Association Between Early Amniotomy in Labor Induction and Severe Maternal and Neonatal Morbidity

Abstract

(Aust N Z J Obstet Gynaecol. 2020;60:108–114) Labor induction is a common obstetric procedure in the United States and is crucial in expediting delivery for women with fetal or maternal indications. However, the optimal method for induction of labor is highly debated and lacks consensus. Amniotomy is frequently a component of labor induction, but many providers have concerns that early amniotomy could increase a variety of delivery complications, such as umbilical cord prolapse, cesarean delivery, infection, and neonatal intensive care unit admission. The primary aim of this study was to assess whether early amniotomy [defined as artificial rupture of membranes (AROM) at <4 cm dilation] affected the duration of labor induction in both nulliparous and multiparous women, and whether it was associated with increases in cesarean delivery rate, severe maternal morbidity, or severe neonatal morbidity.