In what case is the amniotic sac pierced. Why pierce the bladder before childbirth

Approximately 7-10% of women in the maternity hospital undergo an amniotomy. Pregnant women who hear about this manipulation for the first time are frightened by it. Natural questions arise: amniotomy, what is it? Is it dangerous for a child? Not knowing what this procedure is for, many expectant mothers are pre-set negatively. Information about the indications, contraindications and possible consequences of an amniotomy will help you understand if your fears are grounded.

Amniotomy is an obstetric operation (amnion is a water shell, tomie is a dissection), the essence of which is to open the amniotic sac. The amniotic sac and the amniotic fluid that fills it play an important role in the normal intrauterine development of the child. During pregnancy, they protect the fetus from external mechanical stress and microbes.

After opening or natural rupture of the amnion, the uterus receives a signal to expel the fetus. As a result, contractions begin and the baby is born.

Manipulation to open the amniotic sac is carried out with a special tool in the form of a hook at the moment when the bladder is most pronounced so as not to damage the soft tissues of the baby's head. Amniotomy is a completely painless operation, since there are no nerve endings on the membranes.

Types of amniotomy

The opening of the fetal bladder, depending on the moment of the manipulation, is divided into four types:

prenatal (premature) amniotomy - performed before the onset of labor for the purpose of labor induction;
early amniotomy - performed when the cervix opens up to 7 cm;
timely amniotomy - the amniotic sac is opened at a cervical opening of 8-10 cm;
belated amniotomy - opening the amniotic sac on the birth table, when the head has already sunk to the bottom of the small pelvis.

When is it needed?

Basically, amniotomy is performed during childbirth, if the fetal sac has not ruptured on its own. But there are situations in which urgent delivery is necessary. In this case, the puncture of the amniotic sac is performed even in the absence of contractions. The indications for it are:

Postponed pregnancy. A normal pregnancy lasts up to 40 weeks, but if the period is 41 weeks or more, the question arises of the need for labor induction. With a post-term pregnancy, the placenta "ages" and can no longer perform its functions in in full. Accordingly, this is reflected in the child - he begins to experience a lack of oxygen. In the presence of a “mature” cervix (the cervix is soft, shortened, misses 1 finger), the woman agrees and there are no indications for a caesarean section at the moment, a bladder puncture is performed for labor induction. In this case, the fetal head is pressed against the entrance to the small pelvis, and the volume of the uterus decreases somewhat, which contributes to the occurrence of contractions.
Pathological preliminary period. The pathological preliminary period is characterized by long, several days of preparatory contractions that do not turn into normal tribal activity and tire the woman. The child during this period experiences intrauterine hypoxia, which decides the issue in favor of prenatal amniotomy.
Rh-conflict pregnancy. With a negative Rh blood in the mother and positive in the fetus, a conflict arises over the Rh factor. At the same time, antibodies accumulate in the blood of the pregnant woman, which destroy the red blood cells of the fetus. With an increase in antibody titer and the appearance of signs of hemolytic disease of the fetus, urgent delivery is necessary. In this case, the amniotic sac is also punctured without contractions.
Preeclampsia. This is a serious disease of pregnant women, characterized by the occurrence of edema, the appearance of protein in the urine and an increase in blood pressure. In severe cases, preeclampsia and eclampsia join. Preeclampsia adversely affects the condition of the woman and the fetus, which is an indication for amniotomy.

If labor has already begun, with certain characteristics of the body future mother, you will also have to resort to opening the fetal sac. Indications for an amniotomy during childbirth:

Flat fetal bladder. The amount of anterior waters is approximately 200 ml. A flat fetal bladder is practically the absence of anterior waters (5-6 ml), and the fetal membranes are stretched over the baby's head, which interferes with normal labor and can lead to a slowdown and cessation of contractions.
Weakness of tribal forces. In the case of weak, short and unproductive contractions, the opening of the cervix and the advancement of the fetal head are suspended. Because in amniotic fluid contains prostaglandins that stimulate the opening of the cervix, in order to enhance labor activity, an early amniotomy is performed. After the procedure, the woman in labor is observed for 2 hours and, if there is no effect, the issue of labor stimulation with oxytocin is decided.
Low location of the placenta. With this position of the placenta, as a result of contractions, its detachment and bleeding may begin. After the amniotomy, the fetal head is pressed against the entrance to the small pelvis, thereby preventing bleeding.
Polyhydramnios. The uterus, overstretched with a large amount of water, cannot contract properly, which leads to weakness in labor. The need for early amniotomy is also explained by the fact that its implementation reduces the risk of prolapse of umbilical cord loops or small parts of the fetus during spontaneous outflow of water.
High blood pressure. Preeclampsia, hypertension, diseases of the heart and kidneys are accompanied by high blood pressure, which adversely affects the course of childbirth and the condition of the fetus. When the amniotic sac opens, the uterus, having decreased in volume, releases nearby vessels and the pressure decreases.
Increased density of the amniotic sac. Sometimes the fetal membranes are so strong that they cannot open on their own even with the full opening of the cervix. If an amniotomy is not performed, the child may be born in a fetal bladder with water and all membranes (in a shirt), where it can suffocate. Also, this situation can lead to premature detachment of the placenta and bleeding.

