WHO recommendation on early amniotomy and oxytocin for prevention of delay in labour

Pregnant woman receiving intravenous oxytocin.

WHO recommendation on early amniotomy and oxytocin for prevention of delay in labour

 

Recommendation

The use of early amniotomy with early oxytocin augmentation for prevention of delay in labour is not recommended.

(Not recommended)

 

Publication history

First published: February 2018

Updated: No update planned

Assessed as up-to-date: February 2018 

 

Remarks

  • This recommendation has been integrated from the WHO recommendations for augmentation of labour, in which the GDG for that guideline determined it to be a conditional recommendation based on very low-quality evidence.  
  • The GDG noted that the variable reduction in the duration of the first stage of labour itself does not justify the intervention, given that no substantive differences were found in other important clinical outcomes.  
  • The GDG noted the substantial overlap between this intervention and the other components of the active management of labour, and considered it as equally highly prescriptive and interventional. Like the package of active management of labour, the group placed much emphasis on its potential to undermine women’s rights, choices and autonomy as recipients of care, and therefore did not recommend the intervention. Additionally, the intervention is not considered feasible in many settings, as it requires considerable health care resources to implement.
  • The evidence supporting this recommendation can be found in the source guideline document, available at:

 

WHO recommendation on the use of early amniotomy with early oxytocin augmentation for prevention of delay in labour

http://who.int/iris/bitstream/10665/112826/1/WHO_RHR_14.15_eng.pdf

 

Related links

WHO recommendations on intrapartum care for a positive childbirth experience

(2018) - full document and evidence tables

Managing Complications in Pregnancy and Childbirth: A guide for midwives and doctors

Pregnancy, Childbirth, Postpartum and Newborn Care: A guide for essential practice

WHO Programmes: Sexual and Reproductive health

Maternal Health