AMNIOTOMY

AMNIOTOMY (Artificial Rupture of Membranes)

 Amniotomy appears to release a local secretion of endogenous prostaglandins.

1. how to do?
need amniotic hook.


Amniotomy, using a
Hollister Amnihook or
other device, may be used
to rupture the membranes
overlying the presenting
part. Care must be taken
not to damage the fetal
tissues. The operation may
be done blindly by passing
the instrument along the
fingers or by direct vision
using a speculum.

2. precaution? what to noted?

The colour and
quantity of the liquor removed should be noted. Prolapse of the umbilical cord should be
excluded at the beginning and end of the procedure.

3.complication


Placental separation (Abruption)
This may be caused by the sudden reduction in the volume of liquor where there has been
polyhydramnios.


Prolapse of the cord
This will only happen with an ill-fitting presenting part. Cord prolapse, occult or frank,
should give warning signs on the Fetal Heart Rate monitor.


Pulmonary embolism of amniotic fluid
This rare condition presents as severe shock of rapid onset, with intense dyspnoea and often
bleeding. It is associated with amniotomy and strong uterine contractions, and must be
distinguished from eclampsia, abruption, ruptured uterus, and acid aspiration. Treatment
must include positive pressure ventilation, and correction of the inevitable coagulation
defect. Post mortem examination of the maternal lungs will show fetal cells and lanugo.