Are there any contraindications?

Although in many situations opening the amniotic sac facilitates the process of the birth of a child, there are contraindications to this procedure. Amniotomy during childbirth is not performed if:

a pregnant woman has genital herpes in the acute stage;
the fetus is in a foot, pelvic, oblique or transverse presentation;
the placenta is too low;
umbilical cord loops do not allow the procedure to be performed;
natural childbirth is forbidden to a woman for one reason or another.

In turn, a contraindication to delivery naturally is the incorrect location of the fetus and placenta, the presence of scars on the uterus and anomalies in the structure of the birth canal. They are also prohibited with severe symphysitis, heart pathologies and other diseases of the mother that pose a threat to her health and life or interfere with the normal birth process.

Technique

Although an amniotomy is an operation, the presence of a surgeon and an anesthetist is not required. The opening of the amniotic sac (puncture) is performed by an obstetrician during a vaginal examination of a woman in labor. The manipulation is absolutely painless and takes a few minutes. A puncture during pregnancy is performed with a sterile plastic instrument resembling a hook.

The procedure consists of the following steps:

Before an amniotomy, a woman in labor is given No-shpu or another antispasmodic drug. After the start of its action, the woman should lie on the gynecological chair.
Then, the doctor, wearing sterile gloves, expands the woman's vagina and inserts the instrument. Having hooked the amniotic sac with a plastic hook, the obstetrician pulls it out until the membrane is torn. This is followed by the outpouring of water.
At the end of the procedure, the woman needs to remain in a horizontal position for about half an hour. During this time, the child's condition is monitored using special sensors.

The amniotic sac is opened outside the contraction, which ensures the safety and convenience of the procedure. If a woman is diagnosed with polyhydramnios, the water is released slowly to prevent the loops of the umbilical cord or the limbs of the fetus from falling into the vagina.

Mandatory conditions

To avoid complications during manipulation allows compliance with a number of rules. The mandatory conditions, without which an amniotomy is not performed, include:

head presentation of the fetus;
childbirth not earlier than 38 weeks;
no contraindications to natural delivery;
pregnancy with one fetus;
readiness of the birth canal.

The most important indicator is the maturity of the cervix. To perform an amniotomy, it must correspond to 6 points on the Bishop scale - be smoothed, shortened, soft, skip 1-2 fingers.

Complications and consequences

When performed correctly, amniotomy is a safe procedure. But, in rare cases, childbirth after a bladder puncture can be complicated. Among the undesirable consequences of amniotomy are:

Prolapse of the umbilical cord or limbs of the fetus into the vagina of the woman in labor.
Injury to the vessels of the umbilical cord during its sheath attachment, which may be accompanied by massive blood loss.
Deterioration of uteroplacental blood flow after manipulation.
Change in fetal heart rate.

There is also a risk that opening the amniotic sac will not give the desired result and labor activity will not become sufficiently active. In this case, it will be necessary to use drugs that stimulate contractions or conduct caesarean section, since a child's long stay without water threatens his life and health.

Any intervention in the body has its consequences and they are not always positive. But compliance with all the conditions for conducting an amniotomy allows you to minimize the risk of complications. Therefore, if there are indications, you should not refuse to open the fetal bladder and other manipulations necessary during childbirth.

Useful video: the need and possible consequences of amniotomy from the point of view of foreign experts

Olga Rogozhkina

midwife

Childbirth does not always go according to the classical version, as described in books. Sometimes an amniotomy is necessary - forced opening of the amniotic sac to initiate labor. The main condition for the procedure is the physiological readiness of the birth canal (maturity of the cervix) and the professionalism of the obstetrician. For whatever reason, an amniotomy is performed, there is no need to doubt its necessity, since the doctor's task is to preserve the health of the mother and child. Subject to the indications and requirements for manipulation, the procedure has no negative consequences.

I like!

