When you’re pregnant, you come to hear a bewildering number of terms you just might not understand, with references to different medical processes. It can be difficult to work it out. You might, for instance, have heard of the term ‘amniotomy’, but have no clue what it means. Luckily, we’re here to help.
You may know already that the amniotic sac is a closed structure where the foetus develops. It contains a pair of membranes, the inner membrane holds the foetus secure and also contains amniotic fluid. During an amniotomy, the fluid is basically released from the sac to help induce labour.
Why is this done?
You might get an amniotomy (also known as artificial rupture of membranes, or AROM) done for a few reasons. It can be suggested if you’re past your due date, or if you’re in prolonged labour and need to help the process, to check amniotic fluid, or to allow the doctors to place internal monitors so that they can monitor the health of the foetus.
However, this procedure is to be avoided if you’ve have placenta previa (where the baby’s placenta might cover some part of your cervix), if the foetus is in an abnormal position in your uterus, if you have an active herpes infection in your genitalia, or Hepatitis B or C, or if the cervix not yet dilated and if you can’t deliver vaginally for some reason.
You will probably be in the delivery room if this procedure is performed. The doctor might confirm the position of the baby and use an electric foetal monitor. You may be asked to lie down, or also sit up, depending on what the situation requires and the oxygen supply the foetus might need. An amniotomy hook is then carefully inserted into the vagina to break the membrane. If the foetus is not in the correct place for the procedure to be effective, then some pressure might be applied so the foetus can be held in the correct place while the membrane is ruptured.
After the procedure is over, the doctor will make sure to take note of the amniotic fluid and also to check the foetal heartbeat so it can be confirmed that the process hasn’t caused any damage.
What are the risks?
There are several risks to a procedure like an amniotomy.
- Once the membrane has ruptured and the water has broken, there is a risk of infection for the foetus. The mother must then give birth as soon as possible, but this is true even if waters break naturally, as well.
- There may be an issue of umbilical cord prolapse. Cord prolapse means that the umbilical cord emerges with the baby, and this can cause oxygen supply issues for the baby, which might lead to some disorders.
- There may be a very small risk of trauma to the foetal scalp, but usually care is taken to prevent this. There may be a risk of foetal blood loss.
Why would I need one?
If you’ve had a healthy pregnancy and everything is going fine, a doctor is not going to recommend an amniotomy out of the blue. Amniotomia aren’t generally elective procedures, unless in specific circumstances. Additionally, you might be wondering whether they actually do help induce labour.
Actually, there isn’t much evidence to support this one way or the other. An amniotomy by itself might not really help to induce labour as immediately as required. It can be performed by taking other drugs along with it which come with their own set of risks. It might in fact increase the risk of having an unplanned C-section.
Doctors are probably more likely to perform an amniotomy if there is some issue with the foetus so that it needs monitoring, or if they need to check the amniotic fluid, or perhaps if you are quite far past your due date. But at the fag end of your pregnancy, it’s unlikely that you will be asked to consent to such a procedure if things are going smoothly.
If your doctor recommends an amniotomy for whatever reason, and you are scared about it, don’t be. Make sure you’ve picked the right hospital and the right doctor. A procedure like an amniotomy always happens in a strictly controlled situation, so that if there’s the slightest chance of any emergency, it can immediately be taken care of.