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. 2001;2001(3):CD003250.
doi: 10.1002/14651858.CD003250.

Amniotomy plus intravenous oxytocin for induction of labour

G R Howarth  1 , D J Botha
Affiliations

Amniotomy plus intravenous oxytocin for induction of labour

G R Howarth et al. Cochrane Database Syst Rev. 2001.

Abstract

Background: Induction of labour is a common obstetric intervention. Amniotomy alone for induction of labour is reviewed separately and oxytocin alone for induction of labour is being prepared for inclusion in The Cochrane Library. This review will address the use of the combination of these two methods for induction of labour in the third trimester. This is one of a series of reviews of methods of cervical ripening and labour induction using standardised methodology.

Objectives: To determine, from the best available evidence, the efficacy and safety of amniotomy and intravenous oxytocin for third trimester induction of labour.

Search strategy: The Cochrane Pregnancy and Childbirth Group Trials Register, the Cochrane Controlled Trials Register and reference lists of articles were searched. Date of last search: May 2001.

Selection criteria: The criteria for inclusion included the following: (1) clinical trials comparing amniotomy plus intravenous oxytocin used 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 allocation to the treatment or control group; (3) 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: Trial quality assessment and data extraction were done by both reviewers. 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 a series of primary reviews arranged by methods of induction of labour, following a standardised methodology. The data is to be extracted from the primary reviews into a series of secondary reviews, arranged by category of woman.

Main results: Seventeen trials involving 2566 women were included. Amniotomy and intravenous oxytocin were found to result in fewer women being undelivered vaginally at 24 hours than amniotomy alone (relative risk (RR) 0.03, 95% confidence intervals (CI) 0.001-0.49). This finding was based on the results of a single study of 100 women. As regards secondary results amniotomy and intravenous oxytocin resulted in significantly fewer instrumental vaginal deliveries than placebo (RR 0.18, CI 0.05-0.58). Amniotomy and intravenous oxytocin resulted in more postpartum haemorrhage than vaginal prostaglandins (RR 5.5, CI 1.26-24.07). Significantly more women were also dissatisfied with amniotomy and intravenous oxytocin when compared with vaginal prostaglandins, RR 53, CI 3.32-846.51.

Reviewer's conclusions: Data on the effectiveness and safety of amniotomy and intravenous oxytocin are lacking. No recommendations for clinical practice can be made on the basis of this review. Amniotomy and intravenous oxytocin is a combination of two methods of induction of labour and both methods are utilised in clinical practice. If their use is to be continued it is important to compare the effectiveness and safety of these methods, and to define under which clinical circumstances one may be preferable to another.

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Conflict of interest statement

