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

[Display omitted] 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. This study aimed to determine the efficacy of oxytocin combined with calcium v...

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Veröffentlicht in:American journal of obstetrics & gynecology MFM 2024-11, Vol.6 (11), p.101502, Article 101502
Hauptverfasser: Cai, Ruixiang, Chen, Lingyan, Xing, Yunguang, Deng, Yuguo, Li, Juan, Guo, Fangfang, Liu, Li, Xie, Cuihua, Yang, Jinying
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container_issue 11
container_start_page 101502
container_title American journal of obstetrics & gynecology MFM
container_volume 6
creator Cai, Ruixiang
Chen, Lingyan
Xing, Yunguang
Deng, Yuguo
Li, Juan
Guo, Fangfang
Liu, Li
Xie, Cuihua
Yang, Jinying
description [Display omitted] 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. 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. 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. 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. 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. [Display omitted]
doi_str_mv 10.1016/j.ajogmf.2024.101502
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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. 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. 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. 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. [Display omitted]</description><identifier>ISSN: 2589-9333</identifier><identifier>EISSN: 2589-9333</identifier><identifier>DOI: 10.1016/j.ajogmf.2024.101502</identifier><identifier>PMID: 39307241</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; calcium ; Calcium Gluconate - administration &amp; dosage ; combination therapy ; Delivery, Obstetric - methods ; Delivery, Obstetric - statistics &amp; numerical data ; Drug Therapy, Combination ; Female ; Fetal Membranes, Premature Rupture ; Humans ; labor induction ; Labor, Induced - methods ; Oxytocics - administration &amp; dosage ; oxytocin ; Oxytocin - administration &amp; dosage ; Oxytocin - pharmacology ; Pregnancy ; premature rupture of membranes ; Single-Blind Method</subject><ispartof>American journal of obstetrics &amp; gynecology MFM, 2024-11, Vol.6 (11), p.101502, Article 101502</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. 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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. 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. 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. 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. [Display omitted]</description><subject>Adult</subject><subject>calcium</subject><subject>Calcium Gluconate - administration &amp; dosage</subject><subject>combination therapy</subject><subject>Delivery, Obstetric - methods</subject><subject>Delivery, Obstetric - statistics &amp; numerical data</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Fetal Membranes, Premature Rupture</subject><subject>Humans</subject><subject>labor induction</subject><subject>Labor, Induced - methods</subject><subject>Oxytocics - administration &amp; dosage</subject><subject>oxytocin</subject><subject>Oxytocin - administration &amp; dosage</subject><subject>Oxytocin - pharmacology</subject><subject>Pregnancy</subject><subject>premature rupture of membranes</subject><subject>Single-Blind Method</subject><issn>2589-9333</issn><issn>2589-9333</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1OWzEQha2qqCDgDVDlZTcJ_s8NC6QKUaiExAbWlmOPW0fX16nty98b9K1xuKHqitUcjb_jGfsgdELJnBKqTtdzs06_op8zwsS2JQn7hA6Y7JazJef88396Hx2XsiaEMCqEZOoL2udLThZM0AP09_bpuSYbBvwY6m9sTW_DGPFDwen9wKeMw-BGW0MacPK4N6u3Fn5MEXbGCjniTYZo6pgB53HzVhsdIa6yGaCcYYObcCmGF3DYpqHm1PdN1hxMf4T2vOkLHO_qIbr_cXl3cT27ub36efH9ZmbbwnW2XHEhF4ZTypTz0IEyjngplKeGcqpkJ5hQ1EmvFtJT5oFI5zswxCvDwPBD9G26d5PTnxFK1TEUC33fdkxj0ZySjncdZbShYkJtTqVk8HqTQzT5WVOitznotZ5y0Nsc9JRDs33dTRhXEdw_0_uvN-B8AqC98yFA1sUGGCy4kMFW7VL4eMIr9POdWw</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Cai, Ruixiang</creator><creator>Chen, Lingyan</creator><creator>Xing, Yunguang</creator><creator>Deng, Yuguo</creator><creator>Li, Juan</creator><creator>Guo, Fangfang</creator><creator>Liu, Li</creator><creator>Xie, Cuihua</creator><creator>Yang, Jinying</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202411</creationdate><title>Oxytocin with calcium vs oxytocin for induction of labor in women with term premature rupture of membranes: a randomized controlled trial</title><author>Cai, Ruixiang ; 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gynecology MFM</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cai, Ruixiang</au><au>Chen, Lingyan</au><au>Xing, Yunguang</au><au>Deng, Yuguo</au><au>Li, Juan</au><au>Guo, Fangfang</au><au>Liu, Li</au><au>Xie, Cuihua</au><au>Yang, Jinying</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oxytocin with calcium vs oxytocin for induction of labor in women with term premature rupture of membranes: a randomized controlled trial</atitle><jtitle>American journal of obstetrics &amp; gynecology MFM</jtitle><addtitle>Am J Obstet Gynecol MFM</addtitle><date>2024-11</date><risdate>2024</risdate><volume>6</volume><issue>11</issue><spage>101502</spage><pages>101502-</pages><artnum>101502</artnum><issn>2589-9333</issn><eissn>2589-9333</eissn><abstract>[Display omitted] 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. 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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. 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. [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39307241</pmid><doi>10.1016/j.ajogmf.2024.101502</doi></addata></record>
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subjects Adult
calcium
Calcium Gluconate - administration & dosage
combination therapy
Delivery, Obstetric - methods
Delivery, Obstetric - statistics & numerical data
Drug Therapy, Combination
Female
Fetal Membranes, Premature Rupture
Humans
labor induction
Labor, Induced - methods
Oxytocics - administration & dosage
oxytocin
Oxytocin - administration & dosage
Oxytocin - pharmacology
Pregnancy
premature rupture of membranes
Single-Blind Method
title Oxytocin with calcium vs oxytocin for induction of labor in women with term premature rupture of membranes: a randomized controlled trial
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