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Meta-Analysis
. 2013 Jun 18;2013(6):CD006167.
doi: 10.1002/14651858.CD006167.pub4.

Amniotomy for shortening spontaneous labour

Rebecca M D Smyth  1 , Carolyn Markham, Therese Dowswell
Affiliations
Meta-Analysis

Amniotomy for shortening spontaneous labour

Rebecca M D Smyth et al. Cochrane Database Syst Rev. .

Abstract

Background: Intentional artificial rupture of the amniotic membranes during labour, sometimes called amniotomy or 'breaking of the waters', is one of the most commonly performed procedures in modern obstetric and midwifery practice. The primary aim of amniotomy is to speed up contractions and, therefore, shorten the length of labour. However, there are concerns regarding unintended adverse effects on the woman and baby.

Objectives: To determine the effectiveness and safety of amniotomy alone for routinely shortening all labours that start spontaneously.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2013).

Selection criteria: Randomised controlled trials comparing amniotomy alone versus intention to preserve the membranes. We excluded quasi-randomised trials.

Data collection and analysis: Two review authors assessed identified studies for inclusion, assessed risk of bias and extracted data. Primary analysis was by intention-to-treat.

Main results: We have included 15 studies in this updated review, involving 5583 women. Amniotomy alone versus intention to preserve the membranes (no amniotomy) for spontaneous labour There was no clear statistically significant difference between women in the amniotomy and control groups in length of the first stage of labour (mean difference (MD) -20.43 minutes, 95% confidence interval (CI) -95.93 to 55.06), caesarean section (risk ratio (RR) 1.27, 95% CI 0.99 to 1.63), maternal satisfaction with childbirth experience (MD -1.10, 95% CI -7.15 to 4.95) or Apgar score less than seven at five minutes (RR 0.53, 95% CI 0.28 to 1.00). There was no consistency between trials regarding the timing of amniotomy during labour in terms of cervical dilatation. Amniotomy alone versus intention to preserve the membranes (no amniotomy) for spontaneous labours that have become prolonged There was no clear statistically significant difference between women in the amniotomy and control group in caesarean section (RR 0.95, 95% CI 0.15 to 6.08), maternal satisfaction with childbirth experience (MD 22.00, 95% CI 2.74 to 41.26) or Apgar score less than seven at five minutes (RR 2.86, 95% CI 0.12 to 66.11).

Authors' conclusions: On the basis of the findings of this review, we cannot recommend that amniotomy should be introduced routinely as part of standard labour management and care. We recommend that the evidence presented in this review should be made available to women offered an amniotomy and may be useful as a foundation for discussion and any resulting decisions made between women and their caregivers.

