The findings also show that the following practices persist: use of intravenous rehydration; encouraging pushing during the expulsion stage; routine episiotomy; the Kristeller maneuver; use of early amniotomy; and use of oxytocin to induce labor.
Amniotomy neither shortens spontaneous labor nor improves any of the following outcomes: length of first stage of labor, cesarean section rate, maternal satisfaction with childbirth, or Apgar score <7 at 5 minutes (strength of recommendation [SOR]: A, large meta-analyses of randomized controlled trials [RCTs] and a single RCT with conflicting results).
To accomplish this, many methods have been adopted including augmentation of labour by intravenous oxytocin and/ or by early amniotomy. Many people use various antispasmodic agents like drotaverine, hyoscine, dicyclomine and valethamate bromide to accelerate the first stage of labour, thereby reducing the sufferings of labouring mother.
Artificial oxytocin was administered to four of the interviewees, amniotomy and episiotomy were mentioned by three and the Kristeller maneuver (uterine fundal pressure) by one of the interviewees.
Alternatively, if appropriate, cervical ripening followed by oxytocin IOL and amniotomy will help the patient with a prolonged latent phase to enter the active phase of labor.
The argument might be that misoprostol still works whether the cervix is ripe or not but cervical assessment selects out candidates for immediate amniotomy. Amniotomy with or without oxytocin might be more expensive and more laborious than using misoprostol alone.
Labour induction with unfavorable cervix is done with prostaglandins, cervical Foleys catheter, mesoprostol then followed by amniotomy and augmentation with oxytocin, when cervix is favorable then induction with amniotomy and augmentation with oxytocin is carried out.
In contrast, when performing procedures where exposure to body fluids is anticipated, such as an amniotomy or placement of an intrauterine pressure catheter, protection of mucous membranes, skin, and clothing are recommended, with a mask and eye protection, in addition to gloves and an impermeable gown.
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