Clinical inquiries. Does routine amniotomy have a role in normal labor?

It may, depending on the stage of labor and whether the woman has given birth previously. 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 secondstage 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).