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Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 1 Length of first stage of labour.
1.2
1.2. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 2 Caesarean section.
1.3
1.3. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 3 Maternal satisfaction with childbirth experience.
1.4
1.4. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 4 Apgar score less than 7 at 5 minutes.
1.5
1.5. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 5 Length of second stage.
1.6
1.6. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 6 Dysfunctional labour.
1.7
1.7. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 7 Use of pain relief ‐ epidural/narcotic.
1.8
1.8. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 8 Oxytocin augmentation.
1.9
1.9. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 9 Instrumental vaginal birth.
1.10
1.10. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 10 Caesarean section for fetal distress.
1.11
1.11. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 11 Caesarean section for prolonged labour.
1.12
1.12. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 12 Antepartum haemorrhage.
1.13
1.13. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 13 Postpartum haemorrhage.
1.14
1.14. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 14 Cord prolapse.
1.15
1.15. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 15 Maternal infection.
1.16
1.16. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 16 Maternal mortality.
1.17
1.17. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 17 Suboptimal or abnormal fetal heart trace (second stage of labour).
1.18
1.18. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 18 Admission to special care baby unit/neonatal intensive care unit.
1.19
1.19. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 19 Suboptimal or abnormal fetal heart trace (first stage of labour).
1.20
1.20. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 20 Meconium aspiration syndrome.
1.21
1.21. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 21 Acidosis as defined as a cord blood arterial pH of < 7.2.
1.22
1.22. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 22 Perinatal death.
1.23
1.23. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 23 Neonatal jaundice.
1.24
1.24. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 24 Seizures (neonate).
1.25
1.25. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 25 Respiratory distress syndrome.
1.26
1.26. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 26 Fracture.
1.27
1.27. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 27 Intracranial haemorrhage.
1.28
1.28. Analysis
Comparison 1 Amniotomy versus no amniotomy, Outcome 28 Cephalhaematoma.
2.1
2.1. Analysis
Comparison 2 Sensitivity analysis excluding trials with inadequate allocation concealment (c), Outcome 1 Length of first stage of labour.
2.2
2.2. Analysis
Comparison 2 Sensitivity analysis excluding trials with inadequate allocation concealment (c), Outcome 2 Caesarean section.
2.3
2.3. Analysis
Comparison 2 Sensitivity analysis excluding trials with inadequate allocation concealment (c), Outcome 3 Apgar score less than 7 at 5 minutes.
3.1
3.1. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 1 Caesarean section.
3.2
3.2. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 2 Maternal satisfaction with childbirth experience.
3.3
3.3. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 3 Apgar score less than 7 at 5 minutes.
3.4
3.4. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 4 Use of pain relief ‐ epidural/narcotic.
3.5
3.5. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 5 Oxytocin augmentation.
3.6
3.6. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 6 Instrumental vaginal birth.
3.7
3.7. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 7 Caesarean section for fetal distress.
3.8
3.8. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 8 Caesarean section for prolonged labour.
3.9
3.9. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 9 Maternal mortality.
3.10
3.10. Analysis
Comparison 3 Amniotomy vs no amniotomy (dysfunctional labour), Outcome 10 Admission to special care baby unit/neonatal intensive care unit.
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

