title: Early amniotomy after dinoprostone insert used for the induction of labor: a randomized clinical trial.
abstract: OBJECTIVE
  We assessed whether early amniotomy, after ripening with a dinoprostone insert, reduces the duration of labor or increases the rate of delivery within the following 24 h.
  
  
  METHODS
  A prospective randomized controlled study was conducted on 200 consenting, term pregnant women at the Zeynep Kamil Maternity and Children's Training and Research Hospital. Each participant received vaginal inserts of 10 mg dinoprostone. The women were randomly assigned to one of two groups: early amniotomy (artificial rupture of membranes when cervical dilation was at 3 cm) or standard amniotomy (the membranes were left to rupture spontaneously). The primary outcome measures were the time from induction to delivery, and the proportion of women who delivered within 24 h.
  
  
  RESULTS
  The median time interval from induction to delivery (13.72 h compared to 22.73 h) was significantly shorter for women who underwent early amniotomy (p < 0.05). The frequency of vaginal delivery within 24 h was higher in women with early amniotomy (89% compared with 45% in the standard amniotomy, p < 0.05).
  
  
  CONCLUSIONS
  Early amniotomy, after ripening with a dinoprostone insert, is a safe and efficient method for speeding up delivery times without increasing caesarian rates during labor inductions.
authors.affiliation: a Department of Obstetrics and Gynecology , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Evrim
authors.initials: E
authors.lastname: Bostancı
authors.affiliation: a Department of Obstetrics and Gynecology , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Eser
authors.affiliation: a Department of Obstetrics and Gynecology , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Yayla Abide
authors.affiliation: a Department of Obstetrics and Gynecology , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Kılıccı
authors.affiliation: a Department of Obstetrics and Gynecology , Zeynep Kamil Maternity and Children's Training and Research Hospital , Istanbul , Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kucukbas
mesh_terms: D000328:Adult; D000074885:Amniotomy / Q000706:statistics & numerical data*; D020070:Cervical Ripening; D015232:Dinoprostone; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D010120:Oxytocics; D011247:Pregnancy; D055815:Young Adult
chemical_list: D010120:Oxytocics; D015232:Dinoprostone
keywords: Induction of labor; dinoprostone; early amniotomy