There is no pregnant woman who does not worry about the birth of her baby. Everyone is waiting for his appearance and is afraid of pain. Sometimes women who have given birth report that they had a puncture of the bladder before giving birth without contractions. Gynecologists call this procedure an amniotomy. It is tolerated by up to 10 percent of women in labor. Those who find out about this situation start to get scared. They do not have specific ideas and knowledge about the need this process and negatively set themselves up. There is no reason for fear, since it is organized for the good and will not bring harm to the crumbs.

The discharge of water sometimes precedes the onset of labor. It can occur partially or completely, which happens in about 12% of all women. Such a deviation is considered premature rupture of amniotic fluid. This is a very noticeable phenomenon, since it is associated with their large volume.

Normally, they are light or pink and should not have a smell. If a brown, green, or black color is found, then this indicates the presence of a newborn's feces in them. This means that the fetus has oxygen starvation, and it needs a quick delivery. When a yellow tint is mixed in, then there is a Rh conflict. Here, too, urgent action is needed.

When the waters break at home, the woman in labor should urgently go to the hospital. Upon arrival, she reports the exact time of the outpouring. When the body is completely ready for childbirth, contractions occur immediately or after a certain period of time after the water breaks.

What is an amniotomy?

This is an operation to open the amniotic sac. The fetus in the mother's body is protected by a special shell - the amnion. It is he who is filled with amniotic fluid. Protects the baby from bumps and penetration of vaginal infections. It is a kind of "shelter" for the baby. If it is opened or a rupture occurs naturally, then the uterus begins to expel the fetus. As a result, the contractions grow, and the baby is born.

Surgical intervention - a puncture of the bladder before childbirth without contractions is organized with a special device that looks like a hook. It is carried out at the moment of its greatest severity, so as not to touch the soft tissues of the child's head.

Varieties of amniotomy

There are several types, depending on the period of the operation:

Prenatal. It is organized before the onset of contractions to cause labor induction.
Early. It is carried out at the opening of the cervix by seven centimeters.
Timely. When there is an opening up to 10 cm.
Belated. It takes place during the expulsion of the fetus. The procedure is needed to exclude hypoxia in a baby, or bleeding in a woman in labor.

The passage of childbirth occurs without changes and in accordance with the natural state. The well-being of the baby is observed by the KGT apparatus.

Bladder puncture before childbirth without contractions

It is carried out in the following cases:

Postponed pregnancy. It usually lasts forty weeks. But if it increases, then obstetric care is required. The placenta begins to age and loses its functionality. The child experiences suffering due to oxygen starvation.
Preeclampsia is a disease characterized by edema, high blood pressure and the presence of protein in the urine. It has a negative impact on the health of the fetus and mother.
Rhesus conflict. Brings complications and causes stimulation of labor activity.
Hypertension, diabetes mellitus in pregnancy.
Weakness of contractions, impossibility of self-delivery.

When wondering why the bubble is pierced before childbirth, you should trust a professional specialist. After all, he does this when he sees a real threat to the life of the baby and mother.

If childbirth has begun, then the operation is done when there is:

the opening of the cervix by six to eight centimeters, but the water does not depart. Keeping them does not make sense, since the bubble does not fulfill its purpose;
impotence in childbirth. When the contractions fade, the neck slows down the activity and, so that the birth does not stop, the bladder is punctured. Organized monitoring of the mother. In the absence of positive dynamics, oxytocin is administered within two hours;
polyhydramnios. The presence of a large volume of amniotic fluid does not allow the uterus to contract naturally;
high blood pressure in preeclampsia, liver and kidney diseases, has a negative effect on childbirth and the fetus;
flat fetal bladder. In this state (oligohydramnios) there are almost no frontal waters. This contributes to the difficulty of labor and its complete cessation;
low location of the placenta. It can cause detachment and bleeding.

Implementation of the procedure

An amniotomy is considered a surgical intervention, but the surgeon and anesthesiologist may not be present. The doctor does a vaginal examination (gives an assessment of the cervix, the location of the head), then opens the bladder. The process consists of several stages:

Before the start of the operation, the woman's genitals are treated with antiseptic agents, they are offered to take an antispasmodic or no-shpu. After the effect of the drug begins, she is placed on the gynecological chair and must lie motionless, not interfere with the doctor's manipulations.
The healthcare professional puts on gloves and gently inserts the instrument into the vagina. Hooks on the amniotic sac and pulls it until it bursts. The outflow of amniotic fluid begins.
After the action is completed, the woman in labor remains in a horizontal position for another half hour. The fetal condition is monitored by the KGT apparatus.

Opening is carried out only in the absence of contractions, which ensures the convenience and safety of the operation.

How long after the bladder is punctured does labor begin?

