title: Early amniotomy after vaginal misoprostol for induction of labor: a randomized clinical trial.
abstract: OBJECTIVE
  To test the effectiveness and safety of early amniotomy after vaginal misoprostol for the induction of labor.
  
  
  METHODS
  A randomized clinical trial that included 320 women with medical or obstetric indication for labor induction. They were randomly assigned into two equal groups, amniotomy group and control group. Each participant received vaginal misoprostol 50 μg every 6 h for induction of labor. In amniotomy group, amniotomy was done in the early active phase of labor while in the control group, the membranes were left to rupture spontaneously or as judged by the senior resident in the duty.
  
  
  RESULTS
  More subjects in the amniotomy group achieved vaginal delivery within 24 h than in the control group [117 (73.13 %) vs. 105 (65.63 %)]. Subjects in the amniotomy group reported shorter induction to delivery interval (09.72 ± 4.61 h vs. 13.61 ± 5.61, P = .002), and better neonatal outcome compared to the control group. There were no statistically significant differences between both group with regard to number of doses of misoprostol, need for oxytocin, Cesarean Section indication and maternal side effects.
  
  
  CONCLUSIONS
  Early amniotomy after vaginal misoprostol for labor induction is associated with higher successful vaginal delivery rate, shorter labor duration and better neonatal outcome.
authors: Department of Obstetrics and Gynecology, Faculty of medicine, Women's Health Centre, Assiut University, P.O. 71116, Assiut, Egypt.
authors: Mohamed H
authors: MH
authors: Makarem
authors: Kamal M
authors: KM
authors: Zahran
authors: Mohamad S
authors: MS
authors: Abdellah
authors: Mohamed A
authors: MA
authors: Karen
mesh_terms: D000328:Adult; D000650:Amnion / Q000601:surgery*; D001034:Apgar Score; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007751:Labor, Induced / Q000009:adverse effects / Q000379:methods*; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D011247:Pregnancy; D013997:Time Factors; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol