{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T01:56:26Z","timestamp":1773107786818,"version":"3.50.1"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["20K09618,21K09447"],"award-info":[{"award-number":["20K09618,21K09447"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Although fetal growth restriction (FGR) is associated with an increased risk of cesarean delivery during induced labor, there is limited evidence to guide labor management. This study aimed to investigate the prognosis of induced labor in pregnancies with suspected FGR and whether oxytocin discontinuation during the active phase of labor affects maternal and neonatal outcomes.<\/jats:p><jats:p>\n            Study Design\u2003This retrospective cohort study investigated singleton pregnancies with vertex presentation and indications for labor induction owing to FGR after 34.0 weeks of gestation at Osaka University Hospital. From January 2010 to December 2013, women were conventionally managed, and oxytocin was continued until delivery unless there was an indication for discontinuation (conventional management group). From January 2013 to December 2020, oxytocin was routinely discontinued, or the dose was reduced at the beginning of the active phase of labor (oxytocin discontinuation group).<\/jats:p><jats:p>\n            Results\u2003A total of 161 women (conventional management group, n\u2009=\u200974; oxytocin discontinuation group, n\u2009=\u200987) were included. After the active phase of induced labor, the total incidence of cesarean delivery was very low (3.1%), and the duration was short (173\u2009\u00b1\u2009145\u2009minutes). Oxytocin discontinuation was associated with lower cesarean delivery (1.1 vs. 5.4%; p\u2009=\u20090.12) and uterine tachysystole (9.8 vs. 23.0%; p\u2009=\u20090.08) rates and longer duration of the second stage of labor (mean: 56.5\u2009\u00b1\u200990 vs. 34.2\u2009\u00b1\u200945\u2009minutes; p\u2009=\u20090.08) than conventional management; however, the difference was not significant. The other maternal and neonatal outcomes, including postpartum hemorrhage, did not also significantly differ between them.<\/jats:p><jats:p>\n            Conclusion\u2003After the active phase of induced labor for suspected FGR, the risk of cesarean delivery is low, and the high incidence of uterine tachysystole and rapid labor progression should be considered cautiously. Oxytocin can be safely discontinued during the active phase of labor in women undergoing labor induction for FGR without an increased risk of cesarean delivery or other unfavorable outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1933-7340","type":"journal-article","created":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T23:01:35Z","timestamp":1661900495000},"page":"e739-e746","source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Outcome of Inducing Labor in Pregnancies with Suspected Fetal Growth Restriction: Oxytocin Discontinuation during the Active Phase of Labor versus Conventional Management"],"prefix":"10.1055","volume":"41","author":[{"given":"Sayuri","family":"Iwai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0950-7110","authenticated-orcid":false,"given":"Kazuya","family":"Mimura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoko","family":"Kawanishi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Hiramatsu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuji","family":"Tomimatsu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S855","DOI":"10.1016\/j.ajog.2017.12.004","article-title":"Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy","volume":"218","author":"L M McCowan","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"c7087","DOI":"10.1136\/bmj.c7087","article-title":"Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT)","volume":"341","author":"K E Boers","year":"2010","journal-title":"BMJ"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/uog.9041","article-title":"Neurobehavioral outcomes in preterm, growth-restricted infants with and without prenatal advanced signs of brain-sparing","volume":"38","author":"F Figueras","year":"2011","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"07","key":"ref4","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1002\/uog.6249","article-title":"Neurodevelopmental outcome in 2-year-old infants who were small-for-gestational age term fetuses with cerebral blood flow redistribution","volume":"32","author":"E Eixarch","year":"2008","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"8","DOI":"10.14390\/jsshp.HRP2021-010","article-title":"Diagnosis and management of fetal growth restriction and uteroplacental dysfunction in hypertensive disorders of pregnancy in Japan: a nationwide survey by the Japan Society for the Study of Hypertension in Pregnancy (JSSHP)","volume":"10","author":"K Mimura","year":"2022","journal-title":"Hypertens Res Pregnancy"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/S0002-9378(99)70271-1","article-title":"Double-blind comparison of carbetocin versus oxytocin in prevention of uterine atony after cesarean section","volume":"180","author":"J Dansereau","year":"1999","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1111\/j.1399-6576.2009.01964.x","article-title":"Oxytocin infusion: acute hyponatraemia, seizures and coma","volume":"53","author":"D Bergum","year":"2009","journal-title":"Acta Anaesthesiol Scand"},{"issue":"01","key":"ref8","first-page":"100","article-title":"The comparative examination of the effect of two oxytocin administration methods of labor induction on labor duration stages","volume":"16","author":"P Bahadoran","year":"2011","journal-title":"Iran J Nurs Midwifery Res"},{"key":"ref9","first-page":"23","article-title":"A randomized clinical trial on the need of continuing oxytocin infusion in active phase of induced labour","volume":"12","author":"L N Begum","year":"2013","journal-title":"Chattagram Maa-O-Shisu Hosp Med Coll J"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/1471-0528.13589","article-title":"Continuation versus discontinuation of oxytocin infusion during the active phase of labour: a randomised controlled trial","volume":"123","author":"P Bor","year":"2016","journal-title":"BJOG"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"320","DOI":"10.5001\/omj.2015.66","article-title":"Stopping