The start is expected no later than twelve hours later. But today doctors don't wait that long. The child increases the risk of infection with prolonged exposure to an anhydrous environment. Therefore, when three hours pass, and there are no contractions, they resort to drug stimulation.

Duration of labor after the procedure

Women respond as follows:

for those who gave birth for the first time, this activity continued until fourteen hours;
in multiparous from five to twelve.

Contraindications and consequences

The procedure has some limitations and is not performed when:

a pregnant woman has herpes on the genitals in an acute stage;
loops of the umbilical cord create obstacles for the operation;
natural childbirth is not recommended;
there is a low location of the placenta;
the fetus occupies an oblique, transverse, or pelvic presentation;
pelvic constriction of 2-4 categories, a tumor in the small pelvis;
the baby has a weight of more than 4.5 kg;
deformation of the vagina or cervix due to rough scars;
twins that have grown together, triplets;
myopia of a high degree;
acute suffocation of the baby.

There is a ban on heart disease.

Possible Complications

There are several exceptions that lead to negative consequences after an amniotomy:

injury to the umbilical cord vessel when it is attached to the sheath. This will lead to blood loss;
deterioration in the well-being of the baby;
prolapse of arms or legs;
baby heart disease
restless childbirth and their secondary weakness;

Such completion is rare, but sometimes there is a danger that the desired result will not occur when the fetal bladder is punctured. As a result, doctors may use drugs that cause contractions. There are cases when they resort to a caesarean section. Since the prolonged presence of the child without water will have a negative impact.

How does a woman feel during an amniotomy?

Does it hurt or not? Any mother will be afraid because of the possible appearance of pain. But it will not be, because the amniotic sac does not contain nerve endings.

The woman in labor should simply relax and lie down in a comfortable position. With the right procedure, she only feels how the water flows out. They have a warm temperature. If the muscles tense up, then discomfort and adverse outcomes, such as damage to the walls of the vagina, may occur.

Compliance with the rules

There are certain requirements for this operation. To avoid complications, you should adhere to some provisions:

head presentation,
pregnancy at least thirty-eight weeks,
delivery on your own and the lack of prohibitions in this,
readiness of the birth canal,
having only one fetus.

Of great importance is the maturity and readiness of the uterus. To perform the operation, it must be in accordance with six points on the Bishop scale.

The famous doctor M. Auden tells his view of this procedure from the medical point of view of European countries - “this is a relic of the past”:

Each operation, which includes the puncture of the bladder before childbirth without contractions, does not always lead to a positive outcome. The organization of amniotomy, carried out in compliance with all requirements, reduces the risk of various complications. Therefore, when there is a need for it, the pregnant woman must agree to surgery.

According to statistics, at least 50% of women have a bladder puncture before giving birth. Many even believe that this is a routine procedure that is necessarily included in the delivery plan. Why do obstetricians resort to such manipulations? Does it hurt and can the child suffer? How do former women in labor assess the need for such actions and their consequences?

Mandatory step or last resort: why do an amniotomy?

Nature is programmed so that the outflow of amniotic fluid during childbirth occurs without outside interference. Normally, the bubble bursts when the cervix is already almost completely open and the baby is ready to leave the mother's tummy. But in fact, many women before childbirth are given an artificial puncture of the bladder. Such manipulations are usually resorted to if the contractions are already in full swing, attempts will soon begin, and the waters have not yet receded.

The intention to shorten the duration of delivery is the first answer to the question of why the bladder is pierced before childbirth. It is believed that amniotomy improves labor activity, makes it possible to do without stimulation, to examine the amniotic fluid for the presence of meconium or blood in it.

This practice flourishes in maternity hospitals, but it should be understood that this is an optional procedure. Amniotic fluid helps to open the cervix, serves as a kind of "safety cushion" for the baby - it alleviates the pressure and pain that he has to experience during labor, facilitates progress through the birth canal (therefore, the head is less deformed), and reduces the likelihood of intrauterine infection.

When is it really necessary?

The decision on whether to pierce the bladder should be taken by a panel of doctors, but in practice it is often decided by one doctor or even a midwife. There are specific medical indications for this procedure. It is necessary if:

the walls of the bladder are too strong, due to which the fetal membrane is not able to break on its own, even if the neck is fully opened;
labor activity is very weak. Amniotomy will help intensify contractions and increase their duration;
gestosis developed;
pregnancy with Rh-conflict, and this led to complications during childbirth;
the woman in labor has polyhydramnios. If the liquid begins to drain on its own, the umbilical cord may fall out or the contractions will be too sluggish;
low attachment. The placenta may pass ahead of schedule that threatens to cause fetal hypoxia;
irregular and ineffective contractions that do not dilate the cervix. The woman in labor suffers for several days, but the final does not come. Artificial opening stimulates labor activity;
flat bubble. If there are no anterior waters or there are too few of them, then the membrane tightly wraps around the baby's head, which is fraught with the development of premature placental abruption, and this is already an emergency caesarean;
high blood pressure;
the bladder burst at the site of its contact with one of the walls of the uterus, which caused a slow leakage of fluid.

