''Let's go for a breakthrough''. Why open the fetal bladder? Why pierce the bladder before childbirth? When do contractions start after a bladder puncture?

The waiting period for a baby is the most beautiful in the life of every woman. The expectant mother is looking forward to the first meeting with her blood, because she wants to press this little lump to herself as soon as possible, to look at him.

But, despite all the charm, there are not very pleasant sensations that can accompany this period. A young mother will have to face various problems face to face. There are times when, for one reason or another, contractions do not start and doctors for normal birth the baby must be called out with his own hands.

One of the most common options to induce labor is to puncture the amniotic sac. There is no need to be afraid of this procedure, since it is done for the good of the baby and will not harm him in any way.

Puncture without contractions

Very often, the opening of the organ in question in pregnant women causes great excitement, since few people know how this manipulation is performed. The first step is to understand in what cases this procedure is mandatory, and when it is impossible to do without it. In any case, a woman should be aware of the fact that if the doctor told her about the need for a bladder puncture, then you should not refuse.

Often the bubble needs to be pierced, because there is a certain threat to the life of the crumbs. Manipulation is carried out different reasons, on the most common there is a threat and. Also, the bladder is pierced if a woman has a disease such as diabetes, hypertension, impaired kidney function.

Very often, doctors are forced to provoke childbirth in this way during the intrauterine death of a baby, during a pregnancy that is postponed, with.

It also happens that contractions do not appear regularly rarely. In this case, the woman in labor cannot give birth on her own. The opening of the cervix is ​​greatly slowed down, and the child cannot come out normally. And in the amniotic fluid are prostaglandins, which greatly enhance labor activity. Therefore, they decide to perform an amniotomy. If the expected effect from such a manipulation did not work out, then the woman in labor is injected with special medicines that activate .

Women want to know how this procedure is carried out. As noted earlier, there is no need to worry about a bladder puncture. Initially, the maternity hospital workers treat the female genital organs with the help of antiseptic agents, additionally give her a drink with an analgesic agent.

After some time, after the painkiller works, the doctor expands the lumen of the vagina and slowly inserts the hook. With this special tool, the bubble is captured and gently pulled towards itself until the bubble walls burst. Next, the expectant mother is observed for 30 minutes. If everything was done correctly, then the contractions are not long in coming - they begin almost immediately.

This is an absolutely safe procedure. Complications occur very rarely. Manipulation is carried out only with great need, only with the permission of the woman in labor. The doctor must notify the potential consequences.

This may be fetal hypoxia, infection inside the womb (occurs very rarely), the occurrence of bleeding, a weak heartbeat in the baby, prolapse of umbilical cords. And the most important thing is that after the bubble is opened, no more than 20 hours should pass until the birth begins. The baby cannot be without water for a long time, it is dangerous for his life.

Does it hurt to pierce a bladder?

The bubble bursts without pain, because there are no nerve receptors in the fruit shell. This procedure does not last long - a few minutes. However, in almost all cases, the fear of the woman in labor turns out to be higher than the explanations of the doctors, and a spasm of the vaginal muscles occurs. The woman at this time should take one position and not move so that the doctor does not inflict any internal damage.

If you set yourself up correctly and relax completely during the procedure, then there will be no pain, even the smallest. The only thing that a woman can feel is the flow of water from the vagina.

As indicated earlier, the bladder is pierced only in case of great need, and if the doctor told the patient that such a procedure should be done, then she should not refuse it.

Baby scratches after amniotomy

Many women are worried when they see scratches on their little cub's head. Yes, this does happen sometimes. If a bladder puncture was used for childbirth, then the baby may be born with scratches left on the head from a special bladder puncture hook.

Of course, such a spectacle is not pleasant. But don't worry - it's not dangerous at all. Abrasions in the sterile conditions of the maternity hospital quickly healed.

Typically, such traces remain during the amniotomy with. After all, it is in this state that the fetal membranes are on the baby's head.

An obstetric operation aimed at stimulating labor is an opening of the fetal bladder. The procedure is painless, does not affect the health of the mother and fetus.

The waiting period for a baby is a wonderful time in the life of every woman, which is accompanied by various problems and not very pleasant moments.

One of these moments is the absence of contractions. If labor activity does not start for too long, then doctors may decide to induce it. The most popular option for inducing labor is the puncture of the amniotic sac. Manipulation is completely safe for the health of a woman, a baby, and does not cause any pain.

