Early amniotomy after vaginal misoprostol for induction of labor: a randomized clinical trial

Makarem, M.H.; Zahran, Kamal M.; Abdellah, Mohamad S.; Karen, Mohamed A.

doi:10.1007/s00404-013-2747-6

Cited by 12 publications

(14 citation statements)

References 17 publications

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“…3,6 Despite the differences in definition used, almost all studies show a reduction in the duration of labor with early amniotomy. 3,5,6,8,10 The association of early amniotomy with route of delivery, however, has been inconsistent. Some studies have demonstrated an increased risk of cesarean 3,4,11,12,14 while others have reported no significant difference, 6,[8][9][10]17 and one noted a decreased risk.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have demonstrated an increased risk of cesarean 3,4,11,12,14 while others have reported no significant difference, 6,[8][9][10]17 and one noted a decreased risk. 5 Variation in study design and adoption of a more modern labor curve likely contribute to these discrepant outcomes. Overall, previous retrospective cohort studies were more likely to demonstrate an increase in cesarean compared with randomized controlled trials.…”

Section: Discussionmentioning

confidence: 99%

“…Although the majority of published randomized controlled trials and observational studies of early amniotomy in labor induction demonstrate that early amniotomy shortens the duration of labor, [3][4][5][6][7][8][9][10] the effect on cesarean delivery has been inconsistent. [3][4][5][6][8][9][10][11][12][13][14] It is challenging to interpret available data owing to the lack of a clear definition for "early amniotomy."…”

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confidence: 99%

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Maternal and Neonatal Outcomes Associated with Amniotomy among Nulliparous Women Undergoing Labor Induction at Term

et al. 2020

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Objective The aim of the study is to evaluate the association between amniotomy at various time points during labor induction and maternal and neonatal outcomes among term, nulliparous women. Study Design Secondary analysis of a randomized trial of term labor induction versus expectant management in low-risk, nulliparous women (2014–2017) was conducted. Women met inclusion criteria if they underwent induction ≥38 weeks' gestation using oxytocin with documented time and type of membrane rupture. Women with antepartum stillbirth or fetal anomaly were excluded. The primary outcome was cesarean delivery. Secondary outcomes included maternal and neonatal complications. Maternal and neonatal outcomes were compared among women with amniotomy versus women with intact membranes and no amniotomy at six 2-hour time intervals: before oxytocin initiation, 0 to <2 hours after oxytocin, 2 to <4 hours after, 4 to <6 hours after, 6 to <8 hours after, and 8 to <10 hours after. Multivariable logistic regression adjusted for maternal age, body mass index, race/ethnicity, modified Bishop score on admission, treatment group, and hospital (as a random effect). Results Of 6,106 women in the parent trial, 2,854 (46.7%) women met inclusion criteria. Of these 2,340 (82.0%) underwent amniotomy, and majority of the women had amniotomy performed between 2 and <6 hours after oxytocin. Cesarean delivery was less frequent among women with amniotomy 6 to <8 hours after oxytocin compared with women without amniotomy (21.9 vs. 29.7%; adjusted odds ratio 0.61, 95% confidence interval 0.42–0.89). Amniotomy at time intervals ≥4 hours after oxytocin was associated with lower odds of labor duration >24 hours. Amniotomy at time intervals ≥2 hours and <8 hours after oxytocin was associated with lower odds of maternal hospitalization >3 days. Amniotomy was not associated with postpartum or neonatal complications. Conclusion Among a contemporary cohort of nulliparous women undergoing term labor induction, amniotomy was associated with either lower or similar odds of cesarean delivery and other adverse outcomes, compared with no amniotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Maternal and Neonatal Outcomes Associated with Amniotomy among Nulliparous Women Undergoing Labor Induction at Term

et al. 2020

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“…Early artificial rupture of membranes (AROM) has been shown to decrease the duration of labour induction when defined as AROM <3 or 4 cm dilation, [5][6][7] AROM <1 h after transcervical Foley removal, 8 and AROM concurrent with or prior to oxytocin initiation. 6,9 The findings regarding an association between early AROM and caesarean delivery in these studies are conflicting, and evidence about the utility of early AROM in multiparous induction is lacking. Furthermore, no prior observational cohort study or randomised controlled trial has been sufficiently powered to evaluate the association between early AROM and rare adverse outcomes such as severe maternal and neonatal morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…Many providers have concerns about the potential increase in complications such as umbilical cord prolapse, caesarean delivery, infection, and neonatal intensive care unit admission. Early artificial rupture of membranes (AROM) has been shown to decrease the duration of labour induction when defined as AROM <3 or 4 cm dilation, AROM <1 h after transcervical Foley removal, and AROM concurrent with or prior to oxytocin initiation . The findings regarding an association between early AROM and caesarean delivery in these studies are conflicting, and evidence about the utility of early AROM in multiparous induction is lacking.…”

Section: Introductionmentioning

confidence: 99%

Association between early amniotomy in labour induction and severe maternal and neonatal morbidity

Battarbee

Glover

Stamilio

2019

Aust NZ J Obst Gynaeco

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Background Amniotomy is a commonly used, inexpensive method of labour induction; however, the optimal timing of amniotomy during labour induction is debated. Aims To investigate whether artificial rupture of membranes <4 cm dilation is associated with caesarean, severe maternal and neonatal morbidity, and labour induction duration. Materials and Methods Retrospective cohort study of 228 438 deliveries at 19 US hospitals. Women with a viable, singleton gestation undergoing induction ≥37 weeks with cervical dilation <4 cm were included. Women were excluded if membranes spontaneously ruptured <4 cm. Women were compared by early amniotomy (<4 cm dilation) versus not early. The primary outcome was caesarean. Secondary outcomes included severe maternal and neonatal morbidity, and labour duration. Logistic and Cox proportional hazard regression estimated the association between early amniotomy and study outcomes. Results Of 15 525 eligible women, 10 421 (67%) had early amniotomy. Early amniotomy was associated with higher adjusted odds of caesarean and severe maternal morbidity, but not neonatal morbidity. After accounting for interaction, early amniotomy was associated with increasingly higher odds of caesarean as body mass index increased. Early amniotomy was associated with lower odds of severe maternal morbidity among multiparas with mechanical ripening. Median labour induction was 2.5 h shorter with early amniotomy, significant in hazard regression. Conclusions Early amniotomy was associated with increased odds of caesarean among obese women. The association between early amniotomy and severe maternal morbidity varied by maternal characteristics, but early amniotomy was not associated with neonatal morbidity. Early amniotomy in labour induction may be advantageous in certain populations, particularly non‐obese women requiring mechanical ripening.

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Early amniotomy after cervical ripening for induction of labor: a systematic review and meta-analysis of randomized controlled trials

Vivo

Carbone

Saccone

et al. 2020

American Journal of Obstetrics and Gynecology

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Early amniotomy after vaginal misoprostol for induction of labor: a randomized clinical trial

Abstract: Early amniotomy after vaginal misoprostol for labor induction is associated with higher successful vaginal delivery rate, shorter labor duration and better neonatal outcome.

Cited by 12 publications

References 17 publications

Maternal and Neonatal Outcomes Associated with Amniotomy among Nulliparous Women Undergoing Labor Induction at Term

Maternal and Neonatal Outcomes Associated with Amniotomy among Nulliparous Women Undergoing Labor Induction at Term

Association between early amniotomy in labour induction and severe maternal and neonatal morbidity

Early amniotomy after cervical ripening for induction of labor: a systematic review and meta-analysis of randomized controlled trials

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