For Monitoring Labor, Is Inside the Uterus Better Than Outside?

Internal measurement of uterine contractions during induction or augmentation of labor has been advocated by organizations such as the American College of Obstetricians and Gynecologists and the Dutch Society of Obstetrics and Gynaecology, but whether this approach leads to better outcomes is uncertain. Dutch investigators conducted a randomized controlled nonblinded trial to compare outcomes of deliveries that involved internal (734) or external (722) monitoring. The primary outcome was rate of instrumental or cesarean deliveries. Participants had singleton, vertex pregnancies of >36 weeks' gestation and underwent induction or augmentation of labor with oxytocin.

Operative deliveries were performed in 31% of the internal group and 30% of th…