Skip to main content
. Author manuscript; available in PMC: 2014 Sep 11.
Published in final edited form as: Cochrane Database Syst Rev. 2012 Sep 12;9:CD006794. doi: 10.1002/14651858.CD006794.pub3

Comparison 1. Early amniotomy and early oxytocin versus routine care on spontaneous labour.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Caesarean section rate 14 8033 Risk Ratio (M-H, Random, 95% CI) 0.89 [0.79, 1.01]
 1.1 Prevention 11 7753 Risk Ratio (M-H, Random, 95% CI) 0.87 [0.77, 0.99]
 1.2 Therapy 3 280 Risk Ratio (M-H, Random, 95% CI) 1.47 [0.73, 2.96]
2 Spontaneous vaginal delivery 12 6020 Risk Ratio (M-H, Fixed, 95% CI) 1.01 [0.97, 1.05]
 2.1 Prevention 9 5738 Risk Ratio (M-H, Fixed, 95% CI) 1.01 [0.97, 1.05]
 2.2 Therapy 3 282 Risk Ratio (M-H, Fixed, 95% CI) 0.96 [0.85, 1.08]
3 Instrumental vaginal delivery (forceps or vacuum, or both) 12 6018 Risk Ratio (M-H, Fixed, 95% CI) 1.01 [0.92, 1.12]
 3.1 Prevention 9 5738 Risk Ratio (M-H, Fixed, 95% CI) 1.01 [0.92, 1.11]
 3.2 Therapy 3 280 Risk Ratio (M-H, Fixed, 95% CI) 1.32 [0.55, 3.13]
4 Length of first stage of labour 6 2671 Mean Difference (IV, Random, 95% CI) −1.57 [−2.14, −1.01]
 4.1 Prevention 4 2431 Mean Difference (IV, Random, 95% CI) −1.57 [−2.15, 1.00]
 4.2 Therapy 2 240 Mean Difference (IV, Random, 95% CI) −1.58 [−4.27, 1.10]
5 Duration of labour (duration in hours from admission in labour) 8 4816 Mean Difference (IV, Random, 95% CI) −1.28 [−1.97,−0.59]
 5.1 Prevention 7 4675 Mean Difference (IV, Random, 95% CI) −1.11 [−1.82, −0.41]
 5.2 Therapy 1 141 Mean Difference (IV, Random, 95% CI) −3.10 [−4.63,−1.57]
6 Use of epidural analgesia 9 4460 Risk Ratio (M-H, Random, 95% CI) 1.05 [0.99, 1.11]
 6.1 Prevention 6 4180 Risk Ratio (M-H, Random, 95% CI) 1.05 [0.99, 1.10]
 6.2 Therapy 3 280 Risk Ratio (M-H, Random, 95% CI) 1.02 [0.66, 1.59]
7 Hyperstimulation of labour 2 853 Risk Ratio (M-H, Random, 95% CI) 1.37 [0.76, 2.46]
 7.1 Prevention 2 853 Risk Ratio (M-H, Random, 95% CI) 1.37 [0.76, 2.46]
 7.2 Therapy 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
8 Postpartum haemorrhage (greater than 500 ml) 5 2815 Risk Ratio (M-H, Fixed, 95% CI) 0.86 [0.67, 1.11]
 8.1 Prevention 4 2674 Risk Ratio (M-H, Fixed, 95% CI) 0.83 [0.65, 1.08]
 8.2 Therapy 1 141 Risk Ratio (M-H, Fixed, 95% CI) 6.90 [0.36, 131.23]
9 Maternal blood transfusion 3 2977 Risk Ratio (M-H, Random, 95% CI) 1.84 [0.32, 10.48]
 9.1 Prevention 3 2977 Risk Ratio (M-H, Random, 95% CI) 1.84 [0.32, 10.48]
 9.2 Therapy 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
10 Postpartum fever or infection 6 2923 Risk Ratio (M-H, Random, 95% CI) 0.90 [0.69, 1.17]
 10.1 Prevention 5 2824 Risk Ratio (M-H, Random, 95% CI) 0.88 [0.66, 1.16]
 10.2 Therapy 1 99 Risk Ratio (M-H, Random, 95% CI) 1.63 [0.41, 6.47]
11 Apgar score less than seven at five minutes 7 4519 Risk Ratio (M-H, Fixed, 95% CI) 1.11 [0.78, 1.57]
 11.1 Prevention 6 4479 Risk Ratio (M-H, Fixed, 95% CI) 1.10 [0.77, 1.55]
 11.2 Therapy 1 40 Risk Ratio (M-H, Fixed, 95% CI) 2.73 [0.12, 63.19]
12 Acidosis as defined abnormal arterial cord pH (pH less than 7.10 or 7.20) 3 1416 Risk Ratio (M-H, Fixed, 95% CI) 1.11 [0.61, 2.02]
 12.1 Prevention 3 1416 Risk Ratio (M-H, Fixed, 95% CI) 1.11 [0.61, 2.02]
 12.2 Therapy 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
13 Suboptimal or abnormal fetal heart tracing 1 705 Risk Ratio (M-H, Random, 95% CI) 0.50 [0.13, 2.00]
 13.1 Prevention 1 705 Risk Ratio (M-H, Random, 95% CI) 0.50 [0.13, 2.00]
 13.2 Therapy 0 0 Risk Ratio (M-H, Random, 95% CI) 0.0 [0.0, 0.0]
14 Fetal distress 2 1099 Risk Ratio (M-H, Fixed, 95% CI) 1.22 [0.55, 2.69]
 14.1 Prevention 2 1099 Risk Ratio (M-H, Fixed, 95% CI) 1.22 [0.55, 2.69]
 14.2 Therapy 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15 Admission to special care nursery 7 4578 Risk Ratio (M-H, Random, 95% CI) 1.05 [0.77, 1.43]
 15.1 Prevention 6 4479 Risk Ratio (M-H, Random, 95% CI) 1.13 [0.91, 1.41]
 15.2 Therapy 1 99 Risk Ratio (M-H, Random, 95% CI) 0.08 [0.00, 1.30]
16 Seizure/neurological abnormalities 2 2666 Risk Ratio (M-H, Fixed, 95% CI) 0.83 [0.25, 2.71]
 16.1 Prevention 2 2666 Risk Ratio (M-H, Fixed, 95% CI) 0.83 [0.25, 2.71]
 16.2 Therapy 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
17 Jaundice or hyperbilirubinemia 2 2219 Risk Ratio (M-H, Fixed, 95% CI) 1.10 [0.68, 1.77]
 17.1 Prevention 2 2219 Risk Ratio (M-H, Fixed, 95% CI) 1.10 [0.68, 1.77]
 17.2 Therapy 0 0 Risk Ratio (M-H, Fixed, 95% CI) 0.0 [0.0, 0.0]
18 Satisfied with labour experience 3 2618 Risk Ratio (M-H, Fixed, 95% CI) 1.02 [0.99, 1.04]
 18.1 Prevention 2 2436 Risk Ratio (M-H, Fixed, 95% CI) 1.02 [0.99, 1.04]
 18.2 Therapy 1 182 Risk Ratio (M-H, Fixed, 95% CI) 1.02 [0.75, 1.39]