analysis (nulliparous women, 3.8% vs 9.8%; P =.043; multiparous women, 0% vs 6%; P <.0004). Median time to delivery was shortest in the PA group by 3.5 hours in nulliparous women (16.0 vs 19.5 hours, respectively; P =.0002) and 1.5 hours in multiparous women (10.75 vs 12.25 hours, respectively; P <.0001). There were no differences in infectious morbidity or neonatal outcomes between the groups. Conclusion Adherence to a standardized IOL protocol is associated with a decreased rate of FIOL and length of labor.
机译：目的这项研究的目的是确定是否遵循引产协议（IOL）可以降低失败的IOL（FIOL）发生率。研究设计我们对一项医院IOL方案的实施情况进行了为期1年的回顾性图表审查，并将按方案管理的分娩（n = 369）与未分娩的未分娩（n = 230）的母亲和新生儿结局进行了比较。包括至少妊娠24周，宫颈扩张不超过2厘米且接受指定IOL的妇女。遵循协议的（PA）诱导在开始催产素后24小时内进行羊膜切开术，将子宫内压导管放置在潜在的分娩中，将蒙得维的亚单位滴定至200-300或适当的宫颈改变，并在羊膜切开术后至少12小时内给予催产素，然后再行FIOL。被诊断（定义为由于无法参加现役而在分娩时剖宫产）。主要结局是FIOL发生率。通过分层和多变量建模来控制可能的混杂因素。结果PA组的FIOL发生率最低，经均等和多因素分析分层后仍保持显着水平（无卵妇女，3.8％对9.8％; P = .043;多产妇女，0％对6％; P <.0004）。在PA组中，未产妇的分娩中位时间最短，为3.5小时（分别为16.0和19.5小时; P = .0002）和多产妇女的1.5个小时（分别为10.75和12.25小时; P <.0001）。两组之间的感染率或新生儿结局无差异。结论遵守标准化的IOL协议可减少FIOL的发生率并减少劳动时间。

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