Program

Nurse-Midwifery M.S.

Year Approved

2022

First Advisor

Clark, Renee

Second Reader

Katrina Wu

Abstract

Background/Purpose: There is clear evidence available that refutes the practice of routine amniotomy in the spontaneously laboring patient. Amniotomy is an intervention that disrupts a normal physiologic birth and therefore should be utilized judiciously. With a number of individuals undergoing induction of labor, it is important to consider the impact of amniotomy on labor progression as well as on maternal and neonatal outcomes and further determine if it should be an intervention routinely utilized. This integrative review examines the available evidence regarding amniotomy in labor induction. Methods: A literature search was conducted in January 2022 in CINHAL and PubMed with a ten-year date range of 2012 to January 2022. This search yielded a review of 11 articles. Studies included were randomized controlled trials and retrospective cohort studies. Results: Early amniotomy results in a shorter labor duration compared to late or spontaneous amniotomy. Timing of amniotomy did not have a profound impact on maternal and neonatal outcomes including cesarean delivery in non-obese BMI individuals. When utilizing cervical ripening agents, amniotomy shortly after the agent results in a shorter labor duration. Initiation of oxytocin immediately after amniotomy also resulted in a shorter labor duration. Both early and delayed amniotomy increase the risk for cesarean delivery in individuals with obese BMI. Discussion: Early amniotomy during labor induction was found to decrease labor duration without negatively impacting maternal and neonatal outcomes or increasing cesarean delivery rates in individuals with non-obese BMI and therefore, could be considered. Further research should be conducted to determine care of the patient with obese BMI undergoing induction of labor and if amniotomy can be safely utilized.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

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