Indications for an amniotomy

Puncture of the amniotic sac - view surgical intervention which is completely painless and performed without anesthesia. It is carried out according to medical indications, under the supervision of a qualified doctor. Amniotomy can be recommended both before the onset of labor, in order to simulate it, and during an inactive (sluggish) delivery process.

Reasons for this operation:

• pregnancy lasts longer than expected. If all the deadlines for the start of labor have already passed, but the birth has not begun;
• preeclampsia in late pregnancy. This complication threatens with oxygen starvation of the fetus;
• chronic circulatory disorders between the placenta and the fetus, when oxygen starvation increases and cannot be eliminated with medication;
• a large amount of amniotic fluid. This pathology can cause hypoxia, fetal injuries. For this reason, even with a slight opening of the cervix, doctors pierce the bladder to avoid possible complications;
• ineffective contractions;
• the bubble is flat;
• low attached placenta. A puncture when the placenta is low helps to avoid uterine bleeding, the occurrence of its premature detachment;
• Rhesus conflict;
• dense shells. If the cervix is ​​​​fully open, and the bubble has not burst, then doctors perform this manipulation in order to preserve the health of the baby.

How to puncture the fetal bladder

Amniotomy is an obstetric operation that takes a few minutes and is completely harmless. The puncture procedure is carried out exclusively by a gynecologist, not an obstetrician.

Manipulation is carried out directly during a vaginal examination in a gynecological chair. For this, the external genital organs are initially treated with an antiseptic, then the doctor carefully punctures the amniotic sac with a special medical sterile instrument. The tool for this procedure is made of plastic and visually looks like a crochet hook.

At what time

A puncture is prescribed for expectant mothers when they are at 41-42 weeks of gestation, if the uterus is already ready for labor, but there is no activity.

Is it possible to pierce without contractions

The bubble can be pierced before the onset of labor. The main reason for this procedure is the stimulation of contractions in the later stages or when the cervix is ​​​​fully open.

Puncture process

This type of surgical intervention is carried out exclusively by the doctor who will deliver the baby. The procedure is performed during a vaginal examination, the puncture is carried out with a special medical device. After the manipulation, doctors monitor the baby's heartbeat throughout the entire time.

The puncture process is not dangerous for the woman and her baby. But it stimulates the onset of labor, accelerates contractions, and helps the baby to be born faster.

Does it hurt to pierce the bladder

Obstetric intervention on the puncture of the bladder does not cause pain, since it does not have any nerve pain endings.

How long does it take for contractions to start after rupture of the amniotic sac?

If the bladder was punctured in the prenatal period, then normally contractions should be expected over the next two hours. At this time, doctors connect the woman to the CTG machine to monitor the baby's condition and readiness for labor.

In a situation where, after a set time, the contractions did not occur, the doctors decide to stimulate them with the help of special preparations.

This is due to the fact that for an unborn child, being in an anhydrous state for more than 12 hours is a great danger. If stimulant drugs did not help in delivery, then the expectant mother urgently performs a caesarean section.

Is childbirth different after an amniotomy?

During a natural bladder puncture, oxytocin is released and the uterus begins to contract naturally. After the manipulation of the amniotomy, childbirth takes place, as well as after their stimulation, no difference is observed. But before you pierce about amniotic sac the physician must:

• examine the birth canal of a woman and assess how ready they are for the birth process;
• determine the degree of dilatation of the cervix. If a woman is already at 41 or 42 weeks of pregnancy, and no contractions are observed, the cervix is ​​soft, thin and elastic, then this manipulation can be performed. But a puncture is not recommended if the expectant mother's birth canal is not yet prepared for labor;
In contact with

Many pregnant women are afraid of childbirth because of the upcoming pain. Normal labor activity begins with weak contractions and ends with the outflow of amniotic fluid and attempts, resulting in a baby. There are situations when childbirth takes place according to a non-standard scenario and the fetal bladder must be opened. Most often, pregnant women are afraid of this procedure, as women are worried about the condition and health of the baby. Can a piercing really harm a baby? Why is the procedure necessary? What does a woman feel during a puncture?

Pouring of water before contractions

Being in the womb, the child is protected from negative influences and infection by a special water bladder called the amnion. At birth, the baby's head presses on the wall of the uterus, and that on the bladder. The amnion dilates the cervix, preparing it for the passage of the baby.

