Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
Am J Obstet Gynecol. 2012 Nov;207(5):403.e1-5. doi: 10.1016/j.ajog.2012.08.032. Epub 2012 Aug 24.
The purpose of this study was to assess whether early amniotomy reduces the duration of labor or increases the proportion of subjects who are delivered within 24 hours in nulliparous patients who undergo labor induction.
We performed a randomized controlled trial that compared early amniotomy to standard management in nulliparous labor inductions. Inclusion criteria were nulliparity, singleton, term gestation, and a need for labor induction. Subjects were assigned randomly to early amniotomy (artificial rupture of membranes, ≤4 cm) or to standard treatment. There were 2 primary outcomes: (1) time from induction initiation to delivery and (2) the proportion of women who delivered within 24 hours.
Early amniotomy shortens the time to delivery by >2 hours (19.0 vs 21.3 hours) and increases the proportion of induced nulliparous women who deliver within 24 hours (68% vs 56%). These improvements in labor outcomes did not come at the expense of increased complications.
Early amniotomy is a safe and efficacious adjunct in nulliparous labor inductions.
本研究旨在评估在进行引产的初产妇中，早期羊膜穿刺术是否能缩短产程或增加 24 小时内分娩的产妇比例。
我们进行了一项随机对照试验，比较了早期羊膜穿刺术与初产妇引产的标准管理。纳入标准为初产妇、单胎、足月妊娠和需要引产。受试者被随机分配到早期羊膜穿刺术（人工破膜，≤4 厘米）或标准治疗组。有 2 个主要结局：（1）从引产开始到分娩的时间；（2）24 小时内分娩的产妇比例。
早期羊膜穿刺术可将分娩时间缩短>2 小时（19.0 小时 vs 21.3 小时），并增加 24 小时内分娩的初产妇比例（68% vs 56%）。这些产程结局的改善并没有导致并发症增加。
早期羊膜穿刺术是初产妇引产的一种安全有效的辅助手段。
