A recent overview of 23 systematic reviews (16 Cochrane and 7 nonCochrane) relating to the most common care practices for the management of normal labor and delivery in the first stage of labor concluded that evidence does not support routine enemas, perineal shaving, early amniotomy
, continuous electronic fetal heart rate monitoring, and restriction of fluids and food during labor.
doesn't improve other maternal outcomes--instrumented vaginal birth; pain relief; postpartum hemorrhage; serious morbidity or death; umbilical cord prolapse; cesarean section for fetal distress, prolonged labor, antepartum hemorrhage--nor fetal outcomesserious neonatal morbidity or perinatal death; neonatal admission to intensive care; abnormal fetal heart rate tracing in first-stage labor; meconium aspiration; or fetal acidosis (SOR: A, large meta-analyses of RCTs and a single RCT with conflicting results).
and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care.
When ripening of the cervix had been achieved (BS [greater than or equal to] 5), amniotomy
and oxytocin were used to support uterine contractions.
While there is a known increase in the rate of chorioamnionitis in patients exposed to premature spontaneous rupture of membranes [14, 15], none of the randomized controlled trials on early artificial rupture of membranes have been powered to detect differences between the rates of chorioamnionitis in the early and late amniotomy
groups as their primary outcome [8-11].
Our findings confirmed the frequent use of oxytocin in Bialystok hospitals: the birth was induced pharmacologically in 57.5% of cases and 17.5% of the responders were subjected to amniotomy
. No stimulating activities were undertaken in 35.5% of the patients.
In 50% of them, the method of induction was amniotomy
, mostly followed by oxytocin.
This is the standard procedure according to our labour room protocol.10 Maximum of three doses of PGE2 was inserted depending on the Bishop score followed by augmentation with amniotomy
and Oxytocin infusion.
Obese women have slower rates of cervical dilatation (56) so are more likely to need augmentation of labour, as indicated by the need for oxytocin (57% vs 40%) and early amniotomy
(26% vs 15%)36.
Seitchik et al., Amniotomy
and Oxytocin Treatment of Functional
Amniotic fluid sample collection at amniotomy
in laboring patients: The membranes were visualized per Sims speculum examination with good source of light.
The aim of rupturing the amniotic sac (also known as "artificial rupture of the membranes" or "amniotomy
") is to speed UP and strengthen contractions, thus shortening the length of labor.
or Oxytocin for Induction of Labor: Re-Analysis of a Randomized Controlled Trial, 67 Acta Obstetricia et Gynecologica Scandinavica 731 (1988).
The research also found that harm is caused by routine use of intravenous fluids (IVs), amniotomy
(breaking the bag of waters), withholding food and water from women in labor and episiotomy.