Bala Anju, Bagga Rashmi, Kalra Jasvinder, Dutta Sourabh
a Department of Obstetrics and Gynecology , Post Graduate Institute of Medical Education and Research , Chandigarh , India.
b Department of Obstetrics and Gynecology , Guru Teg Bahadur Hospital , New-Delhi , India.
J Matern Fetal Neonatal Med. 2018 Nov;31(22):2994-3001. doi: 10.1080/14767058.2017.1362381. Epub 2017 Aug 9.
To study the effect of "early amniotomy" {initiating induction of labor (IOL) with amniotomy followed by oxytocin} versus "late amniotomy" (initiating IOL with oxytocin followed by amniotomy 4-8 h later) in induced labor.
One hundred and fifty women with Bishop's score of ≥6 undergoing IOL were randomized into "early amniotomy" and "delayed amniotomy".
Early amniotomy resulted in a reduced induction-delivery interval (IDI) (7.35 versus 11.66 h with delayed amniotomy, p = .000) but higher the caesarean section (CS) rate was observed (10.7 versus 2.7% with delayed amniotomy, p = .049). With early amniotomy, the proportion of women delivering within 12 h was higher (86.7 versus 60%, p = .000) and the maximum oxytocin concentration used was lower (30.05 versus 39.68 mU/min, p = .001) as compared to delayed amniotomy. The neonatal outcomes were similar in the two groups. Early amniotomy detected meconium prior to initiating uterine contractions with oxytocin in three women who underwent CS for meconium.
Initiating IOL with amniotomy in women with a favorable cervix was efficacious in expediting delivery, but it resulted in a higher CS rate. The higher CS rate was partly due to CS for meconium detected as a result of early amniotomy. Clinical Trials Registry (CTRI), India: Registration number CTRI/2015/01/005418.
研究“早期人工破膜”（人工破膜后启动引产并使用缩宫素）与“晚期人工破膜”（使用缩宫素启动引产，4 - 8小时后进行人工破膜）在引产中的效果。
150例 Bishop 评分≥6 且接受引产的女性被随机分为“早期人工破膜”组和“延迟人工破膜”组。
早期人工破膜导致引产至分娩间隔时间（IDI）缩短（7.35小时，而延迟人工破膜为11.66小时，p = 0.000），但观察到剖宫产（CS）率更高（10.7%，而延迟人工破膜为2.7%，p = 0.049）。与延迟人工破膜相比，早期人工破膜时在12小时内分娩的女性比例更高（86.7%对60%，p = 0.000），且使用的最大缩宫素浓度更低（30.05对39.68mU/分钟，p = 0.001）。两组的新生儿结局相似。早期人工破膜在3例因胎粪进行剖宫产的女性中，于使用缩宫素启动子宫收缩前检测到胎粪。
对于宫颈条件良好的女性，以人工破膜启动引产在加速分娩方面有效，但导致剖宫产率更高。较高的剖宫产率部分归因于早期人工破膜检测到胎粪而进行的剖宫产。印度临床试验注册中心（CTRI）：注册号CTRI/2015/01/005418。
