BMJ 1994;309:1015-1016 (15 October)

Letters

Non-randomised studies cannot be ignored

EDITOR, - James G Thornton and Richard J Lilford's assessment of the components of active management of labour is equivalent of taking a car to pieces and finding that a gearbox left lying in the road goes neither very far nor very fast.1 The strict diagnosis of labour is not the final component of the management of labour - that is delivery of the placenta; rather it is the first component, both in chronological sequence and in importance.2 The fact that 40% of women diagnosed as not being in labour returned promptly in unequivocal labour implies that the remaining 60% were spared inadvertent and unnecessary induction of labour at that time.

Artificial rupture of membrances is done to confirm the presence of clear liquor as oxytocin is dangerous if no liquor can be seen or if meconium is present. Speeding up established labour has never been claimed to confer more . . . [Full text of this article]


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Relevant Article

Active management of labour: current knowledge and research issues
J G Thornton and R J Lilford
BMJ 1994 309: 366-9. [Abstract] [Full Text]

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