If childbirth begins with the bursting of the bladder, then first the amniotic fluid leaves the woman (for more details, see the article:). Such a condition cannot go unnoticed due to the fact that a lot of water comes out. In the absence of pathologies, it is colorless or light pink in color and odorless. In such a situation, the woman in labor should remember at what time this phenomenon occurred, and urgently contact the maternity hospital.




The brown color of the waters indicates pathology and is the reason for the urgent intervention of doctors for labor induction. In the case of staining yellow there is a Rh conflict, in which the birth of the baby should also be accelerated.

Amniotomy: principle and types of operation

Amniotomy is an operation to rupture the fetal bladder. It is carried out only in emergency cases, subject to certain requirements. The only desire of a woman in labor or a doctor to speed up labor is not enough. The essence of the procedure is to pierce the bladder with a special tool that resembles a hook. Due to the release of amniotic fluid, the uterus begins the process of expelling the fetus.

Stages of the operation:

• The introduction of an antispasmodic - No-Shpy or Drotaverine. This is necessary when the muscles are in good shape, to relax them and reduce spasm.
• Taking a comfortable position. A woman in labor sits on a gynecological chair with her legs wide apart.
• Checking by an obstetrician the condition of the cervix, its readiness for the passage of the child. The doctor determines the location of the fetus and the exact location of its head.
• The introduction of a device resembling a hook into the vagina.
• Bladder puncture. The procedure is performed at the peak of the contraction so as not to damage the fetus.

All fluid is collected in a condition assessment tray. By the color and smell of the water, the gynecologist draws conclusions about the condition of the fetus, if necessary, a neonatologist and other specialists are connected to the birth process. Immediately after the procedure, the woman is given an electrocardiogram to assess the condition of the child.

Varieties of amniotomy depending on the time of the operation:

• Prenatal. Held at total absence signs of the onset of labor.
• Early. It is used when the cervical lumen reaches 5-7 cm, while the preparation is fast.
• Timely. It is performed when opening by 8-10 cm, with strong contractions.
• belated. It is carried out with attempts, rarely used.

When and why is the fetal bladder pierced?

Why is it necessary to pierce the amnion? The fetal bladder is pierced by women when the baby is overcarried. If the gestational age exceeds 41 weeks, and natural labor does not begin, it is necessary to speed up the birth process (we recommend reading:). Postmaturity adversely affects the condition of the fetus:

• there is a lack of oxygen;
• the placenta cannot do its job, as a result, insufficient nutrients are supplied to the child;
• the liquid around the fetus becomes cloudy, harmful trace elements get into it;
• the bones of the skull become very hard and unable to deform when passing through the birth canal.




When the fetal bladder is punctured, contractions are stimulated in about 60% of women. Then childbirth takes place naturally.

A puncture of the bladder before childbirth without contractions is done in the following cases:

• Preeclampsia. This is a dangerous condition characterized by severe swelling, dizziness and high blood pressure. Preeclampsia provokes the development of complications associated with the health of the child.
• Formation of anti-rhesus bodies.
• Diabetes mellitus in pregnancy.
• Early detachment of the placenta. In this case, the child receives an insufficient amount of nutrients and oxygen.
• No fetal heartbeat.
• The density of the shell does not allow it to break on its own.
• The need to carry out childbirth for a period of 38 weeks for medical reasons.

Indications for bladder puncture during the development of normal labor activity (during contractions):

• Prolonged childbirth. With the onset of labor, their weakening sometimes occurs, which can lead to a stop in labor. In this case, an autopsy is done, if there are no contractions, stimulation is carried out with special preparations.
• The performance of the bubble its function. When opened by 6-8 cm, there is no need to save it.
• Polyhydramnios. If there is a lot of fluid in the uterus, it slows down and weakens the natural contractions.
• Hypertension. It can cause hemorrhage in the brain or rupture of the retina during attempts.
• Low water. This state characterized by insufficiency of the anterior waters, while the bladder has a flat shape. The fetus suffers from a lack of oxygen.
• Pathological location of the placenta. If the placenta is below normal, its detachment may occur.




