Amniotomy for shortening spontaneous labour

Smyth, Rebecca; Alldred, S Kate; Markham, Carolyn

doi:10.1002/14651858.cd006167.pub3

Cited by 57 publications

(17 citation statements)

References 41 publications

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“…Required sample size was calculated a priori based on published effect sizes for associations between interventions (eg, amniotomy, epidural analgesia, oxytocin, amniotomy‐oxytocin, and epidural‐oxytocin) and cesarean birth . After accounting for ICC, the required sample size was estimated at an n of 26,071 to detect an effect at 80% power with alpha level (2‐sided) of .05 for most relationships examined in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Cochrane systematic reviews have explored the association between one or 2 intrapartum interventions and cesarean birth, but results differ based on whether the review examined a single intervention or a pair of interventions. For instance, early amniotomy is associated with an increased likelihood of cesarean birth, but early amniotomy combined with early oxytocin augmentation is associated with a reduced likelihood of cesarean birth . Another example is the relationship between epidural analgesia and cesarean birth.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations Among Intrapartum Interventions and Cesarean Birth in Low‐Risk Nulliparous Women with Spontaneous Onset of Labor

Iobst

Bingham

Storr

et al. 2019

J Midwife Womens Health

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Introduction: Cesarean birth rates vary widely across hospitals in the United States, even among women who are considered low-risk for the procedure. This variation has been attributed to differences in health care provider practice, but few studies have explored patterns of labor management in relation to cesarean birth. Methods: This was a retrospective observational study of 26,259 nulliparous, term, singleton gestation, vertex presentation births following spontaneous onset of labor. Births occurred from 2002 to 2007 in 11 hospitals in the Consortium on Safe Labor. Generalized linear mixed modeling was used to examine the relationship between intrapartum interventions (amniotomy, epidural analgesia, oxytocin augmentation) used individually and in combination and the outcome of cesarean birth. Results: More than 90% of the women in this low-risk sample received at least one intervention regardless of mode of birth. Epidural analgesia was the most frequently applied intervention, both when used as a single intervention (18.7%) and in combination with other interventions (79.9%). The strongest associations between these interventions and cesarean birth were observed when 2 or 3 interventions were applied during labor. Compared with women who received no interventions, the strongest association was observed among women who received amniotomy-oxytocin augmentation (adjusted odds ratio [aOR], 1.89; 95% CI, 1.36-2.62). The use of all 3 interventions (amniotomy-epidural analgesia-oxytocin augmentation) showed a similar positive association with cesarean birth (aOR 1.83; 95% CI, 1.50-2.21). Discussion: Findings show that the combined use of amniotomy, epidural analgesia, and oxytocin augmentation is positively associated with cesarean birth. Additional research is needed to examine the timing and sequence of interventions as well as whether a causal relationship exists between combinations of interventions and cesarean birth in low-risk nulliparous women.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Associations Among Intrapartum Interventions and Cesarean Birth in Low‐Risk Nulliparous Women with Spontaneous Onset of Labor

Iobst

Bingham

Storr

et al. 2019

J Midwife Womens Health

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“…Two updated Cochrane systematic reviews on amniotomy for shortening spontaneous labour [14] and amniotomy alone for labour induction [15] were identified in our search. Fifteen studies involving 5583 women were included in the review 'Amniotomy for shortening spontaneous labour' [14].…”

Section: Amniotomymentioning

confidence: 99%

“…Fifteen studies involving 5583 women were included in the review 'Amniotomy for shortening spontaneous labour' [14]. The review cited no change in conclusion after the update and 'cannot recommend that amniotomy should be introduced routinely as part of standard labour management and care' [14]. The review cited no change in conclusion after the update and 'cannot recommend that amniotomy should be introduced routinely as part of standard labour management and care' [14].…”

Section: Amniotomymentioning

confidence: 99%

Non-hormonal methods for induction of labour

Lim

Ng²,

Xu³

2013

Current Opinion in Obstetrics &Amp; Gynecology

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“…Amniotomy carries the risk of umbilical cord prolapse and is contraindicated when the presenting part of the fetus is not engaged in the pelvis and in women with a history of placenta praevia and vasa praevia. It also increases the risk of infection for mother and fetus and is contraindicated in HIV positive women [18,19].…”

Section: Introductionmentioning

confidence: 99%

Feasibility study protocol of a pragmatic, randomised controlled pilot trial: Membrane sweeping to prevent post-term pregnancy: The MILO Study

Finucane

Murphy

Cotter

et al. 2020

Preprint

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BackgroundPost-term pregnancy is associated with an increased risk of maternal complications, respiratory distress and trauma to the neonate. Amniotic membrane sweeping has been recommended as a simple procedure to promote the spontaneous onset of labour. However, despite its widespread use, there is an absence of evidence on a) its effectiveness and b) its optimal timing and frequency. The primary aim of the MILO study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. We will also assess the acceptability and feasibility of the proposed trial interventions to clinicians and women (through focus group interviews).Methods/DesignMulticentre, pragmatic, parallel group, pilot randomised controlled trial with an embedded factorial design. Pregnant women with a live, singleton fetus ≥ 38 weeks gestation, cephalic presentation, longitudinal lie, intact membranes, English speaking and ≥18 years of age will be randomised in a 2:1 ratio to:- Membrane sweep versus no membrane sweepWomen allocated randomly to a sweep will then be randomised further (factorial component) to:- early (from 39 weeks) versus late (from 40 weeks) sweep commencement; and- a single verses weekly sweepThe proposed feasibility study consists of four work packages i.e., (1) a multicentre, pilot randomised trial, 2) a health economic analysis and 3) a qualitative study (4) a study within the host trial (a SWAT).Outcomes to be collected include: recruitment and retention rates, compliance with protocol, randomisation and allocation processes, attrition rates and cost-effectiveness.Focus groups will be held with women and clinicians to explore the acceptability and feasibility of the proposed intervention, study procedures and perceived barriers and enablers to recruitment.DiscussionThe primary aim of the MILO study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. Results will inform whether and how the design of the definitive trial as originally envisaged should be delivered or adapted.Trial RegistrationClinicalTrials.gov, ID: NCT04307199. Registered 12th March 2020. https://clinicaltrials.gov/ct2/show/NCT04307199?id=NCT04307199&draw=2&rank=1

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Amniotomy for shortening spontaneous labour

Cited by 57 publications

References 41 publications

Associations Among Intrapartum Interventions and Cesarean Birth in Low‐Risk Nulliparous Women with Spontaneous Onset of Labor

Associations Among Intrapartum Interventions and Cesarean Birth in Low‐Risk Nulliparous Women with Spontaneous Onset of Labor

Non-hormonal methods for induction of labour

Feasibility study protocol of a pragmatic, randomised controlled pilot trial: Membrane sweeping to prevent post-term pregnancy: The MILO Study

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