Prevalence of amniotomy in Sweden: a nationwide register study

Abstract

Background Amniotomy is a commonly used labor intervention with uncertain evidence, and there are complications connected to the intervention. Yet, the Swedish prevalence of amniotomy is unknown. The aim of the study was therefore to describe the prevalence of amniotomy in Sweden. Methods This nationwide register-based study included 330,913 women giving birth in 2017–2020. Data were collected from the Swedish Pregnancy Register in which the majority of data is collected via direct transfer from medical records. Prevalence of amniotomy was described for all births, for nulliparous and multiparous women with spontaneous onset of labour, and at the hospital level. Descriptive statistics and chi-square test were used to analyse the data. Results For all births, the prevalence of amniotomy was 40.6%. More amniotomies were performed in Robson group 1 compared to Robson group 3; 41.1% vs 32.3% (p < 0.001). The prevalence for all births remained the same during the study period; however, a decrease from 37.5 to 34.1%, was seen in Robson group 1 and Robson group 3 (p < 0.001). Variations in the prevalence between hospitals were reported. The hospitals with the fewest number of births annually had the highest prevalence of amniotomy (45.0%), and the lowest prevalence was reported at the University hospitals (40.4%) (p < 0.001). Conclusions Amniotomy is a common labor intervention in Sweden, given that almost half of the laboring women underwent the intervention. Our results, regarding variations in the prevalence between hospitals, could imply a potential for fewer amniotomies in Swedish childbirth care.

Incidence and risk factors for umbilical cord prolapse in labor when amniotomy is used and with spontaneous rupture of membranes: A Swedish nationwide register study

“…Amniotomy is one of the most used interventions in modern obstetrics. It is performed for various reasons: to induce labor, to enable the use of a scalp electrode, and to treat labor dystocia 9,16,17 . However, the evidence to support an amniotomy to speed up the labor progression, in labors with spontaneous onset, is uncertain 17 .…”

“…It is performed for various reasons: to induce labor, to enable the use of a scalp electrode, and to treat labor dystocia. 9 , 16 , 17 However, the evidence to support an amniotomy to speed up the labor progression, in labors with spontaneous onset, is uncertain. 17 There is also a global concern about the overuse of labor interventions.…”