Contraindications for bladder puncture

A rupture of the amniotic sac is an easy procedure with few complications. The operation significantly speeds up childbirth, but there are a number of contraindications for carrying out:

• exacerbation of genital herpes - in this case, infection of the fetus is possible;
• the placenta is below the required level;
• pathological location of the umbilical cord loops, which can be injured during autopsy;
• there are contraindications to natural childbirth;
• incorrect location of the child (pelvic, transverse);
• scars on the uterus after caesarean section;
• pathology of cardio-vascular system women in labor;
• narrow pelvis of the expectant mother;
• the weight of the child is more than 4.5 kg;
• multiple pregnancy;
• hypoxia;
• folds of the vagina.




Is it painful for the woman in labor?

Most women are interested in whether it hurts to pierce the bladder (see also:). There is no pain during an amniotomy (for more details, see the article:). This is due to the absence of nerve endings on the bladder. The woman feels the exit of the waters without discomfort. Pain can appear with strong tension in the muscles of the vagina, so the woman in labor needs to take a comfortable position and relax as much as possible.

After the woman returns to normal, she should walk more to speed up the contractions. As a rule, they are activated after a few hours. If this does not happen, drug stimulation is used, since prolonged exposure of the fetus without water leads to oxygen starvation. How long does it take to give birth after surgery? The first birth (in primiparas) lasts from 8 to 14 hours, the second - 5-10 hours.

Mandatory conditions for an amniotomy

To reduce the risk of complications, the following conditions must be met, which are checked before the procedure:

• the position of the fetus head down (with a pathological location, it is necessary to carry out a caesarean section);
• normal pregnancy up to 38 weeks;
• no prohibitions on natural childbirth;
• readiness of organs for the passage of the child;
• single pregnancy.




Complications and consequences of the procedure

Usually, if the rules are followed, complications do not arise. The puncture of the amniotic sac is carried out under strict control of the condition of the woman and the child, so the consequences of the operation are positive. The doctor determines at what opening it is necessary to pierce the bladder. In rare cases, it is possible:

• cord injury;
• deterioration of the fetus (monitored by ECG);
• prolapse of the limbs of the child;
• rapid labor (will begin immediately after the amniotomy);
• family weakness.

Initially, nature arranged a woman so that she could bear and give birth to a child without the help of outside medical interventions. But this did not always lead to a successful outcome of pregnancy. Currently, about 10% of women experience such an operation as an amniotomy. What is it, and is it necessary to do it?

In the womb, the baby is surrounded by an amnion - special membrane with amniotic fluid. This shell protects the fetus from possible external infections and does not allow it to hit when moving. When childbirth approaches, the baby's head rests against the cervix, thanks to this process, a fetal bladder is formed, which stretches it and forms the birth canal. In the process of childbirth itself, the bubble bursts, and the baby moves out. However, there are times when the fetal bladder cannot burst on its own and the doctors taking delivery resort to amniotomy and pierce it.

An operation such as an amniotomy is a puncture of the bladder with a special medical instrument. It is done solely by the decision of the doctor and cannot be carried out at the request of the woman in labor . First, the woman is given pain medication. based on drotaverine, then after 30 minutes an examination is carried out on a gynecological chair, and during it the bladder shell is captured with a thin hook similar to a needle and pierced. Capture occurs through that part of the bubble where contact with soft tissues child is minimal. The procedure can be compared to popping a balloon with a needle.

Contrary to the fears of women in labor, the bladder is pierced absolutely painlessly, since there are no nerve endings on the membrane of the fetus. However, fear of this manipulation usually leads to muscle spasm and some women may find that the puncture of the bladder was painful. To avoid discomfort and internal injuries, it is necessary to remain as calm and immobile as possible.

The water flowing out as a result of the amniotomy is collected in a tray and their condition is assessed. Green color amniotic fluid with meconium flakes indicates fetal hypoxia and the need heightened attention to him.

Types of amniotomy

Amniotomy is divided into 4 types according to the timing:



How long does it take to give birth after a bladder piercing?

Women who have undergone a bladder puncture are interested in the question of how long to wait for the birth of their child. Somebody think that the procedure is similar in time to a caesarean section, hoping to enjoy the first minutes with the baby in just a few minutes. However, this is a big misconception.

In general, the process of childbirth after amniotomy does not differ from the natural one. For nulliparous women, the normal duration of labor is 7 to 14 hours. The second birth can drag on for 5 to 12 hours, and each subsequent birth can further reduce the waiting time for a meeting with the baby.

