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. 2000;2000(4):CD002862.
doi: 10.1002/14651858.CD002862.

Amniotomy alone for induction of labour

L Bricker  1 , M Luckas
Affiliations

Amniotomy alone for induction of labour

L Bricker et al. Cochrane Database Syst Rev. 2000.

Abstract

Background: Amniotomy (deliberate rupture of the membranes) is a simple procedure which can be used alone for induction of labour if the membranes are accessible, thus avoiding the need for pharmacological intervention. However, the time interval from amniotomy to established labour may not be acceptable to clinicians and women, and in a number of cases labour may not ensue. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology.

Objectives: To determine the effects of amniotomy alone for third trimester labour induction in women with a live fetus.

Search strategy: The Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled trials register and bibliographies of relevant papers.

Selection criteria: The criteria for inclusion included the following: (1) clinical trials comparing amniotomy alone for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed above it on a predefined list of labour induction methods; (2) random or pseudo-random allocation to the treatment or control group; (3) ideally adequate allocation concealment (4) violations of allocated management not sufficient to materially affect conclusions; (5) clinically meaningful outcome measures reported; (6) data available for analysis according to the random allocation; (7) missing data insufficient to materially affect the conclusions.

Data collection and analysis: This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology. A strategy was developed to deal with the large volume and complexity of trial data relating to labour induction. This involved a two-stage method of data extraction. The initial data extraction was done centrally, and incorporated into the series of primary reviews arranged by methods of induction of labour. The data from the primary reviews will be incorporated into a series of secondary reviews, arranged by category of woman to reflect clinical scenarios. To avoid duplication of data in the primary reviews, the labour induction methods have been listed in a specific order, from one to 25. Each primary review includes comparisons between one of the methods (from two to 25) with only those methods above it on the list. This review includes comparisons between amniotomy alone (number 5 on the list) with only those methods above it on the list (no treatment / placebo; intravaginal prostaglandins; intracervical prostaglandins; and oxytocin alone).

Main results: Two trials comprising 50 and 260 women respectively were eligible for inclusion in this review. No conclusions could be drawn from comparisons of amniotomy alone versus no intervention, and amniotomy alone versus oxytocin alone (small trial, only one pre-specified outcome reported). No trials compared amniotomy alone with intracervical prostaglandins. One trial compared amniotomy alone with a single dose of vaginal prostaglandins for women with a favourable cervix, and found a significant increase in the need for oxytocin augmentation in the amniotomy alone group (44% versus 15%; RR 2.85, 95% CI 1.82-4.46). This should be viewed with caution as this was the result of a single centre trial. Furthermore, secondary intervention occurred 4 hours after amniotomy, and this time interval may not have been appropriate.

Reviewer's conclusions: Data is lacking about the value of amniotomy alone for induction of labour. While there are now other modern methods available for induction of labour (pharmacological agents), there remain clinical scenarios where amniotomy alone may be desirable and appropriate, and this method is worthy of further research. This research should include evaluation of the appropriate time interval from amniotomy to secondary intervention, women and caregivers' satisfaction and economic analysis.

