and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care.
Prior studies have noted a decreased time to delivery of between two and four hours with early amniotomy
but have shown conflicting results on the rate of cesarean section [8-11].
Con la finalidad de responder a la pregunta de si es beneficiosa la amniotomia practicada de rutina en el trabajo de parto, se realizo una revision bibliografica en las bases de datos Medline, Embase y Lilacs, utilizando los terminos amniotomy
, amniotomia, amniorrexis, artificial rupture of the amniotic membranes; se cruzo con labor y se elimino la palabra induction, encontrandose 74 citas publicadas en los ultimos 25 anos, desde articulos de reporte de casos hasta 2 revisiones sistematicas de la biblioteca Cochrane, teniendo como resultado principal el acortamiento del trabajo de parto, una de Fraser y col, actualizada en 1999, y la otra de Smyth y col, actualizada hasta 2007 (1,6).
They were randomized to soak in baths for up to 4 hours or undergo amniotomy
and augmentation as needed, with vaginal exams every 4 hours.
However, the proportion who had labor augmented by amniotomy
, oxytocin or both was significantly lower in the immersion group than in the augmentation group--71% vs.
In both groups, active management of labour was carried out in the form of amniotomy
once patient entered active phase of labour (>3 cm).
So, along with oxytocin administration and early amniotomy
, use of antispasmodic agents to hasten the first stage of labor like hyosine butylbromide, drotaverine, dicyclomine valethamide etc, is also advised4.
The departmental policy for the management of spontaneous labour at term is according to standard protocol which includes early amniotomy
in active labour and augmentation if progress is less than 1cm in an hour.
Most of the time, I can gain entrance to the uterine cavity without performing a concurrent amniotomy
, which allows me to sharply perform the hysterotomy without concern for injuring the fetus.
A randomised controlled trial of early versus delayed use of amniotomy
and oxytocin infusion in nulliparous labour.
Rapid increases in plasma prostaglandin concentrations after vaginal examination and amniotomy
SAN FRANCISCO - Early amniotomy
appears safe and efficacious for shortening labor at term in nulliparous women having an indication for labor induction, according to results of a randomized controlled trial.
Two hundred seventy-four women were randomly assigned to receive membrane sweeping or no membrane sweeping at initiation of formal labor induction with either Cervadil[R] (dinoprostone pessary) or amniotomy
(rupture of membranes).
All women received an amniotomy
and oxytocin when they reached 4-cm dilation.
Immediately after early amniotomy
on diagnosis of labor, 8628 eligible women were randomized to receive either 20 minutes of external fetal monitoring or usual care (intermittent auscultation only).