With a prenatal puncture of the bladder, normal contractions should begin within two hours, while the woman in labor is connected to the CTG apparatus for half an hour to assess the condition of the fetus and readiness to give birth. If after two hours the contractions have not begun and there is no labor activity, then childbirth begins to be stimulated with special preparations. It poses a great danger to the child. being in an anhydrous space in the womb for more than 12 hours, therefore, if after this time the woman has not given birth, then an emergency caesarean section is performed.

Who is an indication and contraindication for amniotomy?

Pierce the fetal bladder is not all women and only in the following cases:

1. Full-term pregnancy from 38 weeks for monofetal and 36 weeks for multiple.
2. Head presentation of the fetus.
3. Estimated body weight more than 3 kilograms.
4. A fully mature cervix and a normal sized pelvis.
5. Absence of contraindications to natural childbirth.

Indications

Like any operation, the bladder is pierced only according to the doctor's indications and after a thorough examination.

Most often, the amnion is pierced when pregnancy is overdue, namely after 41.5 weeks. If a woman has not given birth to a child before this period, then further preservation of pregnancy can be dangerous both for the fetus and for the woman in labor. The placenta begins to age, oxygen to the child gets worse, which is why children born late usually diagnosed as hypoxia.

In addition, amniotomy is indicated in cases where urgent delivery is necessary. These include:

1. Intrauterine death or fetal hypoxia.
2. Premature detachment of the placenta.
3. Preeclampsia and polyhydramnios in a pregnant woman.

With some diseases in a woman, childbirth must be induced already after reaching 38 weeks. For example, with Rh-conflict of mother and child or severe chronic diseases women.

A special case for puncturing the bladder is a long preliminary period, when contractions occur for several days, but they never go into labor. The opening of the cervix does not occur, the woman in labor suffers from endless sick contractions, and the fetus suffers from hypoxia. In this case, amniotomy helps to give birth as soon as possible.

Contraindications

Despite all the benefits of such an operation, amniotomy has a number of contraindications, in which this procedure is strictly prohibited and doctors should choose another method for delivery. Almost all of them are similar to contraindications for natural childbirth.. Among them:



In the absence of contraindications, amniotomy does not threaten the condition of the mother and child and, contrary to opinion, is absolutely not painful. You don't have to give up on this process., because if the doctor prescribed this operation, then there are good reasons for that. It is worth considering how many women have been helped to give birth easily and quickly by amniotomy, and all doubts will immediately be dispelled. By fully following the instructions and advice of your obstetrician-gynecologist, you can be completely calm about the health of your child and be sure that the birth will be successful and without pain.

In utero, the baby is protected by a special membrane - the amnion, filled with amniotic fluid. They protect it from shock when moving, and the shell prevents the upward penetration of infection from the vagina.

During childbirth, the baby's head is pressed against the cervix and a fetal bladder is formed, which, like a hydraulic wedge, gradually stretches the cervix and forms the birth canal. Only after that it breaks on its own. But there are situations when a bubble puncture is performed before childbirth without contractions.

This procedure is not prescribed at the request of the woman or the whim of the doctor. The success of an amniotomy is possible under certain conditions:

• presenting the head of the fetus;
• full-term pregnancy of at least 38 weeks with one fetus;
• estimated fetal weight over 3000 g;
• signs of a mature cervix;
• normal indicators of the size of the pelvis;
• There are no contraindications for natural childbirth.

Types of amniotomy

The moment of the puncture determines the type of procedure:

1. Prenatal - is carried out before the start of contractions, its purpose is labor induction.
2. Early - before opening the neck by 6-7 cm, it is able to speed up this process.
3. Timely - produced with effective contractions, neck opening 8-10 cm.
4. Belated - in modern conditions it is rarely carried out, it is performed at the time of expulsion of the fetus. An amniotomy is needed to avoid bleeding in a woman in labor or hypoxia in a child.

How is childbirth going after a bladder puncture? The process of the birth of a child in this case does not differ from the natural one. In any case, the condition of the fetus is monitored using the CTG apparatus.

Indications for bladder puncture during childbirth

Bladder puncture stimulates planned labor or is carried out during them.

Labor induction with amniotomy is indicated in the following cases:

• preeclampsia, when there are indications for urgent delivery;
• premature detachment of the placenta;
• fetal death in utero;
• prolongation of pregnancy;
• heavy chronic diseases cardiovascular system, lungs, kidneys, in which delivery is indicated from 38 weeks;
• Rhesus conflict between mother and child;
• pathological preliminary period.