None known

Figures

1.3
1.3. Analysis
Comparison 1 IV (intravenous) oxytocin and amniotomy versus placebo/no treatment: all women, Outcome 3 Caesarean section.
1.4
1.4. Analysis
Comparison 1 IV (intravenous) oxytocin and amniotomy versus placebo/no treatment: all women, Outcome 4 Serious neonatal morbidity or perinatal death.
1.10
1.10. Analysis
Comparison 1 IV (intravenous) oxytocin and amniotomy versus placebo/no treatment: all women, Outcome 10 Epidural analgesia.
1.12
1.12. Analysis
Comparison 1 IV (intravenous) oxytocin and amniotomy versus placebo/no treatment: all women, Outcome 12 Meconium stained liquor.
1.25
1.25. Analysis
Comparison 1 IV (intravenous) oxytocin and amniotomy versus placebo/no treatment: all women, Outcome 25 Woman not satisfied.
5.1
5.1. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 1 Vaginal delivery not achieved within 24 hours.
5.2
5.2. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 2 Uterine hyperstimulation with FHR changes.
5.3
5.3. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 3 Caesarean section.
5.4
5.4. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 4 Serious neonatal morbidity or perinatal death.
5.5
5.5. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 5 Serious maternal morbidity or death.
5.6
5.6. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 6 Cervix unfavourable/unchanged after 12 ‐24 hours.
5.7
5.7. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 7 Oxytocin augmentation.
5.8
5.8. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 8 Uterine hyperstimulation without FHR changes.
5.9
5.9. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 9 Uterine rupture.
5.10
5.10. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 10 Epidural analgesia/opioid analgesia.
5.11
5.11. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 11 Instrumental vaginal delivery.
5.12
5.12. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 12 Meconium stained liquor.
5.13
5.13. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 13 Apgar score <7 at 5 minutes.
5.14
5.14. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 14 Neonatal intensive care unit admission.
5.16
5.16. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 16 Perinatal death.
5.19
5.19. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 19 Nausea.
5.20
5.20. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 20 Vomiting.
5.21
5.21. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 21 Diarrhoea.
5.23
5.23. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 23 Post partum haemorrhage.
5.25
5.25. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 25 Woman not satisfied.
5.27
5.27. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 27 Chorioamnionitis.
5.28
5.28. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 28 Retained placenta.
5.29
5.29. Analysis
Comparison 5 IV oxytocin and amniotomy versus vaginal PG:all women, Outcome 29 Precipitate labour.
6.1
6.1. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
6.3
6.3. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 3 Caesarean section.
6.5
6.5. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 5 Serious maternal morbidity or death.
6.6
6.6. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 6 Cervix unfavourable/unchanged after 12 ‐24 hours.
6.7
6.7. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 7 Oxytocin augmentation.
6.8
6.8. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 8 Uterine hyperstimulation without FHR changes.
6.9
6.9. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 9 Uterine rupture.
6.10
6.10. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 10 Epidural analgesia/opioid analgesia.
6.11
6.11. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 11 Instrumental vaginal delivery.
6.13
6.13. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 13 Apgar score <7 at 5 minutes.
6.14
6.14. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 14 Neonatal intensive care unit admission.
6.23
6.23. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 23 Post partum haemorrhage.
6.29
6.29. Analysis
Comparison 6 IV oxytocin and amniotomy versus vaginal PG: all women, unfavourable cervix, Outcome 29 Precipitate labour.
7.2
7.2. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 2 Uterine hyperstimulation with FHR changes.
7.3
7.3. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 3 Caesarean section.
7.4
7.4. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 4 Serious neonatal morbidity or perinatal death.
7.6
7.6. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 6 Cervix unfavourable/unchanged after 12 ‐24 hours.
7.7
7.7. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 7 Oxytocin augmentation.
7.8
7.8. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 8 Uterine hyperstimulation without FHR changes.
7.10
7.10. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 10 Epidural analgesia/opioid analgesia.
7.11
7.11. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 11 Instrumental vaginal delivery.
7.12
7.12. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 12 Meconium stained liquor.
7.13
7.13. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 13 Apgar score <7 at 5 minutes.
7.14
7.14. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 14 Neonatal intensive care admission.
7.19
7.19. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 19 Nausea.
7.23
7.23. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 23 Post partum haemorrhage.
7.25
7.25. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 25 Woman not satisfied.
7.28
7.28. Analysis
Comparison 7 IV oxytocin and amniotomy versus vaginal PG; all women, favourable cervix, Outcome 28 Retained placenta.
8.2
8.2. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 2 Uterine hyperstimulation with FHR changes.
8.3
8.3. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 3 Caesarean section.
8.4
