The outbreak of artificial membranes ( AROM ), also known as amniotomy , may be performed by the midwife or obstetrician to induce or accelerate labor. The membranes may rupture using special tools, such as amnihook or amnicot, or they may be broken by procedural fingers. Different techniques for artificial breakup of membranes have not been much compared in the literature. In one study comparing amnihook versus amnicot for artificial rupture of membranes, amnicot use was associated with fewer scalp lacerations.
By the amnihook method, a sterile plastic hook is inserted into the vagina and used to puncture the membrane containing amniotic fluid. With pierced amniotic fluid, the amniotic fluid is able to get out of the uterus and out of the vagina. The absence of fluid buffers between the fetus and uterus stimulates uterine contractions, which are also promoted by the flow of prostaglandins from the amniotic fluid.
Video Artificial rupture of membranes
Medical use
There are four main reasons for doing amniotomy:
1. To induce labor or increase uterine activity. This is the most common reason for amniotomy. Amniotic fluids are rich in hormones called prostaglandins, and cervical baths by these fluids increase the strength and frequency of uterine contractions. Sometimes, if all the criteria for rupture (listed below) are met, amniotomy is the most interventive way to start labor or make labor more progressive and functional.
2. To enable the doctor or midwife to monitor the baby's heart rate internally. The scalp electrode is placed on the baby's head and the ECG baby's heartbeat can be recorded directly. This provides a much more reliable indication of fetal wellbeing than external monitoring alone. Internal fetal monitoring is often performed if there are complications such as maternal illness, or if there is fetal distress or if the mother is being induced.
3. To check the color of the liquid. If there is suspicion of meconium (infant intestinal contents), certain preparations should be made. Sucking should be arranged and more personnel should be present.
4. To avoid baby aspiration of the contents of the amniotic sac at the time of birth. Most often, the amniotic sac will burst by itself, most often at the beginning of the second stage of labor. If it remains intact, it will definitely break up with the effort to encourage the mother. But in rare cases, a baby can be born with a whole bag that needs to be damaged so that the baby can breathe.
In some cases, the amniotic sac can also rupture if the mother can feel the puffy pockets, and feel the pressure in her vagina because of this.
There is no good evidence in 2014 as to whether antibiotics before the procedure affected the outcome.
Maps Artificial rupture of membranes
Risk
1. The baby may change to the breech position, making labor more difficult if the membranes rupture before the head attachment 2. There is an increased risk of cord prolapse 3. There is an increased risk of infection if there is a long time between rupture and birth.
Criteria
There are certain criteria for amniotomy to be performed:
1. The mother should not have contraindications for vaginal delivery 2. The mother should be in labor or have an indication for childbirth 3. Head must move (0 stations or more).
See also
- The outbreak of the membrane
- Amniotic sacs
References
Source of the article : Wikipedia
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