Closed loop automatic infusion system for induction of labour based on external tocography.

Abstract

AbstractA closed loop automatic infusion system for titrating oxytocin to induce labour based on external tocography was evaluated. Fourty‐one nulliparae and 28 multi‐parae were induced with this system. The obstetric outcome was good with only six caesarean sections; two for fetal distress, two for failed induction and two for malposition and failure to progress. Six nulliparae needed assisted vaginal delivery for prolonged second stage, three due to malposition and three due to poor maternal effort. No multiparae had an instrumental vaginal delivery. Five nulliparae and one multipara with poor cervical score (<=5) were transfered to conventional peristaltic infusion system at the end of nine hours due to failure of progress with clinically inadequate uterine contractions. Of the six, two delivered vaginaily whereas 4 required caesarean section.The neonatal outcome assessed by 1 min and 5 min Agpar scores and umbilical cord arterial pH values was good. The frequency of hypertonic uterine activity was low. With the safety features of alarm and cessation of oxytocin infusion, when uterine hypertonus or abnormal fetal heart rate is encountered, the equipment appears to be an asset for the practice of induction of labour. The adequacy of it's programme for nulliparae with poor score (<=5) has to be further evaluated.