A randomized controlled trial of early amniotomy

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Abstract
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 (< 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.