Program

Nurse-Midwifery M.S.

Year Approved

2019

First Advisor

Wu, Katrina

Abstract

Background/Purpose: Amniotomy has been a tool used for over 50 years to progress labor. This literature review researches the effects that amniotomy has on active labor progression. Theoretical Framework: The theoretical framework selected for this literature review was The System’s Model by Betty Neuman. This theory focuses on the effects that internal and external forces have on health. This was selected because of the effects that amniotomy can have on labor progression. Methods: For this review, the 20 articles were selected following a search in The Cumulative Index to Nursing and Allied Health Literature (CINAHL), CINAHL Plus, Cochrane Database of Systematic Reviews, The American Journal of Obstetrics & Gynecology, Scopus, GOOGLE Scholar, PubMed, and ScienceDirect. These were further evaluated using John Hopkins Nursing Evidence Based Practice Model guidelines and determined to be of high quality. Results/Findings: Throughout this review, it was concluded that amniotomy can be a safe and effective tool in reducing the overall time of labor when used after the cervix is dilated 3cm and the woman is in active labor. Special consideration should be afforded to nulliparous patients, as they can progress much slower. Fifteen selected articles focused on the efficacy of labor progression and how amniotomy effects the pattern of labor. It was found that amniotomy does not raise the risk for cesarean section, shoulder dystocia, or maternal infection when done within the correct parameters. Implications for Research and Practice: The implications for this study encompass the rationale for performing amniotomy and whether or not it is a safe and effective labor intervention. Amniotomy can be a safe and effective tool to progress labor once an active labor pattern is established and the patient is 3-4cm dilated. With limited research on the risks of amniotomy, it should be used judiciously until further studies can conclude its safety.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

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