oxytocin in active labor rather than continuing it until delivery: a viable option for the induction of labor","volume":"30","author":"S Chopra","year":"2015","journal-title":"Oman Med J"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"471.e1","DOI":"10.1016\/j.ajog.2012.08.035","article-title":"Oxytocin discontinuation during active labor in women who undergo labor induction","volume":"207","author":"L C Diven","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3109\/14767058.2014.906573","article-title":"Effect of oxytocin discontinuation during the active phase of labor","volume":"28","author":"F H \u00d6zt\u00fcrk","year":"2015","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref14","first-page":"121","article-title":"Comparative study between continuous use of oxytocin infusion throughout the active phase of labor versus its discontinuation and its effect on the course of labor","volume":"79","author":"A Rashwan","year":"2011","journal-title":"Med J Cairo Univ"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1111\/j.1471-0528.2004.00096.x","article-title":"For how long should oxytocin be continued during induction of labour?","volume":"111","author":"E Daniel-Spiegel","year":"2004","journal-title":"BJOG"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/j.1447-0756.2007.00659.x","article-title":"Prospective randomized study of oxytocin discontinuation after the active stage of labor is established","volume":"33","author":"E Ustunyurt","year":"2007","journal-title":"J Obstet Gynaecol Res"},{"issue":"06","key":"ref18","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1111\/jog.12419","article-title":"Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2014 edition","volume":"40","author":"H Minakami","year":"2014","journal-title":"J Obstet Gynaecol Res"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1097\/01.AOG.0000429658.85846.f9","article-title":"ACOG practice bulletin no. 134: fetal growth restriction","volume":"121","author":"American College of Obstetricians and Gynecologists","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"18","key":"ref20","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.3109\/14767058.2014.980807","article-title":"Fetal growth restriction: risk factors for unplanned primary cesarean delivery","volume":"28","author":"K M Horowitz","year":"2015","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1002\/uog.10150","article-title":"Estimated weight centile as a predictor of perinatal outcome in small-for-gestational-age pregnancies with normal fetal and maternal Doppler indices","volume":"39","author":"S Savchev","year":"2012","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"03","key":"ref22","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1097\/AOG.0b013e31820b0884","article-title":"Fetal brain Doppler to predict cesarean delivery for nonreassuring fetal status in term small-for-gestational-age fetuses","volume":"117","author":"R Cruz-Mart\u00ednez","year":"2011","journal-title":"Obstet Gynecol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1016\/S0140-6736(15)00131-2","article-title":"Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study","volume":"386","author":"U Sovio","year":"2015","journal-title":"Lancet"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1002\/uog.20850","article-title":"Risk factors for cesarean delivery in pregnancy with small-for-gestational-age fetus undergoing induction of labor","volume":"55","author":"C Nwabuobi","year":"2020","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"10","key":"ref25","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1111\/j.1447-0756.2011.01563.x","article-title":"The Doppler cerebroplacental ratio predicts non-reassuring fetal status in intrauterine growth restricted fetuses at term","volume":"37","author":"S Murata","year":"2011","journal-title":"J Obstet Gynaecol Res"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1097\/AOG.0000000000002325","article-title":"Discontinuing oxytocin infusion in the active phase of labor: a systematic review and meta-analysis","volume":"130","author":"G Saccone","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref27","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.wombi.2018.07.003","article-title":"Oxytocin discontinuation after the active phase of induced labor: a systematic review","volume":"32","author":"A Hern\u00e1ndez-Mart\u00ednez","year":"2019","journal-title":"Women Birth"},{"issue":"24","key":"ref28","doi-asserted-by":"crossref","first-page":"4041","DOI":"10.1080\/14767058.2019.1702958","article-title":"Changes in labor outcomes after implementing structured use of oxytocin augmentation with a 4-hour action line","volume":"34","author":"F E Austad","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/aogs.12821","article-title":"Judicious use of oxytocin augmentation for the management of prolonged labor","volume":"95","author":"J Rossen","year":"2016","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"150","DOI":"10.14740\/jocmr2058w","article-title":"Clinical significance of precipitous labor","volume":"7","author":"S Suzuki","year":"2015","journal-title":"J Clin Med Res"},{"issue":"10","key":"ref31","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1542\/pir.35.10.417","article-title":"Respiratory distress in the newborn","volume":"35","author":"S Reuter","year":"2014","journal-title":"Pediatr Rev"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1097\/01.AOG.0000444441.04111.1d","article-title":"Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery","volume":"123","author":"American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1097\/AOG.0000000000003467","article-title":"Labor curve analysis of medically indicated early preterm induction of labor","volume":"134","author":"D A Becker","year":"2019","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1933-7340.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:15:46Z","timestamp":1730812546000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1933-7340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,30]]},"references-count":32,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1933-7340","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8,30]]},"published":{"date-parts":[[2022,8,30]]}}}