PubMed Disclaimer

Conflict of interest statement

None known

Figures

1.3
1.3. Analysis
Comparison 1 (1.1) Amniotomy alone versus no intervention: all women, Outcome 3 Caesarean section.
2.3
2.3. Analysis
Comparison 2 (1.2) Amniotomy alone versus no intervention: all women, unfavourable cervix, Outcome 3 Caesarean section.
3.3
3.3. Analysis
Comparison 3 (1.5) Amniotomy alone versus no intervention: all women, intact membranes, unfavourable cervix, Outcome 3 Caesarean section.
4.3
4.3. Analysis
Comparison 4 (2.1) Amniotomy alone versus oxytocin: all women, Outcome 3 Caesarean section.
5.3
5.3. Analysis
Comparison 5 (2.2) Amniotomy alone versus oxytocin: all women, unfavourable cervix, Outcome 3 Caesarean section.
6.3
6.3. Analysis
Comparison 6 (2.5) Amniotomy alone versus oxytocin: all women, intact membranes, unfavourable cervix, Outcome 3 Caesarean section.
7.2
7.2. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
7.3
7.3. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 3 Caesarean section.
7.7
7.7. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 7 Oxytocin augmentation.
7.8
7.8. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
7.10
7.10. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 10 Epidural analgesia.
7.11
7.11. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 11 Instrumental vaginal delivery.
7.12
7.12. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 12 Meconium‐stained liquor.
7.14
7.14. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 14 Neonatal intensive care unit admission.
7.16
7.16. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 16 Perinatal death.
7.18
7.18. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 18 Maternal side‐effects (all).
7.22
7.22. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 22 Maternal pyrexia.
7.23
7.23. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 23 Postpartum haemorrhage.
7.28
7.28. Analysis
Comparison 7 (3.1) Amniotomy alone versus vaginal prostaglandin: all women, Outcome 28 Antibiotics to baby.
8.2
8.2. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
8.3
8.3. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 3 Caesarean section.
8.7
8.7. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 7 Oxytocin augmentation.
8.8
8.8. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
8.10
8.10. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 10 Epidural analgesia.
8.11
8.11. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 11 Instrumental vaginal delivery.
8.12
8.12. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 12 Meconium‐stained liquor.
8.14
8.14. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 14 Neonatal intensive care unit admission.
8.16
8.16. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 16 Perinatal death.
8.18
8.18. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 18 Maternal side‐effects (all).
8.22
8.22. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 22 Maternal pyrexia.
8.23
8.23. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 23 Postpartum haemorrhage.
8.28
8.28. Analysis
Comparison 8 (3.3) Amniotomy alone versus vaginal prostaglandin: all women, favourable cervix, Outcome 28 Antibiotics to baby.
9.2
9.2. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
9.3
9.3. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 3 Caesarean section.
9.7
9.7. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 7 Oxytocin augmentation.
9.8
9.8. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
9.10
9.10. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 10 Epidural analgesia.
9.11
9.11. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 11 Instrumental vaginal delivery.
9.12
9.12. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 12 Meconium‐stained liquor.
9.14
9.14. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 14 Neonatal intensive care unit admission.
9.16
9.16. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 16 Perinatal death.
9.18
9.18. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 18 Maternal side‐effects (all).
9.22
9.22. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 22 Maternal pyrexia.
9.23
9.23. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 23 Postpartum haemorrhage.
9.28
9.28. Analysis
Comparison 9 (3.6) Amniotomy alone versus vaginal prostaglandin: all women, intact membranes, favourable cervix, Outcome 28 Antibiotics to baby.
10.2
10.2. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
10.3
10.3. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 3 Caesarean section.
10.7
10.7. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 7 Oxytocin augmentation.
10.8
10.8. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
10.10
10.10. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 10 Epidural analgesia.
10.11
10.11. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 11 Instrumental vaginal delivery.
10.12
10.12. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 12 Meconium‐stained liquor.
10.14
10.14. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 14 Neonatal intensive care unit admission.
10.16
10.16. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 16 Perinatal death.
10.18
10.18. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 18 Maternal side‐effects (all).
10.22
10.22. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 22 Maternal pyrexia.
10.23
10.23. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 23 Postpartum haemorrhage.
10.28
10.28. Analysis
Comparison 10 (3.10) Amniotomy alone versus vaginal prostaglandin: primiparae, Outcome 28 Antibiotics to baby.
11.2
11.2. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
11.3
11.3. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 3 Caesarean section.
11.7
11.7. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 7 Oxytocin augmentation.
11.8
11.8. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
11.10
11.10. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 10 Epidural analgesia.
11.11
11.11. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 11 Instrumental vaginal delivery.
11.12
11.12. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 12 Meconium‐stained liquor.
11.14
11.14. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 14 Neonatal intensive care unit admission.
11.16
11.16. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 16 Perinatal death.
11.18
11.18. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 18 Maternal side‐effects (all).
11.22
11.22. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 22 Maternal pyrexia.
11.23
11.23. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 23 Postpartum haemorrhage.
11.28
11.28. Analysis
Comparison 11 (3.12) Amniotomy alone versus vaginal prostaglandin: primiparae, favourable cervix, Outcome 28 Antibiotics to baby.
12.2
12.2. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
12.3
12.3. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 3 Caesarean section.
12.7
12.7. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 7 Oxytocin augmentation.
12.8
12.8. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
12.10
12.10. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 10 Epidural analgesia.
12.11
12.11. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 11 Instrumental vaginal delivery.
12.12
12.12. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 12 Meconium‐stained liquor.
12.14
12.14. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 14 Neonatal intensive care unit admission.
12.16
12.16. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 16 Perinatal death.
12.18
12.18. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 18 Maternal side‐effects (all).
12.22
12.22. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 22 Maternal pyrexia.
12.23
12.23. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 23 Postpartum haemorrhage.
12.28
12.28. Analysis
Comparison 12 (3.15) Amniotomy alone versus vaginal prostaglandin: primiparae, intact membranes, favourable cervix, Outcome 28 Antibiotics to baby.
13.2
13.2. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
13.3
13.3. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 3 Caesarean section.
13.7
13.7. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 7 Oxytocin augmentation.
13.8
13.8. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
13.10
13.10. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 10 Epidural analgesia.
13.11
13.11. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 11 Instrumental vaginal delivery.
13.12
13.12. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 12 Meconium‐stained liquor.
13.14
13.14. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 14 Neonatal intensive care unit admission.
13.16
13.16. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 16 Perinatal death.
13.18
13.18. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 18 Maternal side‐effects (all).
13.22
13.22. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 22 Maternal pyrexia.
13.23
13.23. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 23 Postpartum haemorrhage.
13.28
13.28. Analysis
Comparison 13 (3.19) Amniotomy alone versus vaginal prostaglandin: multiparae, Outcome 28 Antibiotics to baby.
14.2
14.2. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
14.3
14.3. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 3 Caesarean section.
14.7
14.7. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 7 Oxytocin augmentation.
14.8
14.8. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
14.10
14.10. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 10 Epidural analgesia.
14.11
14.11. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 11 Instrumental vaginal delivery.
14.12
14.12. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 12 Meconium‐stained liquor.
14.14
14.14. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 14 Neonatal intensive care unit admission.
14.16
14.16. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 16 Perinatal death.
14.18
14.18. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 18 Maternal side‐effects (all).
14.22
14.22. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 22 Maternal pyrexia.
14.23
14.23. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 23 Postpartum haemorrhage.
14.28
14.28. Analysis
Comparison 14 (3.21) Amniotomy alone versus vaginal prostaglandin: multiparae, favourable cervix, Outcome 28 Antibiotics to baby.
15.2
15.2. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 2 Uterine hyperstimulation with fetal heart rate changes.
15.3
15.3. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 3 Caesarean section.
15.7
15.7. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 7 Oxytocin augmentation.
15.8
15.8. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 8 Uterine hyperstimulation without fetal heart rate changes.
15.10
15.10. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 10 Epidural analgesia.
15.11
15.11. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 11 Instrumental vaginal delivery.
15.12
15.12. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 12 Meconium‐stained liquor.
15.14
15.14. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 14 Neonatal intensive care unit admission.
15.16
15.16. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 16 Perinatal death.
15.18
15.18. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 18 Maternal side‐effects (all).
15.22
15.22. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 22 Maternal pyrexia.
15.23
15.23. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 23 Postpartum haemorrhage.
15.28
15.28. Analysis
Comparison 15 (3.24) Amniotomy alone versus vaginal prostaglandin: multiparae, intact membranes, favourable cervix, Outcome 28 Antibiotics to baby.
See this image and copyright information in PMC

