title: Uterine tachysystole in spontaneous labor at term.
abstract: OBJECTIVE
  The objective of this study is to determine the incidence of uterine tachysystole and its association with spontaneous labor at term.
  
  
  METHODS
  A retrospective cohort study of 8008 women in spontaneous labor (without prostaglandins or oxytocin). Fetal heart tracings and uterine activity were recorded every 15 min.
  
  
  METHODS
  occurrence of tachysystole (> 5 uterine contractions /10 min over 30 min periods).
  
  
  RESULTS
  non-reassuring fetal heart tracings (NRFHT), NICU admissions, and cesarean deliveries.
  
  
  RESULTS
  About 890 patients (11.1 %) had at least one episode of tachysystole. Non-whites have higher incidence of uterine tachysystole; adjusted odds ratio (aOR) was 1.66 for Hispanics (95% CI 1.28-2.05), 1.58 for African Americans (95% CI 1.05-2.38), and 1.51 for Asians (95% CI = 1.13-2.0). The use of epidural analgesia was higher in the tachysystole group (62.2% versus 40.9%, aOR 1.89, CI 1.58-2.26; p < 0.001). Tachysystole was more frequent among nulliparous women and in women carrying higher weight fetuses. Oligohydramnios (aOR 1.62, CI 0.70-3.72; p < 0.004), and NRFHT were more common in the tachysystole group (4.2% versus 2.5%, p = 0.002). Newborns in the tachysystole group were two times more likely to be admitted to NICU (30 /890 [3.4%] versus 122 /7118 [1.7%], OR = 2, p=0.001). There was no difference in the frequency of meconium-stained amniotic fluid or Apgar scores <7 at 5 min.
  
  
  CONCLUSIONS
  Uterine tachysystole occurs in more than 10% of spontaneous labors and is associated with NRFHR, increased rate of caesarean deliveries and NICU admissions. It is not associated with low Apgar scores or meconium-stained amniotic fluid.
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal Fetal Medicine Division, Wayne State University School of Medicine , Detroit , MI , USA .|b Department of Medical Genetics , Wayne State University School of Medicine , Detroit , MI , USA .
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: Ahmed
authors.affiliation: c Department of Obstetrics and Gynecology , Maimonides Medical Center , Brooklyn , NY , USA , and.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhu
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal Fetal Medicine Division, Wayne State University School of Medicine , Detroit , MI , USA .|d Department of Obstetrics and Gynecology , King Abdul-Aziz University , Jeddah , Saudi Arabia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Aldhaheri
authors.affiliation: a Department of Obstetrics and Gynecology , Maternal Fetal Medicine Division, Wayne State University School of Medicine , Detroit , MI , USA .
authors.forename: Sharif
authors.initials: S
authors.lastname: Sakr
authors.affiliation: c Department of Obstetrics and Gynecology , Maimonides Medical Center , Brooklyn , NY , USA , and.
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.affiliation: c Department of Obstetrics and Gynecology , Maimonides Medical Center , Brooklyn , NY , USA , and.
authors.forename: Shoshana
authors.initials: S
authors.lastname: Haberman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D009518:New York / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D011247:Pregnancy; D012189:Retrospective Studies; D014590:Uterine Contraction / Q000502:physiology*; D055815:Young Adult
keywords: Epidural analgesia; NRFHT; spontaneous labor; uterine tachysystole