Effects of amniotomy versus spontaneous rupture of membrane on progress of labour and foetal outcome in primigravidae

Objectives: to compare the efficacy of amniotomy with spontaneous rupture of membranes in terms of progress of labour,mode of delivery and foetal outcome in primigravidae. design: comparative study. place and duration: the study was conducted at gynae unit-1 jinnah postgraduate medical center,karachi over a period of year from 10th july 2002 to 9th july 2003. patients and methods: two-hundred primigravidae in active labour (at least 4 cm cervical dilatation) were randomly assigned for amniotomy. subjects were equally divided into two groups. in subjects of group a amniotomy was carried out and subjects of group b were left for spontaneous rupture of membranes. results of both groups were compared for duration of labour,mode of delivery and foetal outcome in terms of apgar score at 5 minutes and admission to nursery. results: the mean duration of labour was 6.66±1.4 hrs in group-a and 7.66±1.75 hrs in group b showing a significant decrease of 1 hour in duration of labour. there was no significant difference in terms of mode of delivery; foetal apgar at 5 minutes and neonatal admission to nursery in first 24 hrs following delivery also showed non-significant difference between the two groups. conclusions: our study showed that artificially rupturing the membranes during active labour in primigravidae significantly decrease the duration of labour while there was no significant difference in terms of mode of delivery and foetal outcome between the two groups.