Early description of amniotomy in medieval Persia

AIM Artificial rupture of the amniotic membranes during the labor, which is called amniotomy, is a common procedure in modern obstetric and midwifery protocols. There is no definite agreement regarding the timing of amniotomy in a delayed labor. In this study, we have discussed the history of amniotomy in medieval Persia mentioning the Persian medicine recommendations in this regard. METHODS We studied main Persian medicine textbooks such as Canon of Medicine by Avicenna to investigate the history of labor management and amniotomy indications. In addition, amniotomy in current literature was studied using PubMed and Google Scholar databases. RESULTS Persian medicine has recommended artificial rupture of membranes for labor augmentation based on its own theories. Methods for facilitation of the labor have been divided into two groups: one group before and the other during the labor. Avicenna has carefully explained the indication of amniotomy. He has recommended artificial rupture of membranes in cases of intact membranes with cervical dilatation and fetal descent. A needle or a kind of surgical knife called Mabzaa had been introduced for this procedure. CONCLUSIONS It seems that Iranian physicians are the first scholars who have introduced the amniotomy for labor management in the 11th century. Persian medicine recommendations for labor facilitation should be considered in future studies.