De Vivo V, Carbone L, Saccone G, et al. - Researchers sought to assess the efficacy of early amniotomy vs late amniotomy or spontaneous rupture of membranes after cervical ripening. Searching electronic databases from inception of each database through February 2019, they identified four trials for inclusion in this systematic review and meta-analysis. The trials comprised 1,273 women who underwent cervical ripening with either Foley catheter or prostaglandins, and then were randomized to either early amniotomy, or late amniotomy or spontaneous rupture of membranes (controls). Outcomes revealed no increase in the risk of cesarean delivery and a shorter interval from induction to delivery in correlation with routine early amniotomy after cervical ripening.