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