Amniotomy during labor aims to stimulate and accelerate the labor process, by breaking the membranes. This procedure is generally carried out if the amniotic sac has not yet broken before labor or if labor lasts a long time.
Amniotomy procedures are performed by a doctor or midwife by tearing the amniotic sac using an instrument called amnihook and amnicot. The accidental rupture of membranes is believed to stimulate the emergence of stronger uterine contractions, so that the cervix is open and the baby can be born faster.
Reasons for Amniotomy during Childbirth
The amniotic sac is filled with amniotic fluid and the placenta. The function of water and amniotic sac is to protect the fetus from collisions, injuries, and infections, to maintain the body temperature of the fetus to remain normal, as well as a place for the fetus to grow and develop before birth.
Most pregnant women experience naturally ruptured amniotic fluid or rupture on their own, and this is considered a sign that labor has begun. However, in some cases, the amniotic sac does not rupture until labor arrives. In this condition, the doctor or midwife will usually recommend an amniotomy.
In addition, amniotomy is also usually performed to:
1. Induction or initiation of labor
Amniotomy is a good method of labor induction. The purpose of labor induction is that uterine contractions occur and labor begins. This method can be combined with other induction methods, such as administering oxytocin by injection.
2. Strengthening labor contractions
Amniotomy can also be performed as a method of labor augmentation, which is the process of stimulating the uterus so that the frequency, duration, and strength of contractions increase after the appearance of natural contractions.
This method is often used to treat long deliveries that can endanger the condition of the fetus and pregnant women. This prolonged labor can occur because uterine contractions are not strong enough to widen the birth canal or because the baby's size is too large.
In addition, amniotomy can also be done to shorten the time of delivery, prevent complications due to prolonged labor, and to avoid cesarean section.
3. Monitor the condition of the fetus
Amniotomy is sometimes needed to monitor the condition of the fetus in the womb which requires special monitoring. This monitoring is done by attaching electrodes to the fetus, then the electrodes are connected to the monitor.
After connecting to the monitor, the doctor can listen to the fetal heartbeat and monitor fetal activity more clearly, so as to determine the presence or absence of abnormalities in the fetus before delivery.
4. Detect the presence of meconium
Amniotomy can also be done to detect meconium or fetal feces in the amniotic fluid. This action needs to be done because meconium swallowed by the fetus can cause respiratory distress or infection in the baby's lungs.
Although it has several benefits, not all pregnant women need or may undergo an amniotomy. Some conditions that make pregnant women unable to undergo amniotomy are:
- The fetus has not entered the pelvis.
- Breech baby position.
- Placenta previa.
- Vasa Previa. This condition occurs when placental blood vessels or fetal umbilical cord descends until it exits the cervix. This condition has the potential to endanger the lives of the mother and fetus.
In addition, the amnniotomy during childbirth also has several risks, namely:
- Amniotic infection or chorioamnionitis.
- Bleeding after childbirth, especially in pregnant women with vasa previa conditions.
- Pressing or twisting the umbilical cord.
- Fetal distress.
- A cesarean section is needed if an amniotomy does not help in normal labor.
These risks are usually more likely to occur in pregnant women with certain pregnancy problems, or if an amniotomy is performed too quickly (before the estimated time of delivery and there are not yet any signs of labor). As long as the cervix is fully mature or dilated and the baby is ready to be born, the risk of amniotomy is relatively small.
While waiting for the birth of the baby, there is no harm in pregnant women looking for various information about the actions in labor, including amniotomy, if at any time such actions are needed.
To monitor the condition of pregnancy and the fetus and to determine the best method of delivery, do not forget to regularly check with your obstetrician.
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