A randomised controlled trial of early versus delayed use of amniotomy and oxytocin infusion in nulliparous labour

British Journal of Obstetrics and Gynaecology
H Cammu, E Van Eeckhout

Abstract

To compare routine amniotomy and early intravenous oxytocin (active management of labour) with a more selective use of amniotomy and oxytocin in women in true labour who received comparable continuous supportive midwifery care. Randomised controlled trial of nulliparous clinic patients in spontaneous labour at term. Labour and delivery ward of a university teaching hospital. Three hundred and six parturients: 152 received active management of labour; 154 were more selectively managed. 1. Active management: early amniotomy, early use of oxytocin. 2. Selective intervention management: no routine amniotomy and more selective use of oxytocin. Use of oxytocin and amniotomy. Labour duration, mode of delivery. Maternal characteristics were comparable in both groups. Amniotomy was more often performed (91% versus 57%, P <0.01) and oxytocin more often used (53% versus 27%, P < 0.01) in the active management group. The first stage of labour, however, was only shortened by half an hour in the active management group (254 min versus 283 min, P = 0.087). Caesarean section rate (3.9% versus 2.6%), spontaneous vaginal delivery rate (78% versus 79%) and neonatal outcome were not significantly different between groups. Within a set-up of strict...Continue Reading

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Citations

Apr 5, 2000·MCN. the American Journal of Maternal Child Nursing·S Clayworth
Oct 24, 2012·Clinical Obstetrics and Gynecology·David Ware Branch, Robert M Silver
Aug 17, 1996·BMJ : British Medical Journal·J G Thornton
Apr 30, 2014·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Ekaterina MishaninaCatherine Meads
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Oct 30, 2004·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·F Wilcock, J Kingdom
Dec 22, 2006·Journal of Clinical Nursing·Karin SvärdbyEva Sellström
Mar 31, 2015·Gynécologie, obstétrique & fertilité·G Kayem
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Jul 30, 1999·British Journal of Obstetrics and Gynaecology·L Impey, P Boylan
Jul 13, 2013·The Cochrane Database of Systematic Reviews·Philippa L Costley, Christine E East
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Apr 18, 2020·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Augustine OrhueBabatunde Ande
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May 21, 2008·Scandinavian Journal of Caring Sciences·Anna Stålhammar, Barbro Boström

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