Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

If You Use a Screen Reader

This content is available through Read Online (Free) program, which relies on page scans. Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.

Active Management Of Labour: Current Knowledge And Research Issues

James G. Thornton and Richard J. Lilford
BMJ: British Medical Journal
Vol. 309, No. 6951 (Aug. 6, 1994), pp. 366-369
Published by: BMJ
Stable URL: http://www.jstor.org/stable/29724395
Page Count: 4
  • Read Online (Free)
  • Subscribe ($19.50)
  • Cite this Item
Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Active Management Of Labour: Current Knowledge And Research Issues
Preview not available

Abstract

Objectives—To review the evidence that the package of labour interventions collectively called "active management"—namely, strict diagnostic criteria for labour, early amniotomy, early use of oxytocin, and continuous professional support—reduce rates of caesarean sections and operative vaginal delivery in first labours. Design—Review of observational data, supplemented by evidence from four separate overviews of relevant randomised trials previously published as part of the Cochrane Collaboration pregnancy and childbirth database. Results—Observational data do not permit a clear conclusion. There have been no randomised trials of the total package of active management or of the use of strict diagnostic criteria alone, but trials of early amniotomy, early oxytocin, and these interventions combined do not suggest that these interventions are effective in reducing rates of caesarean sections or operative vaginal deliveries. In contrast, the provision of continuous professional support in labour seems to reduce both types of operative delivery, although the effect on caesarean sections is confined to those settings where non-professional companions are not normally present in labour. Conclusions—Delivery units should endeavour to provide continuous professional support in labour, but routine use of amniotomy and early oxytocin is not recommended.

Page Thumbnails

  • Thumbnail: Page 
366
    366
  • Thumbnail: Page 
367
    367
  • Thumbnail: Page 
368
    368
  • Thumbnail: Page 
369
    369