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close this bookCare in Normal Birth (WHO - OMS, 1996, 60 p.)
close this folder3.5 Prevention of Prolonged Labour
View the document(introduction...)
View the document3.5.1 Early amniotomy
View the document3.5.2 Intravenous infusion of oxytocin
View the document3.5.3 Intramuscular oxytocin administration

3.5.1 Early amniotomy

This intervention has been recommended as a routine procedure 1 hour after admission in labour (O’Driscoll et al 1973). In a controlled study a considerable increase of type I decelerations of the fetal heart rate was found after early amniotomy (Schwarcz et al 1973). Several randomized trials suggest that amniotomy early in labour leads to a reduction, on average, of between 60 and 120 minutes in the duration of labour, without effects on the use of analgesia and rates of operative delivery. The trials provide no evidence that early amniotomy has a favourable or unfavourable effect on the condition of the neonate (Fraser et al 1991, 1993, Barrett et al 1992). It is not possible to conclude that early amniotomy has a clear advantage over expectant management, or the reverse. Therefore, in normal labour there should be a valid reason to interfere with the spontaneous timing of the rupture of the membranes.