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Amniotomy (puncture of the fetal bladder)

Many pregnant women are afraid of an amniotomy. This fear is mainly due to a lack of knowledge about this procedure. In fact, an amniotomy is a standard medical procedure that is performed in the delivery room without the presence of anesthesiologists.

What is an amniotomy?

In the womb, the fetus is located in the amniotic sac, a shell that is filled with a liquid called amniotic fluid. During childbirth, the amniotic sac promotes the opening of the uterus, which is necessary for the birth of a child.

Amniotomy is an artificial opening of the fetal bladder.

How is an amniotomy performed?

Everything takes place on an outpatient basis. A woman does not need to prepare for the procedure in advance. An obstetrician-gynecologist performs an amniotomy without the participation of a surgeon and an anesthesiologist. The woman does not experience pain during or after the procedure. This is due to the fact that the membrane being opened is devoid of pain receptors.

The doctor opens the bladder with a special disposable instrument – an amniotome. With further dilution of the membranes, amniotic fluid is released. And in some cases, to determine the amount of remaining water, manipulation can be performed under the supervision of ultrasound.

Usually 5-10 minutes after the end of the amniotomy, a woman can move independently.

Indications for amniotomy

Amniotomy at the EMC clinicAlthough the procedure is simple, it is carried out only according to indications.:

  • Weak labor activity. In this case, the procedure is performed to enhance contractions and the early onset of labor. If the uterus is well prepared for labor, labor usually comes within a few hours after the amniotomy.

  • The flat shape of the fetal bladder. With such a problem, there is a poor water content, which leads to a delay in labor and a lack of contractions.

  • A very dense shell. In this case, self-opening of the bubble is impossible. The birth of a baby in a bubble is extremely dangerous: due to lack of oxygen, the child may suffocate.

  • Delayed pregnancy. After 41 weeks of pregnancy, the baby begins oxygen starvation. Therefore, as in the case of weak labor, the procedure is performed for the early onset of labor.

  • Polyhydramnios. A large amount of water stretches the uterus. This leads to a complication of labor.

  • Rhesus conflict. This problem can lead to fetal death. To save the baby, doctors can call an emergency delivery.

  • Toxicosis. Prolonged toxicosis, up to the 3rd trimester, leads to an increase in a woman's blood pressure, an increased protein content in the tests, and edema. These factors complicate pregnancy and threaten not only the health of the pregnant woman, but also the baby.

  • Low-lying placenta.

Contraindications to amniotomy

  • Presentation of the umbilical cord.

  • Incorrect presentation of the fetus.

  • The disproportionate size of the fetus to the size of the pelvis of the pregnant woman.

  • Multiple pregnancies.

  • Placental presentation.

Risks of amniotomy

The risks are practically reduced to zero. If cases of fetal infection were often recorded many decades ago, now it is very rare, since amniotomy is performed in sterile conditions using disposable equipment. It is extremely rare for bleeding to begin – in such cases, specialists decide on the implementation of CS.

Doctors do not perform an amniotomy if a woman is fundamentally opposed to this procedure. This usually happens if the pregnant woman does not know enough about the procedure and thinks that it will entail serious consequences. The main task of the doctor in this matter is to explain in detail why it is very important to perform an amniotomy in a particular situation and how it can be dangerous to refuse it. Only after detailed explanations should a woman make a decision.

Since the procedure is performed manually, the results largely depend on the doctor. Therefore, you only need to contact specialized clinics where doctors with extensive experience in amniotomy, complicated pregnancy and childbirth work.

Types of amniotomy

  • Prenatal amniotomy. It is performed to accelerate the onset of labor when the due date has come, but labor has not begun. 

  • Early amniotomy. It is usually performed during childbirth, with a dense bladder shell or incomplete opening of the cervix (up to 4-5 cm).

  • Timely opening of the bubble. It is performed during childbirth, with the opening of the cervix by 6-9 cm. to accelerate the full opening of the uterus.

  • A delayed process. Such an amniotomy is performed in the second period of labor if the bladder has burst on its own and there is a possibility that the baby will be born in a shell.

Advantages of contacting the EMC

  • Specialists EMC Maternity hospital trained in the best European clinics.

  • Doctors specialize in managing complex pregnancies and various cases of complicated labor.

  • The latest operating and intensive care equipment.

  • Department of Neonatology.

  • Constant monitoring of patients by medical staff.

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Questions and answers

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The main age group for this operation are patients over 18 years with myopia, hyperopia and astigmatism. There are number contraindications for LASIC such as some chronic diseases, including eye diseases.
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An adjustment of appropriate permanent antihypertensive therapy is required for blood pressure to be stabilized. It is best to schedule a consultation with the cardiologist and undergo heart ultrasound, 24-hour blood pressure monitoring and ECG. You can make an appointment by phone +7 (495) 933-66-55. Specialists of
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Twin pregnancy resulted from IVF, but cervical dilatation occurred and water broke at 20 weeks, so the pregnancy was not maintained. How soon another attempt is possible?
At least a year interval between childbirth and repeated IVF program is required. It is advisable to be prepared and to make every effort to get a singleton pregnancy.
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Hysteroscopy revealed a polyp of the cervical canal, it was removed, but there are plenty of micropolips. May I do IVF or they should be treated?
Usually, all polyps are removed at therapeutic and diagnostic hysteroscopy. It makes no sense to leave them in the uterus cavity. I think that if manipulation such as "Hysteroscopy with separate diagnostic curettage" was done, you have no polyps now and may safely prepare for IVF.

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