The last condition is the occurrence of small contractions over several days, which do not develop into normal labor activity. This causes intrauterine suffering of the fetus from a lack of oxygen and fatigue of the woman.

How long does it take to go into labor after a bladder puncture? The onset of labor is expected no later than 12 hours later. Although at present, doctors do not take that much time to wait. Prolonged exposure of a child to an anhydrous environment increases the risk of infection. Therefore, 3 hours after opening the amnion, if contractions have not begun, stimulation with medications is used.

With already developed labor activity, a puncture is performed according to the following indications:

1. The cervix dilated 6-8 cm, but the water did not break. Their further preservation is impractical, the bubble no longer fulfills its function.
2. Weakness of labor activity. Puncture of the bladder in most cases leads to its activation. After amniotomy, they wait 2 hours, if there is no improvement, then they resort to stimulation with oxytocin.
3. Polyhydramnios overstretches the uterus and prevents normal contractions from developing
4. With oligohydramnios, a flat fetal bladder is observed. It covers the baby's head and does not function during childbirth.
5. A low-attached placenta may begin to slough off after contractions develop. And opening the amnion will allow the fetal head to cling tightly to the lower segment of the uterus and hold back the detachment.
6. At multiple pregnancy perform a puncture of the bladder of the second child 10-15 minutes after the appearance of the first.
7. high arterial pressure decreases after the opening of the waters.

Bladder puncture technique for a woman in labor



• 30 minutes before the stimulation of labor by puncturing the bladder, the woman is injected with the antispasmodic Drotaverine.
• Later, an examination is performed on the obstetric chair, the doctor evaluates the cervix, the location of the head.
• With a sliding movement of the fingers, a special branch is inserted into the vagina - a hook.
• With its help, during the fight, the shell clings, and the gynecologist inserts a finger into the resulting hole. The tool is removed.
• Holding the head of the fetus through the abdomen with the other hand, the membranes are gently separated and the anterior amniotic fluid is released.

They are collected in a tray, visually assess the condition. Green waters with meconium flakes indicate intrauterine fetal hypoxia. This state of affairs deserves further attention. The pediatric service is warned in advance about the possible condition of the child.

If a large volume of water is drained at once, this can lead to prolapse of umbilical cord loops or small parts of the fetal body.

After the procedure, the woman in labor is connected to the CTG apparatus for 30 minutes to assess the condition of the child.



Is it painful or not to perform a bladder puncture before childbirth? The shells are not penetrated by nerve endings, so the procedure is absolutely painless.

However, complications sometimes develop:

• traumatization of the umbilical cord vessel, if it was attached to the membrane;
• prolapse of the loops of the umbilical cord or parts of the body of the fetus (handles, legs);
• deterioration of the fetus;
• violent labor activity;
• secondary generic weakness;
• child infection.

How long does labor last after a bladder puncture? The duration depends on their parity or number:

• In primiparas, the normal duration of labor is 7-14 hours.
• Multiparous people need less time - from 5 to 12.

Contraindications to bladder puncture in a pregnant woman



Despite the ease of implementation and a small number of complications of manipulation, there are serious contraindications for its implementation. Most of them coincide with contraindications for natural childbirth:

1. Herpetic eruptions on the perineum will lead to infection of the child.
2. Pelvic, foot, transverse or oblique presentation of the fetus, loops of the umbilical cord in the head area.
3. Complete placenta previa. Childbirth in this case is impossible - the placenta is attached above the internal pharynx and prevents the lower segment of the uterus from turning around.
4. Insolvency of the scar on the body of the uterus after caesarean section or other surgical interventions.
5. Narrowing of the pelvis of 2-4 degrees, bone deformities, tumor processes in the small pelvis.
6. Fetal weight over 4500 g.
7. Rough scars causing deformation of the cervix or vagina.
8. Triplets, conjoined twins, breech presentation of the first child of twins.
9. High myopia.
10. Delayed fetal development of the 3rd degree.
11. Acute fetal hypoxia.

In the absence of these contraindications, amniotomy is a safe procedure and does not affect the condition of the fetus.

Yulia Shevchenko, obstetrician-gynecologist, specially for the site

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