Effect of early amniotomy on the outcome of spontaneous labour: a randomized controlled trial of pregnant women in Enugu, South-east Nigeria

Livinus N Onah, Cyril C Dim, Uchenna I Nwagha, Benjamin C Ozumba

Abstract

Background: Early amniotomy is common in obstetric practice but, its effectiveness has not been proven.

Objectives: To determine the effects of early amniotomy on the duration of labour, and other maternal / neonatal out- comes of uncomplicated pregnancies in Enugu, South-east Nigeria.

Methods: A randomized controlled study of 214 consenting term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Intervention group received amniotomy early in active labour while the control group had their membranes conserved.

Results: Mean duration of labour for the amniotomy group (279.4 ± 53.7 minutes) was significantly lower than that of con- trol group (354.4 ± 67.5 minutes), (t = -8.988, p <0.001). Three (3.8%) women in amniotomy group needed oxytocin aug- mentation as against 21 (19.6%) women in the control group RR = 0.14, (CI 95%: 0.04 – 0.46), NNT = 16. The two groups did not vary with respect to cesarean section rate, newborn Apgar scores, and need for new born special care unit admission. Conclusion: Early amniotomy when compared to fetal membrane conservation reduced the duration of labour and need for oxytocin augmentation among term singleton pregnant women in Enugu, Nigeria. Its routine use in well selected cases may reduce prolonged labour and its complications.

Keywords: Early amniotomy, duration of labour, oxytocin augmentation, term pregnancy, caesarean section rate, Enugu- Nigeria.