Ajadi 2006 {published data only}
    1. Ajada MA, Kuti O, Orji EO, Ogunniyi SO, Sule SS. The effect of amniotomy on the outcome of spontaneous labour in uncomplicated pregnancy. Journal of Obstetrics and Gynaecology 2006;26(7):631‐4. - PubMed
Barrett 1992 {published and unpublished data}
    1. Barrett JFR, Phillips K, Savage J, Lilford RJ. Randomised trial of routine amniotomy in labour vs the intention to leave the membranes intact until the second stage. Proceedings of Silver Jubilee British Congress of Obstetrics and Gynaecology; 1989 July 4‐7; London, UK. 1989:114.
    1. Barrett JFR, Savage J, Phillips K, Lilford RJ. Randomized trial of amniotomy in labour vs the intention to leave membranes intact until the second stage. British Journal of Obstetrics and Gynaecology 1992;99:5‐10. - PubMed
Blanch 1998 {published and unpublished data}
    1. Blanch G, Lavender T, Walkinshaw S, Alfirevic Z. Dysfunctional labour: a randomised trial. British Journal of Obstetrics and Gynaecology 1998;105(1):117‐20. - PubMed
Franks 1990 {published data only}
    1. Franks P. A randomized trial of amniotomy in active labor. Journal of Family Practice 1990;30:49‐52. - PubMed
Fraser 1991 {published data only}
    1. Fraser WD. A randomized controlled trial of the effect of amniotomy on labour duration [MSc thesis]. Alberta, Canada: University of Calgary, 1988.
    1. Fraser WD, Sauve R, Parboosingh IJ, Fung T, Sokol R, Persaud D. A randomized controlled trial of early amniotomy. British Journal of Obstetrics and Gynaecology 1991;98:84‐91. - PubMed
Fraser 1993 {published data only}
    1. Fraser WD, Marcoux S, Moutquin JM, Christen A. Effect of early amniotomy on the risk of dystocia in nulliparous women. New England Journal of Medicine 1993;328:1145‐9. - PubMed
    1. Fraser WD, Marcoux S, Moutquin JM, Christen A, Armson BA, Verreault JP, et al. The Canadian multicentre RCT of early amniotomy. American Journal of Obstetrics and Gynecology 1992;166:275.
    1. Fraser WD, Marcoux S, Moutquin JM, Christen A, Armson BA, Verreault JP, et al. The Canadian multicentre RCT of early amniotomy. Journal of Perinatal Medicine 1991;2:93S.
    1. Goffinet F, Fraser WD, Marcoux S, Breart G, Moutquin JM, Daris M, et al. Early amniotomy increases the frequency of fetal heart rate abnormalities. British Journal of Obstetrics and Gynaecology 1997;104:548‐53. - PubMed
Garite 1993 {published data only}
    1. Garite TJ, Porto M, Carlson NJ, Rumney PJ, Reimbold PA. The influence of elective amniotomy on fetal heart rate patterns and the course of labor in term patients: a randomized study. American Journal of Obstetrics and Gynecology 1993;168:1827‐32. - PubMed
Guerresi 1981 {published data only}
    1. Guerresi E, Gori G, Beccari A, Farro M, Mazzanti C. Influence of spasmolytic treatment and amniotomy on delivery times: a factorial clinical trial. Clinical Therapeutics 1981;3(5):382‐8. - PubMed
Johnson 1997 {published data only}
    1. Johnson N, Lilford R, Guthrie K, Thornton J, Barker M, Kelly M. Randomised trial comparing a policy of early with selective amniotomy in uncomplicated labour at term. British Journal of Obstetrics and Gynaecology 1997;104:340‐6. - PubMed
    1. Peake K, O'Connor RA. Randomised trial comparing a policy of early with selective amniotomy and uncomplicated labour at term. [letter; comment]. British Journal of Obstetrics and Gynaecology 1997;104:1215‐6. - PubMed
Laros 1972 {published and unpublished data}
    1. Laros RK, Work BA, Witting WC. Amniotomy during the active phase of labor. Obstetrics & Gynecology 1972;39:702‐4. - PubMed
Mikki 2007 {published data only}
    1. Mikki N, Wick L, Abu‐Asab N, Abu‐Rmeileh NM. A trial of amniotomy in a Palestinian hospital. Journal of Obstetrics and Gynaecology 2007;27(4):368‐73. - PubMed
Shobeiri 2007 {published data only}
    1. Shobeiri F, Tehranian N, Nazari M. Amniotomy in labor. International Journal of Gynecology & Obstetrics 2007;96(3):197‐8. - PubMed
Stewart 1982 {published data only}
    1. Stewart P, Kennedy JH, Calder AA. Spontaneous labour: when should the membranes be ruptured?. British Journal of Obstetrics and Gynaecology 1982;89:39‐43. - PubMed
UK Amniotomy 1994 {published data only}
    1. Thornton JG. A multicentre randomised trial of early vs late amniotomy in spontaneous primiparous labour. Journal of Perinatal Medicine 1992;20(1):37.
    1. Thornton JG. A multicentre randomised trial of early vs late amniotomy in spontaneous primiparous labour. Proceedings of 26th British Congress of Obstetrics and Gynaecology; 1992 July 7‐10; Manchester, UK. 1992:82.
    1. Thornton JG. The psychological effects of amniotomy. Proceedings of 26th British Congress of Obstetrics and Gynaecology; 1992 July 7‐10; Manchester, UK. 1992:53.
    1. UK Amniotomy Group. A multicentre randomised trial of amniotomy in spontaneous first labour at term. British Journal of Obstetrics and Gynaecology 1994;101:307‐9. - PubMed
    1. UK Amniotomy Group. Comparing routine vs delayed amniotomy in spontaneous first labor at term. A multicenter randomized trial. Online Journal of Current Clinical Trials 1994;3:122. - PubMed
Wetrich 1970 {published data only}
    1. Wetrich DW. Effect of amniotomy upon labor. Obstetrics & Gynecology 1970;35:800‐6. - PubMed

