Induction of labor: a prospective, randomized study into amniotomy and oxytocin as induction methods in a total unselected population.

All women (n = 223) scheduled for induction of labor were randomized into start with oxcytocin infusion (O) or amniotomy (A). After 4 h an assessment of the progress and prognosis was made. If the progress was not acceptable O was added to A and A to O. Oxcytocin alone showed the lowest frequency of delivered patients. The "amniotomy only" group showed the shortest duration of delivery. The frequency of complications was low but somewhat higher when the initial step was oxcytocin. Oxcytocin alone is not a good method for induction. Early evaluation of the progress and prognosis of the induction is difficult. The combination of amniotomy and oxcytocin seem to be more essential than the choice of initial step. If, however, an infusion of oxcytocin is the first proceeding, amniotomy should be added on a routine basis and without delay. Bishop score is not a conclusive measure of the readiness of uterus to go into labor. Parity may partly be the explanation but other today unknown factors are probably involved in the inducibility.