References

References to studies included in this review

Jagani 1982 {published data only}
    1. Jagani N, Schulman H, Fleischer A, Mitchell J, Randolph G. Role of the cervix in the induction of labor. Obstetrics & Gynecology 1982;59:21‐6. - PubMed
Mahmood 1995 {published data only}
    1. Mahmood TA, Rayner A, Smith NC, Beat I. A randomised prospective trial comparing single dose prostaglandin E2 vaginal gel with forewater amniotomy for induction of labour. European Journal of Obstetrics & Gynecology and Reproductive Biology 1995;58:111‐7. - PubMed

References to studies excluded from this review

Chanrachakul 2003 {published data only}
    1. Chanrachakul B, Herabutya Y. Postterm with favorable cervix: is induction necessary?. European Journal of Obstetrics & Gynecology and Reproductive Biology 2003;106:154‐7. - PubMed
Secher 1981 {published data only}
    1. Secher NJ, Lange AP, Hassing Nielsen F, Thomson Pedersen G, Westergaard JG. Induction of labor with and without primary amniotomy. A randomized study of prostaglandin E2 tablets and intravenous oxytocin. Acta Obstetricia et Gynecologica Scandinavica 1981;60:237‐41. - PubMed
Sivasuriya 1978 {published data only}
    1. Sivasuriya M, Tan KL, Salmon YM, Karim SMM. Neonatal serum bilirubin levels in spontaneous and induced labour. British Journal of Obstetrics and Gynaecology 1978;85:619‐23. - PubMed
Thornton 1989 {published data only}
    1. Thornton S, Davison JM, Baylis PH. Amniotomy‐induced labour is not mediated by endogenous oxytocin. British Journal of Obstetrics and Gynaecology 1989;96:945‐8. - PubMed
Ward 1991 {published data only}
    1. Ward SJ. Induction of labour using prostaglandin gel in patients with a favourable cervix. Proceedings of 2nd European Congress on Prostaglandins in Reproduction; 1991 April 30‐May 3; The Hague, Netherlands. 1991:143.
Westergaard 1983 {published data only}
    1. Westergaard JG, Lange AP, Pedersen GT, Secher NJ. Oral oxytocics for induction of labor. Acta Obstetricia et Gynecologica Scandinavica 1983;62:103‐10. - PubMed

References to studies awaiting assessment

Macones 2011 {published data only}
    1. Macones G, Stamilio D, Rampersad R, Cahill AG, Odibo AO. The efficacy of early amniotomy in nulliparous labor induction: a randomized controlled trial. American Journal of Obstetrics and Gynecology 2011;204(1 Suppl):S4. - PubMed
Rijnders 2007 {published data only}
    1. Rijnders MEB. Costs and effects of amniotomy at home for induction of post term pregnancy (ongoing trial). Current Controlled Trials (www.controlled‐trials.com) (accessed 15 February 2007).

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