References to studies excluded from this review

Abdullah 2010 {published data only}
    1. Abdullah A, Saboohi S, Hashami U. Effects of amniotomy versus spontaneous rupture of membrane on progress of labour and foetal outcome in primigravidae. Journal of Liaquat University of Medical and Health Sciences 2010;9(1):33‐6.
Garmi 2008 {published data only}
    1. Garmi G, Salim R, Kadan I, Zafran N, Shalev E, Nachum Z. Augmentation of labour for prolonged latent phase at term: a randomized comparison between amniotomy, oxytocin or both. American Journal of Obstetrics and Gynecology 2008;199(6 Suppl 1):S58.
Levy 2002 {published data only}
    1. Levy R, Ben‐Arie A, Paz B, Hazan I, Blickstein I, Hagay Z. Randomized clinical trial of early vs late amniotomy following cervical ripening with a foley catheter. American Journal of Obstetrics and Gynecology 2000;182(1 Pt 2):S136. - PubMed
    1. Levy R, Ferber A, Ben‐Arie A, Paz B, Hazan Y, Blickstein I, et al. A randomised comparison of early versus late amniotomy following cervical ripening with a foley catheter. BJOG: an international journal of obstetrics and gynaecology 2002;109:168‐72. - PubMed
Li 2006 {published data only}
    1. Li N, Wang Y, Zhou H. Effects of routine early amniotomy on labor and health status of foetus and neonate: a meta‐analysis. Zhonghua fu chan ke za zhi 2006;41(1):16‐9. - PubMed
Martell 1976 {published data only}
    1. Martell M, Belizan JM, Nieto F, Schwarcz R. Blood acid‐base balance at birth in neonates from labors with early and late rupture of the membranes. Journal of Pediatrics 1976;89:963‐7. - PubMed
Nachum 2010 {published data only}
    1. Nachum Z, Garmi G, Kadan Y, Zafran N, Shalev E, Salim R. Comparison between amniotomy, oxytocin or both for augmentation of labor in prolonged latent phase: a randomized controlled trial. Reproductive Biology and Endocrinology 2010;8:136. - PMC - PubMed
Schwarcz 1973 {published data only}
    1. Schwarcz R, Althabe O, Caldeyro‐Barcia R, Belitsky R, Lanchares JL, Alvarez R, et al. Fetal heart rate patterns in labors with intact and with ruptured membranes. Journal of Perinatal Medicine 1973;1:153‐65. - PubMed
Schwarcz 1975 {published data only}
    1. Caldeyro‐Barcia R, Schwarcz R, Belizan JM, Martell M, Nieto F, Sabatino H, et al. Adverse perinatal effects of early amniotomy during labor. In: Gluck L editor(s). Modern Perinatal Medicine. Chicago: Yearbook Publishers, 1974:431‐49.
    1. Schwarcz R, Belizan JM, Nieto F, Tenzer SM. Latin American collaborative study about the effects of membrane rupture on labor and newborn. Boletin de la Oficina Sanitaria Panamericana 1975;595:1‐80.
Surichamorn 1998 {published data only}
    1. Surichamorn P. Effect of artificial rupture of amniotic membranes and non‐artificial rupture of amniotic membranes to labor time in normal labor women. Chon Buri Hospital Journal 1998;24(1):38‐47.

