Does routine amniotomy have a role in normal labor?

Abstract

Routine amniotomy doesn't significantly reduce the duration of first-stage labor in either primiparous or multiparous women (strength of recommendation [SOR]: A, systematic review of several randomized, controlled trials [RCTs]); it slightly shortens second-stage labor in primiparous women only (SOR: A, systematic review of several RCTs). A trend toward increased rates of cesarean section has been noted in low-risk women who undergo routine amniotomy (SOR: A, systematic review of several RCTs). The procedure doesn't appear to affect neonatal outcomes (SOR: B, uncommon endpoint in several large RCTs).