title: Effect of early amniotomy on the outcome of spontaneous labour: a randomized controlled trial of pregnant women in Enugu, South-east Nigeria.
abstract: BACKGROUND
  Early amniotomy is common in obstetric practice but, its effectiveness has not been proven.
  
  
  OBJECTIVE
  To determine the effects of early amniotomy on the duration of labour, and other maternal / neonatal outcomes of uncomplicated pregnancies in Enugu, South-east Nigeria.
  
  
  METHODS
  A randomized controlled study of 214 consenting term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Intervention group received amniotomy early in active labour while the control group had their membranes conserved.
  
  
  RESULTS
  Mean duration of labour for the amniotomy group (279.4 ± 53.7 minutes) was significantly lower than that of control group (354.4 ± 67.5 minutes), (t = -8.988, p <0.001). Three (3.8%) women in amniotomy group needed oxytocin augmentation as against 21 (19.6%) women in the control group RR = 0.14, (CI 95%: 0.04 - 0.46), NNT = 16. The two groups did not vary with respect to cesarean section rate, newborn Apgar scores, and need for new born special care unit admission.
  
  
  CONCLUSIONS
  Early amniotomy when compared to fetal membrane conservation reduced the duration of labour and need for oxytocin augmentation among term singleton pregnant women in Enugu, Nigeria. Its routine use in well selected cases may reduce prolonged labour and its complications.
authors.affiliation: Departments of Obstetrics and Gynaecology, College of Medicine Enugu State University of Science and Technology, Enugu Nigeria.
authors.forename: Livinus N
authors.initials: LN
authors.lastname: Onah
authors.affiliation: Departments of Obstetrics and Gynaecology, College of Medicine University of Nigeria Enugu Campus, Nigeria.
authors.forename: Cyril C
authors.initials: CC
authors.lastname: Dim
authors.affiliation: Departments of Obstetrics and Gynaecology, College of Medicine University of Nigeria Enugu Campus, Nigeria.
authors.forename: Uchenna I
authors.initials: UI
authors.lastname: Nwagha
authors.affiliation: Departments of Obstetrics and Gynaecology, College of Medicine University of Nigeria Enugu Campus, Nigeria.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Ozumba
mesh_terms: D000328:Adult; D000650:Amnion / Q000601:surgery*; D005321:Extraembryonic Membranes; D005260:Female; D005865:Gestational Age; D006784:Hospitals, Teaching; D006801:Humans; D007745:Labor Onset; D009549:Nigeria; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013997:Time Factors
chemical_list: D010121:Oxytocin
keywords: Early amniotomy; Enugu-Nigeria; caesarean section rate; duration of labour; oxytocin augmentation; term pregnancy