A Case-Control Study Comparing an Early Amniotomy with A Selective Amniotomy in Women who are in Simple Labour at Term
Main Article Content
Abstract
Background - In many nations, the Caesarean section rate exceeds 20%. Prolonged labor is the primary diagnosis causing the high rate in nullipara. The current review evaluates the outcomes of a policy of early amniotomy with spontaneous rupture of membranes for the treatment or prevention of labor progress delays.
Objectives – A comparison of spontaneous membrane rupture and early amniotomy for accelerating contractions and cutting labor time. To ascertain the efficacy and safety of amniotomy for reducing the length of all spontaneously initiating, uncomplicated labors, the efficacy and safety of amniotomy for effect on the caesarean delivery rate, and the efficacy and safety of amniotomy for influence on mother and newborn outcome.
Materials and Methodology – This investigation was prospective and observational. From December 2017 to June 2019 (18 months), all patients from Satara District who met the inclusion and exclusion criteria were enrolled in the department of obstetrics and gynecology at Krishna Institute of Medical Sciences, Karad. 100 patients who met the eligibility requirements were randomly assigned to one of the two groups. 50 women each were assigned to the AROM and the spontaneous rupture of membranes groups. The length of labor, the frequency of cesarean deliveries, and the impact of these factors on the outcomes of the mother and the baby are compared between the two groups.
Results – Patients' ages ranged from 20 to 40 years. In primigravidas and multigravidas, early amniotomy reduces I stage labor time by 4.86 hours and 2.26 hours, respectively (p value 0.0001). In primigravidas, the mean cervical dilatation occurred at a higher rate in the AROM group (1.69 cm/hr vs. 1.06 cm/hr, a difference of 0.62 cm/hr).
The mean cervical dilatation rate in multigravidas was likewise higher in the AROM group, at 2.08 cm/hr, compared to the SROM group, at 1.24 cm/hr, a difference of 0.84 cm/hr. In the AROM group, there is a marginally statistically insignificant rise in the rate of cesarean sections and instrumental deliveries. Both groups' neonatal outcomes were found to be comparable.
Conclusion – The study demonstrates that the AROM group's labor is shorter than that of the spontaneous rupture of membranes group. Additionally, the color of the liquor provides insight into fetal health, which aids in selecting the route of delivery. Consequently, the practice of early amniotomy appears to be justifiable in a growing nation like ours.
Article Details
References
Abdullah, A., Saboohi, S., & Hashami, U. (2010). Effects of amniotomy versus spontaneous rupture of membrane on progress of labour and foetal outcome in primigravidae. JLUMHS, 9(01), 33.
American College of Obstetricians and Gynaecologists. (2009). ACOG practice bulletin no. 107: induction of labor. Obstet Gynecol, 114, 386-397.
Archie, C. L., & Roman, A. S. (2013). Normal & abnormal labor & delivery. Current Diagnovghyysis & Treatment in Obstetrics & Gynaecology 11th edn McGraw-Hill Companies, New York, 154-162.
Barrett, J. F., Savage, J., Phillips, K., & Lilford, R. J. (1992). Randomized Trial of Amniotomy in Labor Versus the Intention to Leave Membranes Intact Until the Second Stage. Obstetrical & Gynecological Survey, 47(8), 539-541.
Busowski, J. D., & Parsons, M. T. (1995). Amniotomy to Induce Labour. Clinical Obstetrics and Gynaecology, 38(2), 246–258.
Cohain, J. S. (2013). The less studied effects of Amniotomy. The Journal of Maternal-Fetal & Neonatal Medicine, 26(17), 1687–1690.
Fraser, W., Vendittelli, F., Krauss, I., & Bréart, G. (1998). Effects of early augmentation of labour with amniotomy and oxytocin in nulliparous women: a meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 105(2), 189-194.
Goffinct, F., Fraser, W., Marcoux, S., Breart, G., Moutquin, J. M., & Daris, M. (1997). Early amniotomy increases the frequency of foetal heart rate abnormalities. BJOG: An International Journal of Obstetrics and Gynaecology, 104(5), 548–553.
Johnson, N., Lilford, R., Guthrie, K., Thornton, J., Barker, M., & Kelly, M. (1997). Randomised trial comparing a policy of early with selective amniotomy in uncomplicated labour at term. BJOG: An International Journal of Obstetrics & Gynaecology, 104(3), 340-346.
Li, N., Wang, Y., & Zhou, H. (2006). Effects of routine early amniotomy on labor and health status of foetus and neonate: a meta-analysis. Zhonghua fu chan ke za zhi, 41(1), 16-19.
Osuntokun, A. (2005). Book Review: Review Essay on the Book War and Peace in Yorubaland 1793-1893 Edited By Adeagbo Akinjogbin Heinemann Educational Books (Nig.) Plc Ibadan, 1998, 525 Ppword,. Lagos Historical Review, 1(1).
Rogers, R., Gilson, G. J., Miller, A. C., Izquierdo, L. E., Curet, L. B., & Qualls, C. R. (1997). Active management of labour: Does it make a difference? American Journal of Obstetrics and Gynaecology, 177(3), 599–605.
Smyth, R. M., Markham, C., & Dowswell, T. (2013). Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews, (6).
Wei, S., Wo, B. L., Qi, H. P., Xu, H., Luo, Z. C., Roy, C., & Fraser, W. D. (2012). 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, (9).
World Health Organization, & World Health Organization. Reproductive Health. (2003). Managing complications in pregnancy and childbirth: a guide for midwives and doctors. World Health Organization.