Amniotomy - types, methods, indications and contraindications, complications

Types of amniotomy

About 7% of women before birth pass through the procedure of amniotomy. Pregnant women, as a rule, are afraid of a new complex word, are looking for information about this manipulation. So, what is this procedure?

Amniotomy in translation means amnion - water shell, tomie - dissection. That is, this operation is an autopsy of the fetal bladder. It is made a special medical tool, similar to a hook, when the amniotic fluid is clearly expressed. The procedure of amniotomy is absolutely painless, as there are no nerve endings on the membranes.

Amniotomy depending on the period of childbirth is divided into 4 types:

  1. Prenatal or premature. It is done before the onset of labor for the purpose of induction.
  2. Early amniotomy. It is made at the stage of opening the cervix up to 7 cm.
  3. Timely amniotomy. The fetal bladder is opened when the neck is opened 8-10 cm.
  4. Delayed amniotomy. It is done when the head of the child is already lowered to the bottom of the small pelvis.

When is an amniotomy necessary?

At the last stage of pregnancy there may be situations when immediate delivery is necessary. They happen even in the absence of fights. So, what are the indications for the use of amniotomy?

  1. Migrated pregnancy. At a term of 41 weeks or more, the question of birth-strain necessarily arises. After all, in this case the placenta "grows old" and does not cope with its functions of supplying the fetus from the mother with everything necessary. The kid begins to feel a lack of oxygen. If the cervix is ??mature and the woman agrees to such a procedure, then it is carried out.
  2. Pathological preliminar period. He is characterized by very long fights, not passing into normal labor. It tires the woman, the child undergoes hypoxia and then the question of amniotomy is solved.
  3. Rh-incompatibility. If the rhesus of the mother and fetus are different, then there is a conflict over the Rh factor. In the woman's blood, antibodies accumulate. They destroy the red blood cells of a child. In this case, too, the operation of opening the fetal bladder is used.
  4. Gestosis. In this serious disease, pregnant women suffer edema, high blood pressure, a protein appears in the urine. To avoid severe consequences resort to amniotomy.

Early amniotomy is performed in the following cases:

  1. With a flat fetal bladder, that is, when the front waters and fetal membranes are practically absent from the head of the child.
  2. With the weakness of the ancestral powers of women. To enhance labor activity, an early amniotomy surgery is performed.
  3. Low location of the placenta. In this case, it may be detached, bleeding.
  4. Polyhydramnios. Stretched by an excessive amount of fluid, the uterus is simply unable to contract properly. This leads to a weakening of labor and is an indication for the use of amniotomy.
  5. High pressure. Gestosis, hypertension, heart disease and kidneys also affect the birth process and the fetus. An autopsy of the fetal bladder releases the vessels and reduces pressure.

Delayed amniotomy is used when the membranes are too dense and can not be opened by themselves. This situation contributes to premature detachment of the placenta, bleeding.

Despite widespread practice of amniotomy, there are a number of opinions about its inefficiency. So, some studies have stated that this operation does not accelerate births, it makes the fights even harder. Other studies have confirmed that in some parturient women, in particular, amniotomy relieves pain.

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