Question

In between contractions, her sister gives her a shoulder rub and during contractions she applies pressure to her lower back. The nurse suggests that she change positions to help the baby to move. She gets into a number of positions including a squatting position supported by her sister and mother and the pelvic tilt (on all fours, applying movement to her lower back) and eventually no longer feels the lower back pain. She is examined and found to be 8 cm and 100% effaced and at station -1 and her membranes are still intact.

Her doctor arrived a few hours ago and now suggests that he "break her water" to try to speed up the labor. She has no idea what he is talking about and needs an explanation of what the procedure is and why it is necessary. She wants to know if it will hurt and if there are any risks involved.

Questions 6 through 13 are not answered: 7. How would the nurse answer these questions? Explain this procedure in detail.

Answer 1

This procedure is known as Amniotomy, which means deliberate rupture of the membrane, this is a simple procedure that is done to induce or accelerate labor.

During the natural process of labor, the water breaks when the baby's head puts pressure on the amniotic sac, causing it to rupture.

An amniotomy is generaly performed by obstetrician, the procedure is done using a amniotic membrane perforator also known as amnihook, the doctor ruptures the amniotic membrane with the hook timing it in between contractions, the hook is inserted through the vag!na, once the membrane is ruptured, amniotic fluid escapes from the uterus and exits through the vag!na, the absence of fluid buffer between the fetus and uterus stimulates uterine contraction to facilitate birth, after a amniotomy is performed the individual is expected to give birth within 24 hours.

This procedure is performed when some complication occurs, for eg, if the person is suffering from placenta pervia ( in this condition the baby's placenta partially or completly covers the cervix, which is the outlet of uterus) , or when there is classical uterine incision or when the fetus position is abnormal.

Some risk associated with this include, cord prolapse, cord compression, fetal blood loss, fetal scalp trauma.

This procedure does not hurt but you might have discomfort when hook is insereted into the cervix.