We thank Dr Kasapoglu for his interest in our article on the role of early amniotomy in nulliparous labor induction. Dr Kasapoglu raises 2 points in his letter.

First, he has some concerns about our sample size as it relates to one of the primary outcomes: proportion of women delivered with 24 hours. I believe that he assumed that this was limited to those women who delivered vaginally. In fact, this primary outcome included women who both delivered vaginally and by cesarean.

Dr Kasapoglu’s second point relates to postrandomization exclusions for spontaneous rupture of membranes in the control arm. This study was analyzed with the intent-to-treat principle, which means that, once a patient is randomly assigned, the data were analyzed according to that assignment. We do believe that this is the proper approach to analyzing clinical trial data.