Amniotomy

Amniotomy is done for the below reasons:

• To start the delivery process
• To speed up the delivery process if it has stalled or slowed for several hours
• To attach a monitoring device to the baby’s head and record the heartbeat in a lengthy or high-risk labor and delivery
• To examine the amniotic fluid for fetal stool, this may indicate fetal distress

Amniotomy involves risks and possible complications. Complications may become serious in some cases. Complications can develop during the procedure or after some days:

• Excessive vaginal bleeding
• Fetal blood loss: This may be a life-threatening complication needing emergency cesarean delivery to save the fetus.
• Umbilical cord prolapse: This occurs when the umbilical cord comes out of the uterus before the baby. This can compress the umbilical cord between the baby and the mother and cut off blood supply to the baby. Umbilical cord prolapse may require an emergency cesarean delivery.
• Infection in the mother or the baby:  Once a woman’s membranes have ruptured, either via natural or artificial means, the fetus becomes vulnerable to infections that can ascend from the vagina into the uterus. This may lead to conditions, such as placentitis or chorioamnionitis (which can result in lifelong diabetes if improperly handled). 
• Injury to the baby, especially the head of the baby.

An amniotomy is performed with the patient lying on a hospital bed in a labor or delivery room. In some cases, the patient is asked to stay in a semi-sitting position to minimize cord compression and ensure good oxygen supply for the fetus. The procedure is performed by an obstetrician.

• The doctor may insert a small surgical hook or a gloved finger that has a hook on it through the vagina into your uterus.
• The doctor may scratch the surface of the amniotic sac to break the membrane. The amniotic sac is a fluid-filled sac, composed of membranes in which the fetus or baby develops. If the fetus is not in the correct place position for the procedure to be effective, then some pressure might be applied to the fetus so that it can be held in the correct place while the membrane is ruptured.
• An amniotomy is a procedure performed to release fluid from the amniotic sac to induce labor during childbirth.
• As the amniotic fluid begins to flow out, the doctor keeps one hand in the vagina to let it flow gradually and prevent umbilical cord prolapse. As a follow-up step, the doctor measures and notes the color and consistency of the fluid.
• The doctor might confirm the position of the baby and use an electric fetal monitor to check the fetal heartbeat, so it can be confirmed that the process has not caused any damage.
• The patient may feel brief discomfort as the amniotomy hook goes through the vagina or cervix. The rupture itself is painless for both the mother and baby.

Once the procedure is completed, delivery should take place within 24 hours to prevent infection.