Additional references

Alfirevic 2006
    1. Alfirevic Z, Devane D, Gyte GML. Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD006066] - DOI - PubMed
Bohra 2003
    1. Bohra U, Donnelly J, O’Connell MP, Geary MP, MacQuillan K, Keane DP. Active management of labour revisited: the first 1000 primiparous labours in 2000. Journal of Obstetrics and Gynaecology 2003;23(2):118‐20. - PubMed
Bricker 2000
    1. Bricker L, Luckas M. Amniotomy alone for induction of labour. Cochrane Database of Systematic Reviews 2000, Issue 4. [DOI: 10.1002/14651858.CD002862] - DOI - PMC - PubMed
Brown 2008
    1. Brown HC, Paranjothy S, Dowswell T, Thomas J. Package of care for active management in labour for reducing caesarean section rates in low‐risk women. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD004907.pub2] - DOI - PMC - PubMed
Busowski 1995
    1. Busowski JD, Parsons MT. Amniotomy to induce labour. Clinical Obstetrics and Gynecology 1995;38(2):246‐58. - PubMed
Calder 1999
    1. Calder AA. Chapter 20. Normal labour. In: Edmonds DK editor(s). Dewhurst’s Textbook of Obstetrics and Gynaecology for Postgraduates. 6th Edition. Blackwell Science, 1999.
Caldeyro‐Barcia 1972
    1. Caldeyro‐Barcia R. The effects of rupture of membranes on fetal heart rate patterns. International Journal of Gynecology & Obstetrics 1972;10:169‐72.
Camey 1996
    1. Camey XC, Barrios CG, Guerrero XR, Nunez‐Urquiza RM, Hernandez DG, Glass AL. Traditional birth attendants in Mexico: advantages and inadequacies of care for normal deliveries. Social Science and Medicine 1996;43(2):199‐207. - PubMed
Chanrachakul 2001
    1. Chanrachakul B, Herabutya Y, Panburana P. Active management of labor: is it suitable for a developing country?. International Journal of Gynecology & Obstetrics 2001;72:229‐34. - PubMed
Clements 2001
    1. Clements C. Amniotomy in spontaneous, uncomplicated labour at term. British Journal of Midwifery 2001;9(10):629‐34.
Deeks 2001
    1. Deeks JJ, Altman DG, Bradburn MJ. Statistical methods for examining heterogeneity and combining results from several studies in meta‐analysis. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic Reviews in Health Care: Meta‐analysis in Context. London: BMJ Books, 2001.
Downe 2001
    1. Downe S, McCormick C, Lawrence Beech B. Labour interventions associated with normal birth. British Journal of Midwifery 2001;9(10):602‐6.
Dunn 1992
    1. Dunn PM. Dr Thomas Denman of London (1733‐1815): rupture of the membranes and management of the cord. Archives of Disease in Childhood 1992;67(7 Spec No):882‐4. - PMC - PubMed
Enkin 2000a
    1. Enkin M, Keirse MJNC, Neilson J, Crowther C, Duley L, Hodnett E, et al. Chapter 31. Monitoring the progress of labour. A Guide to Effective Care in Pregnancy and Childbirth. 3rd Edition. Oxford: Oxford University Press, 2000:281‐8.
Enkin 2000b
    1. Enkin M, Keirse MJNC, Neilson J, Crowther C, Duley L, Hodnett E, et al. Chapter 35. Prolonged labour. A Guide to Effective Care in Pregnancy and Childbirth. 3rd Edition. Oxford: Oxford University Press, 2000:332‐40.
Fok 2005
    1. Fok WY, Leung TY, Tsui MH, Leung TN, Lau TK. Fetal hemodynamic changes after amniotomy. Acta Obstetricia et Gynecologica Scandinavica 2005;84:166‐9. - PubMed
Frigoletto 1995
    1. Frigoletto FD, Lieberman E, Lang JM, Cohen A, Barss V, Ringer S, et al. A clinical trial of active management in labour. New England Journal of Medicine 1995;333(12):745‐50. - PubMed
Gates 2005
    1. Gates S. Methodological Guidelines. The Editorial Team. Pregnancy and Childbirth Group. About The Cochrane Collaboration (Cochrane Review Groups (CRGs)) 2005, Issue 1.
Gibb 1992
    1. Gibb D, Arulkumaran S. Chapter 8. Cardiotocograph interpretation: clinical scenarios. Meconium‐stained amniotic fluid. Fetal Monitoring in Practice. Oxford: Butterworth‐Heinemann, 1992:130.
Goffinet 1997
    1. Goffinet F, Fraser W, Marcoux S. Early amniotomy increases the frequency of fetal heart rate abnormalities. British Journal of Obstetrics and Gynaecology 1997;104(5):548‐53. - PubMed
