Amniotomy

Aka: Amniotomy, AROM, Artificial Rupture of Membranes

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II. Indications

  1. Labor Induction (adjunctive measure)

III. 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

IV. 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]

V. Complications

  1. Umbilical Cord Prolapse
  2. Chorioamnionitis
  3. Fetal injury
  4. Non-reassuring Fetal Heart Tracing

VI. References

  1. Wheeler (2022) Am Fam Physician 105(2): 177-86 [PubMed]

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Related Studies

Ontology: Amniotomy at delivery (C0177273)

Definition (NCI) Perforation of fetal membranes to facilitate childbirth.(NICHD)
Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 31914005, 408817009
English artificial rupture of membrane, artificial membrane rupture, artificial rupture of membranes, Artificial Rupture of Membrane, Amniotomy at delivery, Artificial rupture of membranes at delivery, AROM, Amniotomy at delivery, NOS, Artificial rupture of membranes at delivery, NOS, Amniotomy at delivery (procedure), Artificial rupture of membranes at time of delivery
Spanish ruptura artificial de membranas en el parto, amniotomía en el parto (procedimiento), amniotomía en el parto
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Procedure

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