Procedure

Amniotomy

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Amniotomy, AROM, Artificial Rupture of Membranes

  • See Also
  1. Labor Induction
  2. Cervical Ripening
  • Indications
  1. Labor Induction (adjunctive measure)
  • Technique
  1. Continuous Fetal Monitoring during procedure
  2. Start with sterile cervical exam
    1. Confirm vertex presentation
    2. Confirm fetal head well applied to Cervix
  3. Rupture Membranes
    1. Option 1
      1. Insert amniohook, guided with fingers into Cervix, with hook initially toward hand
      2. Identify amniotic fluid pocket and rotate the amniohook against the pocket to rupture membranes
    2. Option 2
      1. Apply fetal scalp electrode
  4. Examining fingers remain at Cervix after rupturing membranes
    1. Confirm cord is not present as the fetal head applies more firmly to the Cervix
  5. Observe color of ruptured membranes
  • Efficacy
  1. Conflicting evidence for benefit in Labor Induction
    1. De Vivo (2020) Am J Obstet Gynecol 222(4): 320-9 +PMID:31398311 [PubMed]
    2. Smyth (2013) Cochrane Database Syst Rev (6): CD006167 +PMID:23780653 [PubMed]
  • Complications
  1. Umbilical Cord Prolapse
  2. Chorioamnionitis
  3. Fetal injury
  4. Non-reassuring Fetal Heart Tracing
  • References
  1. Wheeler (2022) Am Fam Physician 105(2): 177-86 [PubMed]