[The timing of amniotomy: its effect on mother and infant]

This study was undertaken to determine how amniotomy performed during different phases of delivery affects mother and child. 1504 out of 4770 birth recorded during one year at the University Department of Obstetrics and Gynaecology in Graz were analyzed. None of these was associated with the presence of risk factors at the onset of delivery nor when amniotomy was performed. Regardless of parity, the number of ensuing complications was clearly related to the time at which amniotomy was performed: the earlier the amnion was perforated, the higher the rate of complications, particularly with primiparae. The aim of activation of labour, thereby accelerating the process of delivery by early amniotomy, was not, however, achieved. Consequently, amniotomy should not be regarded as the method of choice for the programmed induction or the acceleration of delivery. Medication should be the first step taken towards getting delivery under way and amniotomy postponed until contractions are well established and the uterine os is at least 7 cm open in primiparae and at least 4 cm in multiparae.