Early amniotomy after dinoprostone insert used for the induction of labor: a randomized clinical trial

Abstract

Purpose: We assessed whether early amniotomy, after ripening with a dinoprostone insert, reduces the duration of labor or increases the rate of delivery within the following 24 h.

Methods: A prospective randomized controlled study was conducted on 200 consenting, term pregnant women at the Zeynep Kamil Maternity and Children's Training and Research Hospital. Each participant received vaginal inserts of 10 mg dinoprostone. The women were randomly assigned to one of two groups: early amniotomy (artificial rupture of membranes when cervical dilation was at 3 cm) or standard amniotomy (the membranes were left to rupture spontaneously). The primary outcome measures were the time from induction to delivery, and the proportion of women who delivered within 24 h.

Results: The median time interval from induction to delivery (13.72 h compared to 22.73 h) was significantly shorter for women who underwent early amniotomy (p < 0.05). The frequency of vaginal delivery within 24 h was higher in women with early amniotomy (89% compared with 45% in the standard amniotomy, p < 0.05).

Conclusions: Early amniotomy, after ripening with a dinoprostone insert, is a safe and efficient method for speeding up delivery times without increasing caesarian rates during labor inductions.

Keywords: Induction of labor; dinoprostone; early amniotomy.