When asked if the study was mixing cervical ripening with labor induction, Dr. Macones said, "I think the lines between ripening and induction are actually quite gray." He contended that the study’s aim was to assess the impact of amniotomy when the intention was to perform it as early as possible.
An alternative approach would be to look at women once their cervix is ripened and then ask what the role of amniotomy is, he acknowledged. "But I think that’s a little bit different question than we actually had."
Finally, an attendee questioned the importance of what might seem to be fairly small labor benefits with early amniotomy, given the potential for harm.
"I would argue that it matters to women that time to delivery is shorter," Dr. Macones commented. And it also matters to obstetricians in terms of "being efficient health care providers."
Dr. Macones did not report any relevant financial disclosures.