8.4. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 4 Serious neonatal morbidity or perinatal death.
8.5
8.5. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 5 Serious maternal morbidity or death.
8.10
8.10. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 10 Epidural analgesia/opioid analgesia.
8.11
8.11. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 11 Instrumental vaginal delivery.
8.19
8.19. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 19 Nausea.
8.20
8.20. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 20 Vomiting.
8.21
8.21. Analysis
Comparison 8 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, variable or undefined cervix, Outcome 21 Diarrhoea.
9.3
9.3. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 3 Caesarean section.
9.6
9.6. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 6 Cervix unfavourable/unchanged after 12 ‐24 hours.
9.8
9.8. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 8 Uterine hyperstimulation without FHR changes.
9.11
9.11. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 11 Instrumental vaginal delivery.
9.12
9.12. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 12 Meconium stained liquor.
9.14
9.14. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 14 Neonatal intensive care admission.
9.19
9.19. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 19 Nausea.
9.28
9.28. Analysis
Comparison 9 IV oxytocin and amniotomy versus vaginal PG: all women, intact membranes, favourable cervix, Outcome 28 Retained placenta.
10.3
10.3. Analysis
Comparison 10 IV oxytocin and amniotomy versus vaginal PG:all primiparae, Outcome 3 Caesarean section.
10.5
10.5. Analysis
Comparison 10 IV oxytocin and amniotomy versus vaginal PG:all primiparae, Outcome 5 Serious maternal morbidity or death.
10.7
10.7. Analysis
Comparison 10 IV oxytocin and amniotomy versus vaginal PG:all primiparae, Outcome 7 Oxytocin augmentation.
10.8
10.8. Analysis
Comparison 10 IV oxytocin and amniotomy versus vaginal PG:all primiparae, Outcome 8 Uterine hyperstimulation without FHR changes.
10.11
10.11. Analysis
Comparison 10 IV oxytocin and amniotomy versus vaginal PG:all primiparae, Outcome 11 Instrumental vaginal delivery.
10.23
10.23. Analysis
Comparison 10 IV oxytocin and amniotomy versus vaginal PG:all primiparae, Outcome 23 Post partum haemorrhage.
10.29
10.29. Analysis
Comparison 10 IV oxytocin and amniotomy versus vaginal PG:all primiparae, Outcome 29 Precipitate labour.
11.3
11.3. Analysis
Comparison 11 IV oxytocin and amniotomy versus vaginal PG: all primiparae, unfavourable cervix, Outcome 3 Caesarean section.
11.5
11.5. Analysis
Comparison 11 IV oxytocin and amniotomy versus vaginal PG: all primiparae, unfavourable cervix, Outcome 5 Serious maternal morbidity or death.
11.7
11.7. Analysis
Comparison 11 IV oxytocin and amniotomy versus vaginal PG: all primiparae, unfavourable cervix, Outcome 7 Oxytocin augmentation.
11.8
11.8. Analysis
Comparison 11 IV oxytocin and amniotomy versus vaginal PG: all primiparae, unfavourable cervix, Outcome 8 Uterine hyperstimulation without FHR changes.
11.11
11.11. Analysis
Comparison 11 IV oxytocin and amniotomy versus vaginal PG: all primiparae, unfavourable cervix, Outcome 11 Instrumental vaginal delivery.
11.23
11.23. Analysis
Comparison 11 IV oxytocin and amniotomy versus vaginal PG: all primiparae, unfavourable cervix, Outcome 23 Post partum haemorrhage.
11.29
11.29. Analysis
Comparison 11 IV oxytocin and amniotomy versus vaginal PG: all primiparae, unfavourable cervix, Outcome 29 Precipitate labour.
12.2
12.2. Analysis
Comparison 12 IV oxytocin and amniotomy versus vaginal PG: all multiparae (without previous caesarean section), Outcome 2 Uterine hyperstimulation with FHR changes.
12.3
12.3. Analysis
Comparison 12 IV oxytocin and amniotomy versus vaginal PG: all multiparae (without previous caesarean section), Outcome 3 Caesarean section.
12.7
12.7. Analysis
Comparison 12 IV oxytocin and amniotomy versus vaginal PG: all multiparae (without previous caesarean section), Outcome 7 Oxytocin augmentation.
12.11
12.11. Analysis
Comparison 12 IV oxytocin and amniotomy versus vaginal PG: all multiparae (without previous caesarean section), Outcome 11 Instrumental vaginal delivery.
12.23
12.23. Analysis
Comparison 12 IV oxytocin and amniotomy versus vaginal PG: all multiparae (without previous caesarean section), Outcome 23 Post partum haemorrhage.
12.25
12.25. Analysis
Comparison 12 IV oxytocin and amniotomy versus vaginal PG: all multiparae (without previous caesarean section), Outcome 25 Women not satisfied.
13.2
13.2. Analysis
Comparison 13 IV oxytocin and amniotomy versus vaginal PG: all multiparae, favourable cervix, Outcome 2 Uterine hyperstimulation with FHR changes.
13.3
13.3. Analysis
Comparison 13 IV oxytocin and amniotomy versus vaginal PG: all multiparae, favourable cervix, Outcome 3 Caesarean section.
13.4
13.4. Analysis
Comparison 13 IV oxytocin and amniotomy versus vaginal PG: all multiparae, favourable cervix, Outcome 4 Serious neonatal morbidity or perinatal death.
13.8
13.8. Analysis
Comparison 13 IV oxytocin and amniotomy versus vaginal PG: all multiparae, favourable cervix, Outcome 8 Uterine hyperstimulation without FHR changes.
13.11
13.11. Analysis
Comparison 13 IV oxytocin and amniotomy versus vaginal PG: all multiparae, favourable cervix, Outcome 11 Instrumental vaginal delivery.
13.23
13.23. Analysis
Comparison 13 IV oxytocin and amniotomy versus vaginal PG: all multiparae, favourable cervix, Outcome 23 Post partum haemorrhage.
13.25
13.25. Analysis
Comparison 13 IV oxytocin and amniotomy versus vaginal PG: all multiparae, favourable cervix, Outcome 25 Woman not satisfied.
14.1
14.1. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 1 Vaginal delivery not achieved in 24 hours.
14.3
14.3. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 3 Caesarean section.
14.6