Higgins 2005
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5 [updated March 2005]. In: The Cochrane Library, Issue 3, 2005. Chichester, UK: John Wiley & Sons, Ltd. 2005.
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Howarth 2001
    1. Howarth GR, Botha DJ. Amniotomy plus intravenous oxytocin for induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 3. [DOI: 10.1002/14651858.CD003250] - DOI - PMC - PubMed
Impey 1999
    1. Impey L. Maternal attitudes to amniotomy and labour duration: a survey in early pregnancy. Birth 1999;26(4):211‐4. - PubMed
Jowitt 1993
    1. Jowitt M. Chapter 9. The cascade of intervention. Childbirth Unmasked. Wooller, 1993.
Kwast 1994
    1. Kwast BE, Lennox CE, Farley TMM, Olayinka I. World Health Organization partograph in management of labour. Lancet 1994;343(8910):1399‐404. - PubMed
NCT 1989
    1. National Childbirth Trust. Rupture of the Membranes in Labour. A Survey Conducted by the National Childbirth Trust. London: National Childbirth Trust Publications, 1989.
Neilson 2003
    1. Neilson JP, Lavender T, Quenby S, Wray S. Obstructed labour. British Medical Bulletin 2003;67:191‐204. - PubMed
O'Driscoll 1993
    1. O’Driscoll K, Meagher D, Boylan P. Chapter 4. Duration of labour. Active Management of Labour. 3rd Edition. London: Mosby, 1993.
Rana 2003
    1. Rana TG, Rajopadhyaya R, Bajracharya B, Karmacharya M, Osrin D. Comparison of midwifery‐led and consultant‐led maternity care for low risk deliveries in Nepal. Health Policy and Planning 2003;18(3):330‐7. - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Robertson 1997
    1. Robertson A. Chapter 6. How can I help. The Midwife Companion. ACE Graphics, 1997.
Robinson 2000
    1. Robinson J. Her master’s voice? Amniotomy in Dublin. British Journal of Midwifery 2000;8(1):110.
Stewart 1995
    1. Stewart P, Kennedy JH, Calder AA. Spontaneous labour: when should the membranes be ruptured?. British Journal of Obstetrics and Gynaecology 1995;89(1):39‐43. - PubMed
Thomas 2001
    1. Thomas J, Kelly AJ, Kavanagh J. Oestrogens alone or with amniotomy for cervical ripening or induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 4. [DOI: 10.1002/14651858.CD003393] - DOI - PMC - PubMed
Van Meir 1997
    1. Meir CA, Ramirez MM, Matthews SG, Calder AA, Keirse MJNC, Challis JRG. Chorionic prostaglandin catabolism is decreased in the lower uterine segment with term labour. Placenta 1997;18:109‐14. - PubMed
Vincent 2005
    1. Vincent M. Amniotomy: to do or not to do?. Midwifery 2005;8(5):228‐9. - PubMed
Wei 2012
    1. Wei S, Wo BL, Qi HP, Xu H, Luo ZC, Roy C, et al. Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care. Cochrane Database of Systematic Reviews 2012, Issue 9. [DOI: 10.1002/14651858.CD006794.pub3] - DOI - PMC - PubMed
WHO 2004
    1. WHO, UNICEF, UNFPA. Maternal Mortality in 2000: estimates developed by WHO, UNICEF and UNFPA, Geneva 2004. http://www.who.int/reproductive‐health/publications/maternal_mortality_2... (accessed March 2006).
WHO 2006
    1. WHO. Managing complications in pregnancy and childbirth – a guide for midwives and doctors. www.who.int/reproductive ‐health/impac/Procedures/Induction (accessed March 2006).

References to other published versions of this review

CDSR 2006
    1. Fraser WD, Turcot L, Krauss I, Brisson‐Carrol G. Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD000015.pub2] - DOI
Smyth 2007a
    1. Smyth R, Alldred SK, Markham C. Amniotomy for shortening spontaneous labour (Protocol). Cochrane Database of Systematic Reviews 2007, Issue 1. [DOI: 10.1002/14651858.CD006167] - DOI - PubMed
Smyth 2007b
    1. Smyth RMD, Alldred SK, Markham C. Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD006167.pub2] - DOI - PubMed
Smyth 2013
    1. Smyth RMD, Alldred SK, Markham C. Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews 2013, Issue 1. [DOI: 10.1002/14651858.CD006167.pub3] - DOI - PubMed

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