Fraser W D, Sauve R, Parboosingh I J, Fung T, Sokol R, Persaud D
University of Calgary, Department of Obstetrics and Gynaecology.
Br J Obstet Gynaecol. 1991 Jan;98(1):84-91. doi: 10.1111/j.1471-0528.1991.tb10316.x.
OBJECTIVE-To determine if a policy of early amniotomy resulted in a reduction in mean labour duration when compared to a policy of conservation of the membranes. DESIGN-A single-centre randomized controlled trial. SETTING-A tertiary care teaching hospital in Alberta, Canada. SUBJECTS-Ninety-seven term nulliparae in spontaneous labour, baby in cephalic presentation. INTERVENTION-Early amniotomy versus intent to keep membranes intact. MAIN OUTCOME MEASURES-Interval from randomization to delivery, rate of abnormalities of fetal heart rate tracings, cord artery blood pH, Apgar scores. RESULTS-The mean interval from randomization to delivery was 390.9 (SE 29.1) min in the amniotomy group and 442.9 (SE 34.1) min in the control group (P = 0.251). There were no differences between groups in the occurrence of fetal heart rate tracing abnormalities, nor was there a difference in the proportion of babies with abnormal Apgar scores, or abnormal cord pH (less than 7.20). CONCLUSION-The results of the study fail to support the long held belief that early amniotomy is an effective method for reducing labour duration.
目的——确定与胎膜保守策略相比，早期人工破膜策略是否能缩短平均产程。设计——单中心随机对照试验。地点——加拿大艾伯塔省的一家三级护理教学医院。研究对象——97名足月初产妇，自然分娩，胎儿头先露。干预措施——早期人工破膜与保持胎膜完整。主要观察指标——从随机分组到分娩的时间间隔、胎儿心率监测异常率、脐动脉血pH值、阿氏评分。结果——人工破膜组从随机分组到分娩的平均时间间隔为390.9（标准误29.1）分钟，对照组为442.9（标准误34.1）分钟（P = 0.251）。两组在胎儿心率监测异常发生率方面无差异，阿氏评分异常或脐动脉血pH值异常（低于7.20）的婴儿比例也无差异。结论——该研究结果未能支持长期以来的观点，即早期人工破膜是缩短产程的有效方法。
