Hearing such a medical term as “amniotomy”, expectant mothers begin to wonder what it means and often find warning and even frightening feedback from “experienced women in labor” about this procedure. Often after this, a woman has a fear of childbirth, and distrust of doctors appears. In our material, we will easily explain what the concept of “amniotomy” actually means, we will determine when such a manipulation is prescribed and what risks exist.
What does the term mean?
So, amniotomy - what is it? This is an artificial rupture of the membranes with the help of a special medical tool.
As you know, the unborn child in the womb of a woman is in a dense bladder filled with amniotic fluid. Thus, the fetus is protected from external negative effects and intrauterine infection. In addition, amniotic fluid is involved in metabolic processes, contain various beneficial substances.
With a normal course of labor, the membranes rupture under the pressure of the uterus during labor, after which amniotic fluid flows. And only then the child moves along the birth canal.
But not in all cases everything happens so smoothly. In some situations, tearing the protective tissue is necessary artificially. Then the woman is prescribed an amniotomy. What is it and what are the medical indications for such a manipulation, we will describe below.
Indications for amniotomy
The procedure is performed to solve such medical problems as artificial stimulation of childbirth or help with delivery.
In what cases amniotomy is prescribed even before the onset of the natural process of giving birth to a baby:
- a pregnancy confirmed by diagnostic tests;
- gestosis in late pregnancy;
- the presence of a Rhesus conflict;
- detection in the expectant mother of serious pathologies from the heart muscle, kidneys, lungs, metabolic and autoimmune processes;
- detachment of a normally located placenta in late pregnancy;
- diagnosis of fetal hypoxia of the fetus;
- prolonged insolvency of labor;
- prolapse of the fetal bladder (protrusion into the cervix);
- intrauterine death of the fetus for a period of more than 28 weeks.
That is, the amniotomy procedure is carried out when it is urgently necessary to induce labor activity artificially for medical reasons. Usually within 12 hours after the manipulation, the woman begins labor pains. If labor has not begun after the indicated time, the doctors decide on the need for medication or a caesarean section.
Amniotomy is often performed during childbirth. The doctor will recommend such a manipulation in the following cases:
- the fetal bladder did not burst on its own when there was an opening of the cervix by 8 cm;
- multiple pregnancy;
- lack of amniotic fluid (oligohydramnios);
- excess intrauterine fluid (polyhydramnios);
- prolonged cervical dilatation ;
- placental presentation;
- weak labor, lack of contractions or attempts;
- post-term pregnancy;
- high blood pressure in a woman.
Mandatory conditions for
Even with medical indications, an amniotomy is not always possible. In order to perform the manipulation, the presence of certain conditions is necessary:
- there should be only one fetus;
- the position of the child in the uterus is head;
- gestational age is 38 weeks or more;
- fetal weight not more than 3 kg;
- the size of the pelvis of a woman meets the established standards;
- there are no scars on the uterus ;
- the birth canal is ready for the advancement of the child (when viewed, shortening of the cervix is confirmed).
Types of Amniotomy
In medicine, it is customary to classify a procedure depending on the period of its implementation:
- Prenatal. This procedure is carried out with the aim of inducing labor activity prematurely. For example, when diagnosing a woman with a pathology such as prolapse of the fetal bladder, the doctor may decide on the artificial stimulation of labor.
- Early amniotomy is performed even if the woman has contractions and incomplete (up to 6 cm) neck opening. The purpose of this manipulation is to accelerate labor.
- Timely amniotomy - what is it? This type of procedure is performed with the full opening of the cervix to activate or strengthen contractions.
- A delayed amniotomy is performed already at the stage of an attempt, if the fetal bladder has not yet burst naturally. What is the danger of having a baby in the membranes or, as the people call it, “in a shirt”? This situation is considered a deviation from the norm, it is fraught with complications such as the opening of bleeding in a woman or the development of hypoxia in a child.
Contraindications
An amniotomy is prohibited in cases where all of the above conditions are not met or natural delivery is contraindicated, for example, with:
- improper presentation of the fetus;
- genital herpes;
- large child;
- the presence of scars on the wall of the uterus and vagina;
- intrauterine hypoxia.
How is amniotomy performed?
The amniotomy procedure is performed by an obstetrician-gynecologist in a maternity hospital. A special medical instrument is used, which is called a “branch” and has the form of a hook. The doctor makes a hole in the fetal membrane with a tool, and then expands the hole with his fingers. In this case, the specialist controls the amount of amniotic fluid flow.
After this, the woman must lie down for half an hour. During this period, doctors monitor the condition of the woman and her fetus: they monitor the heartbeat, fix the appearance of contractions, and analyze the general indicators. Depending on how the body of the expectant mother reacted to the procedure, doctors draw up a diagram of further actions.
Amniotomy: consequences
Amniotomy usually goes away without any complications. But with improper manipulation, the development of conditions such as:
- prolapse of the umbilical cord or parts of the baby's body (legs or arms), which complicates further management of childbirth;
- bleeding caused by rupture of a large vessel;
- weak labor activity;
- violations in the condition of the fetus as a result of sudden changes in living conditions;
- excessive activation of the birth process;
- infection of the mother or child.
Most often, childbirth after amniotomy begins in a few hours and proceeds rapidly.
Amniotomy Reviews
Experts say that the procedure is safe and not difficult to carry out. Amniotomy has been used in obstetrics for several decades, helping to prevent serious complications during childbirth. Such a simple, affordable, not requiring special equipment and expensive reagents method daily helps babies to be born healthy.
Patient Reviews
Ambiguous reviews are left by patients who underwent such a procedure as amniotomy. What it is, how the procedure is carried out, whether it causes painful sensations and why it is dangerous - these are the most common questions of expectant mothers about such medical manipulation.
We will share the views of women who have experienced the procedure on their own experience. So, some argue that the procedure is completely painless. It is noted that after the manipulation, the child was born naturally several hours later, and the procedure did not negatively affect the baby’s health.
Other patients speak of pain, heavy childbirth. After an amniotomy, cases are sometimes noted when the baby is born with scratches on the head.
Choosing where to give birth to a baby, expectant mothers should analyze the reviews about conducting an amniotomy in a particular medical institution. This is especially true for those women who have indications for the procedure. As soon as the correct medical manipulation is safe and can help the baby to be born healthy.