Onah Livinus N, Dim Cyril C, Nwagha Uchenna I, Ozumba Benjamin C
Departments of Obstetrics and Gynaecology, College of Medicine Enugu State University of Science and Technology, Enugu Nigeria.
Departments of Obstetrics and Gynaecology, College of Medicine University of Nigeria Enugu Campus, Nigeria.
Afr Health Sci. 2015 Dec;15(4):1097-103. doi: 10.4314/ahs.v15i4.7.
Early amniotomy is common in obstetric practice but, its effectiveness has not been proven.
To determine the effects of early amniotomy on the duration of labour, and other maternal / neonatal outcomes of uncomplicated pregnancies in Enugu, South-east Nigeria.
A randomized controlled study of 214 consenting term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Intervention group received amniotomy early in active labour while the control group had their membranes conserved.
Mean duration of labour for the amniotomy group (279.4 ± 53.7 minutes) was significantly lower than that of control group (354.4 ± 67.5 minutes), (t = -8.988, p <0.001). Three (3.8%) women in amniotomy group needed oxytocin augmentation as against 21 (19.6%) women in the control group RR = 0.14, (CI 95%: 0.04 - 0.46), NNT = 16. The two groups did not vary with respect to cesarean section rate, newborn Apgar scores, and need for new born special care unit admission.
Early amniotomy when compared to fetal membrane conservation reduced the duration of labour and need for oxytocin augmentation among term singleton pregnant women in Enugu, Nigeria. Its routine use in well selected cases may reduce prolonged labour and its complications.
早期人工破膜在产科实践中很常见，但其有效性尚未得到证实。
确定早期人工破膜对尼日利亚东南部埃努古地区无并发症妊娠的产程及其他母儿结局的影响。
在尼日利亚埃努古的尼日利亚大学教学医院对214名同意参与的足月孕妇进行随机对照研究。干预组在活跃期早期接受人工破膜，而对照组胎膜保持完整。
人工破膜组的平均产程（279.4±53.7分钟）显著低于对照组（354.4±67.5分钟），（t=-8.988，p<0.001）。人工破膜组有3名（3.8%）妇女需要使用缩宫素加强宫缩，而对照组有21名（19.6%）妇女需要，相对危险度RR=0.14，（95%可信区间：0.04 - 0.46），需治疗人数NNT=16。两组在剖宫产率、新生儿阿氏评分以及新生儿入住特殊护理病房的需求方面无差异。
与保留胎膜相比，早期人工破膜可缩短尼日利亚埃努古地区足月单胎孕妇的产程，并减少缩宫素加强宫缩的需求。在精心挑选的病例中常规使用早期人工破膜可能会减少产程延长及其并发症。
