title: Identification of first-stage labor arrest by electromyography in term nulliparous women after induction of labor.
abstract: BACKGROUND
  Worldwide induction and cesarean delivery rates have increased rapidly, with consequences for subsequent pregnancies. The majority of intrapartum cesarean deliveries are performed for failure to progress, typically in nulliparous women at term. Current uterine registration techniques fail to identify inefficient contractions leading to first-stage labor arrest. An alternative technique, uterine electromyography has been shown to identify inefficient contractions leading to first-stage arrest of labor in nulliparous women with spontaneous onset of labor at term. The objective of this study was to determine whether this finding can be reproduced in induction of labor.
  
  
  METHODS
  Uterine activity was measured in 141 nulliparous women with singleton term pregnancies and a fetus in cephalic position during induced labor. Electrical activity of the myometrium during contractions was characterized by its power density spectrum.
  
  
  RESULTS
  No significant differences were found in contraction characteristics between women with induced labor delivering vaginally with or without oxytocin and women with arrested labor with subsequent cesarean delivery.
  
  
  CONCLUSIONS
  Uterine electromyography shows no correlation with progression of labor in induced labor, which is in contrast to spontaneous labor.
authors.affiliation: Department of Obstetrics, University Medical Center, Utrecht, the Netherlands.
authors.forename: Blanka
authors.identifier: http://orcid.org/0000-0002-7641-4897
authors.initials: B
authors.lastname: Vasak
authors.affiliation: Department of Obstetrics, University Medical Center, Utrecht, the Netherlands.
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: Graatsma
authors.affiliation: Department of Obstetrics, The Sykehuset Telemark HF Hospital, Skien, Norway.
authors.forename: Elske
authors.initials: E
authors.lastname: Hekman-Drost
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Marinus J
authors.identifier: http://orcid.org/0000-0001-9400-0615
authors.initials: MJ
authors.lastname: Eijkemans
authors.affiliation: Department of Obstetrics, Sint Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Jules H
authors.initials: JH
authors.lastname: Schagen van Leeuwen
authors.affiliation: Department of Obstetrics, University Medical Center, Utrecht, the Netherlands.
authors.forename: Gerard H A
authors.initials: GHA
authors.lastname: Visser
authors.affiliation: Department of Obstetrics, University Medical Center, Utrecht, the Netherlands.
authors.forename: Benoit C
authors.initials: BC
authors.lastname: Jacod
mesh_terms: D000328:Adult; D004576:Electromyography; D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000502:physiology*; D007751:Labor, Induced; D008875:Middle Aged; D009426:Netherlands; D007744:Obstetric Labor Complications / Q000175:diagnosis* / Q000503:physiopathology; D010298:Parity; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D014590:Uterine Contraction / Q000502:physiology*; D055815:Young Adult
keywords: Cesarean delivery; induction of labor; labor arrest; parturition; uterine electromyography