Amniotomy is an artificial opening of a fetal bladder.
a) early amniotomy - performed in the first stage of labor with the opening of the cervix to 7 cm;
b) timely amniotomy - performed when the cervix is opened by 7 cm or more;
c) belated amniotomy - after the full disclosure of the cervix and unvistorous waters.
Indications for an amniotomy:
1. Delayed rupture of the bladder with excessively dense skin.
2. A flat fetal bladder, since it does not fulfill its function as a hydraulic wedge, inhibits labor and can lead to premature detachment of the placenta.
3. Weak labor activity (carrying out amniotomy improves the efficiency of induction).
4. Polyhydramnios - pererazhtagnuta uterus leads to the weakness of labor.
5. Low location of the placenta - amniotomy stops further placental abruption.
6. Delay in the birth of the second fetus in twins.
7. Severe forms of late gestosis - amniotomy leads to a decrease in intrauterine pressure and accelerates the birth process, which is important for the normalization of hemodynamics.
8. The condition for the use of obstetric forceps is the rupture of the bladder.
Technique of operation: after treatment of external genitals disinfectant solutions in the vagina enter the index and middle fingers tear them shells strained during fetal bony contractions. If this method fails, the bladder ruptures the bulimoles with forceps or forceps. This is done under the control of vision (the vagina is injected with mirrors) or fingers (the tool is inserted along the fingers and under their control, the shells are torn). A hand inserted into the vagina restraining the flow of water to prevent the loss of small parts of the fetus.