Objective::To investigate the effect of early versus late amniotomy after induction of labor(IOL)with vaginally administered misoprostol.Methods::This randomized clinical trial was conducted at the Department of Obste...Objective::To investigate the effect of early versus late amniotomy after induction of labor(IOL)with vaginally administered misoprostol.Methods::This randomized clinical trial was conducted at the Department of Obstetrics and Gynecology,Menoufia University,from May 2019 to March 2020,and included 120 nulliparous women at term(≥37 weeks’gestation)undergoing IOL.Computer-generated randomization was used to randomize the participants into either the early amniotomy group(3 cm cervical dilatation;n=60)or the late amniotomy group(7 cm cervical dilatation;n=60).All participants received misoprostol(25μg)vaginally to induce labor.The primary outcome was the induction-to-delivery interval,defined as the time from the initiation of IOL to the time of delivery.Results::Women in the early amniotomy group had a shorter duration of labor(12.60±5.36 h)than those in the late amniotomy group(16.67±7.26 h).The mean time from rupture of the fetal membrane to delivery was significantly shorter in the late(2.51±0.36 h)than in the early amniotomy group(3.1±0.89 h).There was no statistically significant difference between the groups in terms of maternal complications(fever,nausea,vomiting,and uterine hyperstimulation)or neonatal complications(meconium-stained liquor,APGAR score<7 at 1 and 5 min,and neonatal intensive care unit admission).Conclusions::IOL using vaginally administered misoprostol followed by early amniotomy was accompanied by a shorter duration of labor and decreased use of oxytocin.There was no significant difference between the early and late amniotomy groups in terms of the rate of cesarean section or maternal and neonatal complications.展开更多
Objective: The objective of this study was to determine if early rupture of membranes (ROM) in women undergoing induction of labor (IOL) at term is associated with an increased rate of clinical chorioamnionitis. Study...Objective: The objective of this study was to determine if early rupture of membranes (ROM) in women undergoing induction of labor (IOL) at term is associated with an increased rate of clinical chorioamnionitis. Study Design: A retrospective cohort study was performed on women undergoing IOL. Early ROM was defined as ROM at a modified Bishop score less than 5, cervical dilation less than 4 cm, or cervical effacement less than 80%. The rate of clinical chorioamnionitis was compared between women with early and late ROM. Results: The rate of clinical chorioamnionitis was 8.6% (24/279). ROM at an effacement of less than 80% was associated with a rate of clinical chorioamnionitis of 15.4% (12/78) compared to 6.0% (12/201) at an effacement of equal to or greater than 80%, p = 0.017. The rate of cesarean delivery was higher for patients with early ROM by any definition: 32% compared to 17.5% by modified Bishop score (p = 0.031), 32.4% versus 18.2% by cervical dilation (p = 0.049), and 33.3% versus 14.9% by cervical effacement (p = 0.001). Conclusions: In patients undergoing IOL, early ROM may be associated with an increased rate of clinical chorioamnionitis when performed at a cervical effacement of less than 80% and an increased rate of cesarean delivery.展开更多
文摘Objective::To investigate the effect of early versus late amniotomy after induction of labor(IOL)with vaginally administered misoprostol.Methods::This randomized clinical trial was conducted at the Department of Obstetrics and Gynecology,Menoufia University,from May 2019 to March 2020,and included 120 nulliparous women at term(≥37 weeks’gestation)undergoing IOL.Computer-generated randomization was used to randomize the participants into either the early amniotomy group(3 cm cervical dilatation;n=60)or the late amniotomy group(7 cm cervical dilatation;n=60).All participants received misoprostol(25μg)vaginally to induce labor.The primary outcome was the induction-to-delivery interval,defined as the time from the initiation of IOL to the time of delivery.Results::Women in the early amniotomy group had a shorter duration of labor(12.60±5.36 h)than those in the late amniotomy group(16.67±7.26 h).The mean time from rupture of the fetal membrane to delivery was significantly shorter in the late(2.51±0.36 h)than in the early amniotomy group(3.1±0.89 h).There was no statistically significant difference between the groups in terms of maternal complications(fever,nausea,vomiting,and uterine hyperstimulation)or neonatal complications(meconium-stained liquor,APGAR score<7 at 1 and 5 min,and neonatal intensive care unit admission).Conclusions::IOL using vaginally administered misoprostol followed by early amniotomy was accompanied by a shorter duration of labor and decreased use of oxytocin.There was no significant difference between the early and late amniotomy groups in terms of the rate of cesarean section or maternal and neonatal complications.
文摘Objective: The objective of this study was to determine if early rupture of membranes (ROM) in women undergoing induction of labor (IOL) at term is associated with an increased rate of clinical chorioamnionitis. Study Design: A retrospective cohort study was performed on women undergoing IOL. Early ROM was defined as ROM at a modified Bishop score less than 5, cervical dilation less than 4 cm, or cervical effacement less than 80%. The rate of clinical chorioamnionitis was compared between women with early and late ROM. Results: The rate of clinical chorioamnionitis was 8.6% (24/279). ROM at an effacement of less than 80% was associated with a rate of clinical chorioamnionitis of 15.4% (12/78) compared to 6.0% (12/201) at an effacement of equal to or greater than 80%, p = 0.017. The rate of cesarean delivery was higher for patients with early ROM by any definition: 32% compared to 17.5% by modified Bishop score (p = 0.031), 32.4% versus 18.2% by cervical dilation (p = 0.049), and 33.3% versus 14.9% by cervical effacement (p = 0.001). Conclusions: In patients undergoing IOL, early ROM may be associated with an increased rate of clinical chorioamnionitis when performed at a cervical effacement of less than 80% and an increased rate of cesarean delivery.
