JIMMA UNIVERSITY

COLLEGE OF HEALTH SCIENCE

SCHOOL OF MIDWIFERY
IBI III INDIVIDUAL ASSIGNMENT

Name ………………………………………………………….id no.

Warite Hirpho……………………………………………..

Submitted to Mehlet M(Bsc, Msc)

JIMMA ETHIOPIA.
Definition of amniotomy.

Amniotomy also known as artificial rupture of membranes (AROM) and by the lay
description "breaking the water," is the intentional rupture of the amniotic sac by an
obstetrical provider.

Amniotomy is the procedure by which the amniotic sac is deliberately ruptured so as to

cause the release of amniotic fluid. Amniotomy is usually performed for the purpose of
inducing or expediting labor or in anticipation of the placement of internal monitors
(uterine pressure catheters or fetal scalp electrodes).

Amniotomy is usually performed for the purpose of inducing or expediting labor or in

anticipation of the placement of internal monitors (uterine pressure catheters or fetal scalp
electrodes.

Amniotomy is intentional rupture of the amnion chiefly to induce or facilitate

labor
Indications

 To induce labor in conjunction with an oxytocin infusion

 To accelerate labor because amniotomy increases plasma prostaglandins
 To monitor the fetus or uterus
 To try to stop the bleeding during labour in case of partial placenta praevia (be
careful not to perforate the placenta).

Contra-indications

 Vasa Previa (a condition in which the fetal blood vessels cross or run near the
internal opening of the uterus)
 Complete placenta praevia
 Transverse lie
 Dilation less than 5 cm, irregular contractions (false labour, latent phase)
 Breech presentation prior to full dilation (keep the amniotic sac intact as long as
possible).
 HIV or hepatitis B infection (or context of high-prevalence) prior to full dilation:
keep the amniotic sac intact as long as possible to reduce the risk of mother-to-
child transmission.
 Presenting part not engaged: risk of cord prolapse.
 Any contraindications to vaginal delivery
 The head of the child has not dropped deep into the pelvis
 Abnormal fetus positioning
Advantages
 labor may be shortened by an hour
 facilitates collection of the amniotic fluid, which can be examined, e.g. for the
presence of meconium, indicating fetal distress.
 the fetal heart rate can be monitored with cardiotocography directly on the baby's
scalp

Disadvantages
 the baby may turn to a breech position, making birth more difficult if the
membranes are ruptured before head engagement
 increased risk of umbilical cord prolapse
 increased risk of infection if there is a prolonged time between rupture and birth.

Procedure of amniotomy.
 Place the woman on her back with knees bent and thighs apart.
 Wear sterile gloves.
 Swab the perineum and the vagina with 10% povidone iodine.
 With one hand, prepare access to the sac (hand well into the cervix). With the
other hand, slide the amnihook between the fingers of the first hand—which
spreads the vagina and the cervix and guides the tip—and make a small cut in
the sac as it bulges during a contraction. Let the fluid drain slowly then, use a
finger to enlarge the opening.
 Note the colour of the amniotic fluid (clear, greenish, or blood-stained). Isolated
meconium staining, in the absence of an abnormal foetal heart rate, is not
diagnostic of foetal distress, but requires closer monitoring.
 Make sure the cord has not prolapsed.

 Monitor the foetal heart rate before and after amniotomy.

 Post procedure care.

 Hemodynamic status of the pregnant woman

 Vital signs
 Any signs of infection
 Any signs of cord prolapse
 Fetal heart rate
 Color of the amniotic fluid (liquor)

Complication of amniotomy.

 Intrapartum chorioamnionitis (infection during the delivery).

 Prolapse of the umbilical cord (the umbilical cord drops into the vagina
ahead of the baby and obstruction of labor).
 Fetal bradycardia (irregular heartbeat).
 Fetal scalp trauma (injury to the fetal head).
 Fetal blood loss.