14.6. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 6 Cervix unfavourable/unchanged after 12‐24 hours.
14.9
14.9. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 9 Uterine rupture.
14.10
14.10. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 10 Epidural analgesia.
14.11
14.11. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 11 Instrumental vaginal delivery.
14.13
14.13. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 13 Apgar score < 7 at 5 minutes.
14.14
14.14. Analysis
Comparison 14 IV oxytocin and amniotomy versus vaginal PG: all women, previous caesarean section., Outcome 14 Neonatal intensive care unit admission.
15.1
15.1. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 1 Vaginal delivery not achieved in 24 hours.
15.3
15.3. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 3 Caesarean section.
15.6
15.6. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 6 Cervix unfavourable/unchanged after 12‐24 hours.
15.9
15.9. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 9 Uterine rupture.
15.10
15.10. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 10 Epidural analgesia.
15.11
15.11. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 11 Instrumental vaginal delivery.
15.13
15.13. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 13 Apgar score < 7 at 5 minutes.
15.14
15.14. Analysis
Comparison 15 IV Oxytocin and amniotomy versus vaginal PG:all women, previous CS, unfavourable cervix, Outcome 14 Neonatal intensive care unit admission.
16.1
16.1. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 1 Vaginal delivery not achieved in 24 hours.
16.3
16.3. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 3 Caesarean section.
16.6
16.6. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 6 Cervix unfavourable/unchanged after 12‐24 hours.
16.9
16.9. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 9 Uterine rupture.
16.10
16.10. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 10 Epidural analgesia.
16.11
16.11. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 11 Instrumental vaginal delivery.
16.13
16.13. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 13 Apgar score < 7 at 5 minutes.
16.14
16.14. Analysis
Comparison 16 IV Oxytocin and amniotomy versus vaginal PG: all women, previous CS, intact membranes, unfavourable cervix, Outcome 14 Neonatal intensive care unit admission.
17.1
17.1. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 1 Vaginal delivery not achieved within 24 hours.
17.2
17.2. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 2 Uterine hyperstimulation with FHR changes.
17.3
17.3. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 3 Caesarean section.
17.7
17.7. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 7 Oxytocin augmentation.
17.8
17.8. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 8 Uterine hyperstimulation without FHR changes.
17.11
17.11. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 11 Instrumental vaginal delivery.
17.12
17.12. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 12 Meconium stained liquor.
17.25
17.25. Analysis
Comparison 17 IV oxytocin and amniotomy versus intracervical PG: all women, Outcome 25 Woman not satisfied.
18.1
18.1. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
18.2
18.2. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 2 Uterine hyperstimulation with FHR changes.
18.3
18.3. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 3 Caesarean section.
18.7
18.7. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 7 Oxytocin augmentation.
18.8
18.8. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 8 Uterine hyperstimulation without FHR changes.
18.11
18.11. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 11 Instrumental vaginal delivery.
18.12
18.12. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 12 Meconium stained liquor.
18.25
18.25. Analysis
Comparison 18 IV oxytocin and amniotomy versus intracervical PG: all women, favourable cervix, Outcome 25 Women not satisfied.
19.3
19.3. Analysis
Comparison 19 IV oxytocin and amniotomy versus oxytocin alone: all women, Outcome 3 Caesarean section.
19.8
19.8. Analysis
Comparison 19 IV oxytocin and amniotomy versus oxytocin alone: all women, Outcome 8 Uterine hyperstimulation without FHR changes.
19.10
19.10. Analysis
Comparison 19 IV oxytocin and amniotomy versus oxytocin alone: all women, Outcome 10 Epidural analgesia.
19.12
19.12. Analysis
Comparison 19 IV oxytocin and amniotomy versus oxytocin alone: all women, Outcome 12 Mecomium stained liquor.
19.13
19.13. Analysis
Comparison 19 IV oxytocin and amniotomy versus oxytocin alone: all women, Outcome 13 Apgar score <7 at 5 minutes.
20.3
20.3. Analysis
Comparison 20 IV oxytocin and amniotomy versus oxytocin alone: all women, intact membranes, variable or undefined cervix, Outcome 3 Caesarean section.
20.8
20.8. Analysis
Comparison 20 IV oxytocin and amniotomy versus oxytocin alone: all women, intact membranes, variable or undefined cervix, Outcome 8 Uterine hyperstimulation without FHR changes.
20.10
20.10. Analysis
Comparison 20 IV oxytocin and amniotomy versus oxytocin alone: all women, intact membranes, variable or undefined cervix, Outcome 10 Epidural analgesia.
20.12
20.12. Analysis
Comparison 20 IV oxytocin and amniotomy versus oxytocin alone: all women, intact membranes, variable or undefined cervix, Outcome 12 Mecomium stained liquor.
20.13
20.13. Analysis
Comparison 20 IV oxytocin and amniotomy versus oxytocin alone: all women, intact membranes, variable or undefined cervix, Outcome 13 Apgar score <7 at 5 minutes.
21.1
21.1. Analysis
Comparison 21 IV oxytocin and amniotomy versus amniotomy alone: all women, Outcome 1 Vaginal delivery not achieved within 24 hours.
21.3
21.3. Analysis
Comparison 21 IV oxytocin and amniotomy versus amniotomy alone: all women, Outcome 3 Caesarean section.
21.10
21.10. Analysis
