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Related Experiment Video

Updated: May 9, 2026

Electromyometrial Imaging of Uterine Contractions in Pregnant Women
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Published on: May 26, 2023

Internal versus external tocodynamometry during induced or augmented labour.

Jannet J H Bakker1, Petra F Janssen, Karlijn van Halem

  • 1Department of Obstetrics and Gynaecology, Academic Medical Center, Meibergdreef 9, Amsterdam, Netherlands, 1105 AZ.

The Cochrane Database of Systematic Reviews
|August 6, 2013
PubMed
Summary

Internal tocodynamometry (IT) and external tocodynamometry (ET) show no significant differences in maternal or neonatal outcomes during oxytocin-induced labor. Insufficient evidence exists to recommend one method over the other for labor induction or augmentation.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Clinical Trials

Background:

  • Uterine contraction monitoring is crucial during oxytocin-induced labor to prevent fetal distress from hyperstimulation.
  • Internal tocodynamometry (IT) offers more accurate intrauterine pressure measurement than external tocodynamometry (ET).
  • IT involves higher costs and potential risks compared to ET.

Purpose of the Study:

  • To compare the effectiveness of internal tocodynamometry (IT) versus external tocodynamometry (ET) for monitoring uterine contractions during labor induction or augmentation with intravenous oxytocin.

Main Methods:

  • Searched Cochrane Pregnancy and Childbirth Group's Trials Register and PubMed for relevant randomized controlled trials.
  • Included published randomized controlled trials comparing IT and ET in women receiving oxytocin for labor induction or augmentation.
  • Excluded quasi-randomized trials; extracted data independently, assessing risk of bias.

Main Results:

  • Three studies with 1945 women were included; risk of bias was mixed.
  • No significant differences were found between IT and ET for neonatal outcomes (Apgar score, umbilical artery pH, NICU admission, hospitalization).
  • Instrumental delivery rates and hyperstimulation incidence did not differ significantly between the IT and ET groups.

Conclusions:

  • This review found no significant differences in maternal or neonatal outcomes between internal and external tocodynamometry.
  • Based on moderate-quality evidence from three studies, there is insufficient data to recommend one method over the other.
  • Further research may be needed to definitively guide the choice of tocodynamometry during oxytocin administration for labor induction or augmentation.