Value Assessed of Amniotomy in Shortening Labor

Review of studies suggests some increased risk of Caesarean section, but findings inconclusive

MONDAY, Oct. 22 (HealthDay News) -- A review of studies assessing the safety and efficacy of amniotomy, or "breaking of the waters," for shortening labor concludes that the procedure should not be routinely employed, although the results were qualified, according to a report published online Oct. 17 in the Cochrane Database of Systematic Reviews.

Rebecca M.D. Smyth, a research associate at the University of Liverpool in the U.K., and colleagues reviewed 14 randomized trials involving 4,893 women with singleton pregnancies, comparing amniotomy alone versus intention to preserve amniotic membranes.

No differences were observed between the two groups in length of the first stage of labor, although differences in study measurements may have influenced that finding. There was some evidence to suggest that the amniotomy group might have a reduced risk of five-minute Apgar score of less than seven, and that it might increase the risk of delivery by Caesarean section, but those findings did not reach the level of statistical significance.

"On the basis of the findings of this review, we cannot recommend that amniotomy should be introduced routinely as part of standard labor management and care," the authors conclude.

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