Comparison 21 IV oxytocin and amniotomy versus amniotomy alone: all women, Outcome 10 Epidural analgesia/opioid analgesia.
21.11
21.11. Analysis
Comparison 21 IV oxytocin and amniotomy versus amniotomy alone: all women, Outcome 11 Instrumental vaginal delivery.
21.16
21.16. Analysis
Comparison 21 IV oxytocin and amniotomy versus amniotomy alone: all women, Outcome 16 Perinatal death.
21.23
21.23. Analysis
Comparison 21 IV oxytocin and amniotomy versus amniotomy alone: all women, Outcome 23 Post partum haemorrhage.
21.30
21.30. Analysis
Comparison 21 IV oxytocin and amniotomy versus amniotomy alone: all women, Outcome 30 Puerpural pyrexia.
22.1
22.1. Analysis
Comparison 22 IV oxytocin and amniotomy versus amniotomy alone: all women, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
22.3
22.3. Analysis
Comparison 22 IV oxytocin and amniotomy versus amniotomy alone: all women, favourable cervix, Outcome 3 Caesarean section.
22.10
22.10. Analysis
Comparison 22 IV oxytocin and amniotomy versus amniotomy alone: all women, favourable cervix, Outcome 10 Epidural analgesia/opioid analgesia.
22.11
22.11. Analysis
Comparison 22 IV oxytocin and amniotomy versus amniotomy alone: all women, favourable cervix, Outcome 11 Instrumental vaginal delivery.
22.16
22.16. Analysis
Comparison 22 IV oxytocin and amniotomy versus amniotomy alone: all women, favourable cervix, Outcome 16 Perinatal death.
22.23
22.23. Analysis
Comparison 22 IV oxytocin and amniotomy versus amniotomy alone: all women, favourable cervix, Outcome 23 Post partum haemorrhage.
22.30
22.30. Analysis
Comparison 22 IV oxytocin and amniotomy versus amniotomy alone: all women, favourable cervix, Outcome 30 Puerpural pyrexia.
23.1
23.1. Analysis
Comparison 23 IV oxytocin and amniotomy versus amniotomy alone: all women, intact membranes, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
23.3
23.3. Analysis
Comparison 23 IV oxytocin and amniotomy versus amniotomy alone: all women, intact membranes, favourable cervix, Outcome 3 Caesarean section.
23.10
23.10. Analysis
Comparison 23 IV oxytocin and amniotomy versus amniotomy alone: all women, intact membranes, favourable cervix, Outcome 10 Epidural analgesia/opioid analgesia.
23.11
23.11. Analysis
Comparison 23 IV oxytocin and amniotomy versus amniotomy alone: all women, intact membranes, favourable cervix, Outcome 11 Instrumental vaginal delivery.
23.16
23.16. Analysis
Comparison 23 IV oxytocin and amniotomy versus amniotomy alone: all women, intact membranes, favourable cervix, Outcome 16 Perinatal death.
23.23
23.23. Analysis
Comparison 23 IV oxytocin and amniotomy versus amniotomy alone: all women, intact membranes, favourable cervix, Outcome 23 Post partum haemorrhage.
23.30
23.30. Analysis
Comparison 23 IV oxytocin and amniotomy versus amniotomy alone: all women, intact membranes, favourable cervix, Outcome 30 Puerpural pyrexia.
24.1
24.1. Analysis
Comparison 24 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, Outcome 1 Vaginal delivery not achieved within 24 hours.
24.3
24.3. Analysis
Comparison 24 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, Outcome 3 Caesarean section.
24.10
24.10. Analysis
Comparison 24 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, Outcome 10 Epidural analgesia/opioid analgesia.
24.11
24.11. Analysis
Comparison 24 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, Outcome 11 Instrumental vaginal delivery.
24.16
24.16. Analysis
Comparison 24 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, Outcome 16 Perinatal death.
24.23
24.23. Analysis
Comparison 24 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, Outcome 23 Post partum haemorrhage.
24.30
24.30. Analysis
Comparison 24 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, Outcome 30 Puerpural pyrexia.
25.1
25.1. Analysis
Comparison 25 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
25.3
25.3. Analysis
Comparison 25 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, favourable cervix, Outcome 3 Caesarean section.
25.10
25.10. Analysis
Comparison 25 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, favourable cervix, Outcome 10 Epidural analgesia/opioid analgesia.
25.11
25.11. Analysis
Comparison 25 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, favourable cervix, Outcome 11 Instrumental vaginal delivery.
25.16
25.16. Analysis
Comparison 25 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, favourable cervix, Outcome 16 Perinatal death.
25.23
25.23. Analysis
Comparison 25 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, favourable cervix, Outcome 23 Post partum haemorrhage.
25.30
25.30. Analysis
Comparison 25 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, favourable cervix, Outcome 30 Puerpural pyrexia.
26.1
26.1. Analysis
Comparison 26 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, intact membranes, favourable cervix, Outcome 1 Vaginal delivery not achieved within 24 hours.
26.3
26.3. Analysis
Comparison 26 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, intact membranes, favourable cervix, Outcome 3 Caesarean section.
26.10
26.10. Analysis
Comparison 26 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, intact membranes, favourable cervix, Outcome 10 Epidural analgesia/opioid analgesia.
26.11
26.11. Analysis
Comparison 26 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, intact membranes, favourable cervix, Outcome 11 Instrumental vaginal delivery.
26.16
26.16. Analysis
Comparison 26 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, intact membranes, favourable cervix, Outcome 16 Perinatal death.
26.23
26.23. Analysis
Comparison 26 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, intact membranes, favourable cervix, Outcome 23 Post partum haemorrhage.
26.30
26.30. Analysis
Comparison 26 IV oxytocin and amniotomy versus amniotomy alone: all primiparae, intact membranes, favourable cervix, Outcome 30 Puerpural pyrexia.
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References

