How effective are early amniotomy and early oxytocin for prevention or therapy for delay in labour progress, with respect to the caesarean birth rate and indicators of maternal and neonatal morbidity?
The trials did not provide sufficient evidence on indicators of maternal or neonatal health, including women's satisfaction and views on the experience. Documentation of other aspects of care, such as continuous professional support, mobility and positions during labour, was limited. Women in the control group also received oxytocin but often later than in the intervention group. The severity of delay which was sufficient to justify interventions remains to be defined.
Caesarean section rates are over 20% in many developed countries. The main diagnosis contributing to the high rate in nulliparous women is dystocia or prolonged labour. The present review assesses the effects of a policy of early amniotomy with early oxytocin administration for the prevention or therapy for delay in labour progress.