Amniotomy is a common obstetric operation, whose purpose is to reveal fetal membranes.
At present, it carried out in 7-10% of cases, and may be made ??before the onset of labor in childbirth at the opening of the cervix up to 7 cm (early amniotomy), with full disclosure of the cervix (timely amniotomy) and at the end of the period of exile, when the baby runs the risk of being born in the shells, as they themselves never were revealed (delayed amniotomy).
In normal fetal bladder works kind of wedge during childbirth, contributing to the soft opening of the cervix. At the peak of each bout poured amniotic fluid bubble is introduced into the cervix, crushing it like a wedge, forcing the slowly but surely revealed. When the opening is in 4-7 or more inches of membranes revealed itself, water breaks. So it is normal.
If the outpouring of water was too early, it creates a risk of infection of the fetus and the uterus, which is why amniotomy produce only according to strict indications.
Amniotomy is performed with the purpose or cause, or induce labor, in some cases it is the prevention of complications.
Prenatal amniotomy can be done with the full availability of the birth canal for delivery when the cervix is soft, smooth and slightly opened.
This is done in the following cases:
– When the prolongation of pregnancy, since the prolongation of pregnancy over 41-42 weeks increases the risk of intrauterine fetal hypoxia, the bones of the skull of the child gradually lose the ability to configure and adapt the head to the mother’s birth canal, which creates an increased risk of injury for children and women in childbirth.
– In gestosis, when the woman’s condition deteriorates, there is increasing edema, increased blood pressure and increases the amount of protein in the urine, and it becomes apparent threat of pre-eclampsia, severe complications of late gestosis, which is expressed in the throes of a pregnant woman.
– If you need urgent delivery in situations of increasing Rhesus-conflict.
– When a pathological preliminary period, when the contractions become painful training for women, but did not lead to self-start labor.
In all these cases the operation is performed only with the consent of the pregnant woman, you need to understand that amniotomy induce labor, which can last a long time, especially if they are the first, and the fetal bladder is already opened with all the consequences in view of the threat of infection of the fetus, for example.
Amniotomy in labor
Amniotomy during labor in the following cases:
– Early amniotomy is performed when polyhydramnios. Self-discharge of amniotic fluid in polyhydramnios is often accompanied by complications, such as umbilical cord prolapse of loops or limbs of the fetus, perhaps even placental abruption. Amniotomy prevents complications and reduces the volume of the uterus, which leads to a further course of normal childbirth.
– Amniotomy is used in cases of primary uterine inertia, when the fight did not increase with time on the force. Pressing and pressure on the cervix itself a dense head of the child increases in labor, and often this is enough to make other arrangements are not required, for example, prostaglandin induction of labor (enzaprost) or oxytocin.
– In some cases, the amniotic bubble has a small amount of water (oligohydramnios), very dense, and the water front does not. Such fetal bladder is called flat. It does not work like a wedge, but does not pull over the head of the child, thereby inhibiting the development of delivery. In such cases, as required amniotomy.
– If a woman has high blood pressure, contributes to its lower amniotomy.
– The location of low and marginal placenta abruption amniotomy facilitates pressing the edges and stop bleeding.
– If the fetal bladder and did not reveal itself until the end of the period of exile, the child may be born under a lucky (and thus suffocate). That is why in the absence of autopsy of membranes in labor at full opening of the cervix it is usually opened. It is no longer needed, and only hinders the promotion of the fetal head.
For amniotomy using a special hook.
Amniotomy technique is simple, all her own obstetrician. The doctor gets 2 fingers into the vagina, the hook is hidden between them to inadvertently injure a woman. Then, the index finger at the height of contractions fetal bladder is opened, water is controlled by rupture of a finger to prevent complications (eg, a loop of umbilical cord prolapse with polyhydramnios).
The operation is painless, because the fetal bladder in the first place belongs to the child, not my mother, and secondly, does not have nerve endings.
Births occur after amniotomy faster it should be noted that the widespread amniotomy resulted in fewer complications in childbirth.
- By itself, the procedure is practically safe, the only births should end in the next 10-12 hours maximum, otherwise the sound diagnosis: a long dry period. Then, without antibiotics will not do.