Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care

Abstract

In prevention trials, early intervention with amniotomy and oxytocin appears to be associated with a modest reduction in the rate of caesarean section over standard care.

Labour augmentation and fetal outcomes in relation to birth positions: A secondary analysis of an RCT evaluating birth seat births

“…Yet no significant difference in duration of the second stage of labour was reported. A Cochrane systematic review showed that early augmentation of labour was associated with an increase in spontaneous vaginal births (Wei et al, 2009 Bugg et al, (2011) did not find any detectable adverse effects for mother or infant with oxytocin use. However several researchers have reported that women who were given synthetic oxytocin were less likely to achieve a spontaneous vaginal birth.…”

Oxytocin administration during spontaneous labor: Guidelines for clinical practice. Chapter 3: Interventions associated with oxytocin administration during spontaneous labor

“…A c c e p t e d M a n u s c r i p t 6 6 We identified four meta-analyses grouping together randomized or quasi-randomized trials published between 1998 and 2013 on this topic [5][6][7][8]. The first meta-analysis focused on the combined effects of an early amniotomy and early prescription of oxytocin on the risk of cesareans in nulliparas.…”

“…This first meta-analysis was updated in 2013 in the Cochrane Database [6], which excluded the studies with small sample sizes [9,10,11] and the two unpublished trials (Labrecque et al, Verkuyl et al). It also included 9 supplementary studies [8,[12][13][14][15][16][17][18][19][20][21][22][23].…”

“…It also included 9 supplementary studies [8,[12][13][14][15][16][17][18][19][20][21][22][23]. This meta-analysis (14 studies, 8033 women), unlike the first one [5], concerned both nulliparous and parous women, but had the same objectives [6]. The authors found a non-significant trend towards a reduction in the risk of cesarean delivery in the overall intervention group (n=8033, RR 0.89, 95% CI 0.79-1.01).…”

“…It used 7 of the 14 studies included in [6] above and found a modest but not significant reduction in the number of cesareans in the active management group (n=5390, RR 0.88, 95% CI 0.77-1.01) [7] (LE2). Finally, the meta-analysis by Wei et al [6] also included the meta-analysis published in 2000 by Saddler [8] (LE2). None of these meta-analyses found any other comorbidity associated with one management rather than another.…”