What is Amniotomy?
Amniotomy, also known as artificial rupture of membranes (AROM), is a medical procedure used to induce or accelerate labor. It involves the deliberate rupturing of the amniotic sac to release amniotic fluid, which can stimulate contractions and progress labor. This procedure is typically performed using a specialized instrument called an amnihook or a similar device.
To induce labor in cases of post-term pregnancy or when there are signs of
fetal distress To augment labor that is not progressing adequately
To facilitate internal monitoring of
fetal heart rate or uterine contractions
In cases of chorioamnionitis, where there is an infection of the amniotic sac
How is Amniotomy Performed?
Amniotomy is typically performed by an obstetrician or a trained healthcare provider. The procedure involves the following steps:
The patient is positioned comfortably, usually in a semi-reclined or lithotomy position.
The healthcare provider performs a sterile examination to locate the amniotic sac.
An amnihook or similar instrument is gently inserted through the cervix and used to rupture the amniotic sac.
The amniotic fluid is allowed to drain, and the progress of labor is monitored closely.
It can help to induce or accelerate labor, reducing the need for other interventions such as
oxytocin administration.
It allows for internal monitoring of the fetus, which can provide more accurate information about
fetal well-being.
It can help to relieve certain complications, such as excessive amniotic fluid (polyhydramnios).
Infection: The procedure can introduce bacteria into the uterine cavity, increasing the risk of
intra-amniotic infection.
Umbilical cord prolapse: If the baby's head is not well-engaged in the pelvis, the umbilical cord may slip out through the cervix, leading to a medical emergency.
Fetal distress: Rapid changes in intrauterine pressure can sometimes cause distress in the fetus.
Prolonged labor: In some cases, amniotomy may not effectively stimulate labor, leading to prolonged labor and the need for additional interventions.
Administration of medications like oxytocin to stimulate contractions
Use of mechanical methods such as a
Foley catheter to ripen the cervix
Waiting for spontaneous labor to begin naturally, if there are no immediate risks to the mother or
fetusConclusion
Amniotomy is a valuable medical procedure that can help manage labor and address certain complications. It is important for healthcare providers to carefully consider the indications, benefits, and risks before performing this intervention. Informed consent and thorough communication with the patient are essential to ensure a positive outcome.
