Early amniotomy after vaginal misoprostol for induction of labor: a randomized clinical trial
- 517 Downloads
To test the effectiveness and safety of early amniotomy after vaginal misoprostol for the induction of labor.
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.
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.
Early amniotomy after vaginal misoprostol for labor induction is associated with higher successful vaginal delivery rate, shorter labor duration and better neonatal outcome.
KeywordsAmniotomy Induction of labor Misoprostol
Conflict of interest
The authors have no conflicts of interest concerning the work reported in this paper.
- 3.Alfirevic Z (2001) Oral misoprostol for induction of labour (Cochrance Review). Cochrane Database Syst Rev 2:CD001338.EAGoogle Scholar
- 4.Boulvain M and Irion O (2000) Stripping/sweeping of the membranes for inducing labour or preventing post-term pregnancy 2004. Cochrane Database Syst Rev (2):CD000451Google Scholar
- 5.Boulvain Michel, Anthony J Kelly, Cornelia Lohse, Catalin M Stan, Olivier Irion (2001) “Mechanical methods for induction of labour”. Cochrane Database of Syst Rev (4): CD001233. doi: 10.1002/14651858.CD001233. PMID 11687101
- 6.Selo-Ojeme Dan O, Pisal Pradnya, Lawal Olalekan, Rogers Cathy, Shah Abhijeet, Sinha Smitha (2009) A randomised controlled trial of amniotomy and immediate oxytocin infusion versus amniotomy and delayed oxytocin infusion for induction of labour at term. Arch Gynecol Obstet 279:813–820PubMedCrossRefGoogle Scholar
- 7.Dreifuss JJ (1993) Oxytocin in reproductive biology: newly discovered sites of production and of action. In: Campana A (ed) Reproductive health. Ares Serono Symposia, Lisbon, pp 71–74Google Scholar
- 9.Fraser WD, Turcot L, Krauss I, Brisson-Carrol G (2000) Amniotomy for shortening spontaneous labour. Cochrane Database Syst Rev (2):CD000015Google Scholar
- 10.Fraser WD, Turcot L, Krauss I, Brisson-Carrol G (2006) Amniotomy for shortening spontaneous labour. Cochrane Database Syst Rev Issue 3: Art. No.:CD000015. DOI: 10.1002/14651858 (withdrawn)
- 11.Garite TJ, Porto M, Carlson NJ, Rumney PJ, Reimbold PA Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange 92668. 1993 Jun;168(6 Pt 1):1827–31; discussion 1831–2Google Scholar
- 15.Li N, Wang Y, Zhou H (2006) Effects of routine early amniotomy on labor and health status of fetus and neonate: a meta-analysis. Shonghua Fu Chan Ke Za Zhi 41:16–19 (in Chinese)Google Scholar
- 17.Nachum Z, Garmi G, Kadan Y, Zafran N, Shalev E, Salim R.Rappaport Faculty of Medicine Technion, Israel Institute of Technology, Department of Obstetrics and Gynecology, Ha’Emek Medical Center, Afula, Israel. 2010 Nov 7;8:136Google Scholar
- 18.Seaward PG, Hannah ME, Myhr TL et al (1997) International multicentre term prelabor rupture of membranes study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. Am J Obstet Gynecol 177:1024–1029PubMedCrossRefGoogle Scholar
- 22.Wei S, Wo BL, Xu H, Luo ZC, Roy C, Fraser WD Département d’Obstétrique-Gynécologie, Université de Montréal, Hôpital Sainte-Justine, Bureau 4986, 3175 Chemin de la côte Sainte-Catherine, Montréal, Province of Quebec, Canada, H3T 1C5. 2009 Apr 15;(2):CD006Google Scholar