References to studies included in this review

Dommisse 1987 {published data only}
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Henry 1969 {published data only}
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Leijon 1980 {published data only}
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Lykkesfeldt 1979 {published data only}
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Secher 1981 {published data only}
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Sellers 1988 {published data only}
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Sivasuriya 1978 {published data only}
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Steer 1976 {published data only}
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Steer 1985 {published data only}
    1. Steer PJ, Carter MC, Choong K, Hanson M, Gordon AJ, Pradhan P. A multicentre prospective randomized controlled trial of induction of labour with an automatic closed‐loop feedback controlled oxytocin infusion system. Br J Obstet Gynaecol 1985;92:1127‐33. - PubMed
Suikkari 1983 {published data only}
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Thomas 1974 {published data only}
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Tylleskar 1978 {published data only}
    1. Tylleskar J, Finnstrom O, Hedenskog S, Leijon I, Ryden G. Spontaneous delivery‐elective induction for convenience, a comparative study [Abstract no 345]. Proceedings of 6th European Congress of Perinatal Medicine; 1978 Aug 29‐Sept 1; Vienna, Austria. 1978.
Tylleskar 1979 {published data only}
    1. Tylleskar J, Finnstrom O, Leijon I, Hedenskog S, Ryden G. Spontaneous labor and elective induction ‐ a prospective randomized study. I Effects on mother and fetus. Acta Obstet Gynecol Scand 1979;58:513‐8. - PubMed
Varma 1981 {published data only}
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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}
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Witter 1987 {published data only}
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Witter 1989 {published data only}
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References to studies awaiting assessment

Chanrachakul 2003 {published data only}
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Chua 1988 {published data only}
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Selo‐Ojeme 2007 {published data only}
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Publication types