From women giving birth, one can hear about such a thing as a puncture of the bubble before childbirth without contractions. This procedure is called amniotomy. Usually about 7-10% of women in labor encounter her. Many pregnant women, when they hear about amniotomy, get scared. Having no idea about the correctness and necessity of this procedure, women set themselves up negatively.
What happens if the fetal bladder bursts before contractions?
In some cases, labor begins with the outflow of water. Moreover, it can be full or partial. According to statistics, such a deviation can occur in 12% of all women. This process is called premature discharge of amniotic fluid.
Women immediately notice this phenomenon, especially if it happens with a lot of water.
The amniotic fluid should be light or pink and odorless. If black, brown or green is mixed with it, then this means that the feces of the newborn are in the waters. This suggests that the fetus has experienced oxygen starvation, which requires rapid delivery. An admixture of yellow color may indicate the presence of a Rhesus conflict, which also requires quick action.
When the water leaves at home, the woman in labor must urgently go to the hospital. In a hospital, a woman must accurately indicate the time of their departure.
If the body is completely ready for the birth of a child, contractions begin immediately or after some time after the discharge of water.
What is amniotomy?
Amniotomy is an operation in which an amniotic fluid is opened. In utero, the fetus is protected by a special shell - an amnion, which is filled with amniotic fluid. It protects the child from bumps and infection from the vagina.
If an autopsy or rupture occurs naturally, the uterus begins the process of fetal extermination. As a result, contractions develop and a child is born.
The operation to pierce the bladder before childbirth without contractions is carried out by a special device in the form of a hook at the time of its greatest severity, so as not to affect the soft tissue of the head of the child.
Types of Amniotomy
The puncture of the bubble before childbirth can be divided into several varieties, which depends on the time of the operation:
- Prenatal. It is carried out before contractions for the purpose of labor stimulation.
- Early It is performed if the opening of the cervix is up to 7 cm.
- Timely. If the neck is open up to 8-10 cm.
- Belated. It can be carried out at the time of expulsion of the fetus. The procedure is used to prevent hypoxia in the fetus or bleeding in the woman in labor.
The process of passing birth does not change at all and corresponds to the natural. The condition of the fetus is necessarily recorded using the KGT apparatus.
When is an amniotomy necessary?
There is a stimulation of labor by piercing the bladder in the event of situations when emergency delivery is needed. The procedure can be carried out in the absence of contractions:
- Postponed pregnancy. Normal pregnancy lasts 40 weeks, if it is longer, then the question is raised about the need for obstetric care. The placenta in this situation is aging and cannot fulfill its functions. As a result of this, the child suffers while experiencing oxygen starvation.
- Gestosis. This disease is characterized by edema, high blood pressure and the presence of protein in the urine. Gestosis negatively affects the health of the mother and fetus, so an amniotomy is needed.
- Rhesus conflict. Such a pregnancy is considered difficult, therefore, this operation helps to stimulate labor.
If labor activity has begun, then surgery is resorted to in the following cases:
- Weak labor. If the contractions do not intensify, but their weakening occurs, the neck slows down the birth process, and so that they do not stop, a bubble is punctured. A woman in labor is observed for 2 hours, if there is no positive dynamics, then a decision is made to resort to Oxytocin.
- Polyhydramnios. The presence of a large amount of amniotic fluid leads to the fact that the uterus cannot naturally contract.
- High blood pressure. Diseases of the kidneys and heart, gestosis contribute to an increase in blood pressure, which negatively affects the birth process and the condition of the fetus.
- Flat fetal bladder. In this situation, the front waters are almost completely absent, which complicates labor and can be stopped.
- Low location of the placenta. This position of the placenta can lead to its detachment and bleeding.
In some cases, contraindications arise for this procedure.
Are there any contraindications?
Puncture of the bubble before childbirth helps to facilitate the process of giving birth, but in some cases there are some limitations of the procedure. An amniotomy is not performed if:
- a pregnant woman has herpes on the genitals in the acute stage;
- the placenta has a low location;
- umbilical cord loops interfere with surgery;
- not recommended natural childbirth;
- finding the fetus in oblique, transverse and pelvic presentation.
The procedure is prohibited for diseases of the heart of the mother, with the existence of scars on the cervix and other pathologies.
How is a bubble pierced?
Why and how do they pierce the bubble before giving birth? Amniotomy is equivalent to surgery, but the presence of an anesthesiologist and surgeon is optional. After a vaginal examination, the doctor opens the bladder. The procedure includes several stages:
- Before the operation, the woman takes No-Shpu or another antispasmodic. After exposure to the medicine, the woman lies on a gynecological chair.
- Then the specialist, wearing gloves, inserts an instrument into the vagina. The amniotic fluid is hooked and pulled by the doctor until it ruptures. After this, amniotic fluid begins to pour out.
- After the end of the manipulation, the woman is in a horizontal position for 30 minutes. The condition of the fetus is monitored by the KGT apparatus.
The bubble necessarily opens in the absence of contractions, which leads to the convenience and safety of the operation.
What does a woman feel with amniotomy?
Puncture of the bubble before childbirth - does it hurt or not? Any woman is afraid of such a procedure because of the possible occurrence of pain. However, in this case, unpleasant sensations are not observed, because the amniotic fluid has no nerve endings.
A woman just needs to relax and take a comfortable position. All that she can feel after a properly performed procedure is only the flow of amniotic fluid.
With muscle tension, unpleasant sensations and negative consequences in the form of injuries to the walls of the vagina can occur.
Mandatory conditions
What are the conditions for piercing the bubble before childbirth? To avoid complications during the procedure, you must follow some rules. These include:
- proper presentation of the fetus (head);
- pregnancy, the term of which is not less than 38 weeks;
- natural delivery and the absence of restrictions to this;
- preparedness of the birth canal;
- pregnancy with one fetus.
The importance is the readiness and maturity of the uterus. During the operation, it should correspond to 6 points on the Bishop scale.
Complications and consequences of amniotomy
With faultless puncture of the bladder before childbirth, the whole process is safe. But there are a few exceptions when, after an amniotomy, childbirth can be complicated. The following consequences exist:
- injury to the vessel of the umbilical cord, if it is fixed to the sheath, which can lead to blood loss;
- the condition of the child worsens;
- loops of the umbilical cord or limb of the fetus (arms, legs) drop out;
- violation of the heartbeat of the child;
- violent labor;
- secondary patrimonial weakness.
There is a risk that a puncture of the fetal bladder will not lead to the desired result and labor will not become active. Therefore, doctors resort to the use of drugs that cause contractions. In some situations, a woman undergoes a cesarean section because a long stay of a child without water is fraught with negative consequences.
How long does labor last after a bladder puncture before birth? The reviews of women who went through this procedure are as follows:
- in women who gave birth for the first time, childbirth took place within 7-14 hours;
- in multiparous women, this can take from 5-12 hours.
Any intervention, which can also be attributed to a puncture of the bubble, sometimes leads to consequences that are not always positive. Amniotomy should be carried out in compliance with all necessary conditions, which will reduce the risk of complications of various kinds. Therefore, if necessary, this procedure women should not refuse surgery and other manipulations necessary during childbirth.