The New England journal of medicine
The most recent articles from:
N. Engl. J. Med.
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Comment Letter
Clinical problem-solving: things are seldom what they seem.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of early amniotomy on the risk of dystocia in nulliparous women. The Canadian Early Amniotomy Study Group.
Early amniotomy has been advocated as a means of preventing dystocia, but its efficacy has not been studied prospectively. The purpose of this multicenter study was to determine whether routine early amniotomy reduces the risk of dystocia for nulliparous women in spontaneous labor. ⋯ Early amniotomy is an effective method of shortening the duration of labor and reducing the frequency of dystocia among nulliparous women in labor, but it does not lower the rate of cesarean section.