title: A randomized controlled trial of early amniotomy.
abstract: OBJECTIVE-To determine if a policy of early amniotomy resulted in a reduction in mean labour duration when compared to a policy of conservation of the membranes. DESIGN-A single-centre randomized controlled trial. SETTING-A tertiary care teaching hospital in Alberta, Canada. SUBJECTS-Ninety-seven term nulliparae in spontaneous labour, baby in cephalic presentation. INTERVENTION-Early amniotomy versus intent to keep membranes intact. MAIN OUTCOME MEASURES-Interval from randomization to delivery, rate of abnormalities of fetal heart rate tracings, cord artery blood pH, Apgar scores. RESULTS-The mean interval from randomization to delivery was 390.9 (SE 29.1) min in the amniotomy group and 442.9 (SE 34.1) min in the control group (P = 0.251). There were no differences between groups in the occurrence of fetal heart rate tracing abnormalities, nor was there a difference in the proportion of babies with abnormal Apgar scores, or abnormal cord pH (less than 7.20). CONCLUSION-The results of the study fail to support the long held belief that early amniotomy is an effective method for reducing labour duration.
authors.affiliation: University of Calgary, Department of Obstetrics and Gynaecology.
authors.forename: W D
authors.initials: WD
authors.lastname: Fraser
authors.forename: R
authors.initials: R
authors.lastname: Sauve
authors.forename: I J
authors.initials: IJ
authors.lastname: Parboosingh
authors.forename: T
authors.initials: T
authors.lastname: Fung
authors.forename: R
authors.initials: R
authors.lastname: Sokol
authors.forename: D
authors.initials: D
authors.lastname: Persaud
mesh_terms: D000650:Amnion / Q000601:surgery*; D001034:Apgar Score; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007747:Labor Stage, First; D007751:Labor, Induced / Q000379:methods*; D011247:Pregnancy; D013997:Time Factors