The puncture of the bladder before childbirth without contractions for labor induction, according to many doctors, is an unnecessary and even harmful measure. Early amniotomy (up to 6-7 cm) does not prevent, but increases distress. This reduces the amount of water, which provokes partial compression of the umbilical cord and a decrease in the amount of oxygen that the baby receives. But it is necessary if the woman passed the term (the puncture will "start" childbirth).

Important! If the bubble does not burst itself by the end of the first phase of labor (7-8 cm), then the staff is obliged to open it, because at this stage it simply interferes.

Who can't?

Contraindications to this procedure are: herpes on the perineum, complete placenta previa, foot, pelvic, oblique or transverse location of the fetus, an umbilical cord loop on the head, a weak scar on the uterus after cesarean, tumors, narrowing of the small pelvis, the baby's weight is more than 4.5 kg, deformation of the vagina due to cicatricial changes, high myopia, triplets, fetal growth retardation of the 3rd degree, acute hypoxia.

Will it hurt?

For such manipulations, a special tool is used - a branch, a thin metal needle with a curved end. Everything happens very quickly, under sterile conditions. The woman in labor is placed on a chair, during the vaginal examination, this hook is inserted into the vagina and the membrane is torn. The gynecologist inserts a finger into the resulting hole and releases water. No painful sensations arise, because nature does not provide for the sheath of nerve endings.

Did the puncture help give birth faster: what do women say?

So is it necessary or not to do a bladder puncture before childbirth? If we summarize the reviews, the conclusions will be as follows:

usually no one asks a woman in labor if she agrees to such a procedure, and the moment is not the most suitable. Therefore, it is better to find a doctor in advance, whose actions she trusts;
if the obstetrician insists that this is necessary, then it is better not to refuse. After all, on her own she will not be able to determine whether there is evidence for this. In addition, some women note that after the puncture, the waters are already green, so this was a clearly necessary measure. But some strongly disagree. They believe that it is possible to challenge the decision of the obstetrician, ask what this situation threatens, and ask for another hour or two for spontaneous rupture;
a puncture speeds up the process and relieves pain (especially if this is not the first baby). Therefore, the help of doctors is necessary: protracted childbirth exhausts a woman, she may not have the strength to give birth herself. But some write that the puncture did not speed things up. After such a manipulation, 5-12 hours passed - and nothing. As a result, I had to put oxytocin;
making a puncture does not hurt, you don’t feel anything at all;
the procedure is far from safe. There are reviews in which women report that the baby had a wound on the head after birth.

Throughout pregnancy, the baby is surrounded by amniotic fluid, which reliably protect him from external stimuli. With the onset of labor, with each contraction of the uterus, the amniotic sac is compressed, which in turn puts pressure on the internal os of the uterus, contributing to its opening. Normally, with full or almost complete opening of the uterine os, the fetal bladder ruptures, followed by the outflow of amniotic fluid. In some cases, there is a need for an amniotomy - an operative puncture of the fetal bladder.

What is a rupture of the fetal bladder?

Amniotomy is a procedure in which the doctor performs an instrumental opening of the amnion using a special surgical tool that resembles a hook. After a vaginal examination under the control of the hand, the doctor gently inserts the instrument into the cervical canal, makes a small hole in the amnion, and then stretches it with his fingers. The procedure does not require special preparation or anesthesia.

IMPORTANT! Amniotic fluid is conventionally divided into "anterior" and "rear". After the amniotomy, only a part of the “front” waters is poured out, so the stories about difficult “dry” births that are full of forums are nothing more than fiction.

Amniotic sac puncture: main indications

There must be good reasons for opening the amnion, because the procedure is performed in only 10-15% of cases of all births. The need for amniotomy arises in the following situations:

If the gestational age has exceeded 41 weeks
With a complicated course of pregnancy, for example, late gestosis, when it is necessary to speed up the course of labor to alleviate the condition of the woman in labor
In the event of a condition that threatens the fetus (partial placental abruption, low-lying placenta, cord entanglement, prolonged anhydrous period)
Weakness of labor activity, as well as factors that can contribute to this (overdistension of the uterus with polyhydramnios, twins, physical fatigue of the woman in labor, cervical dilatation of more than 7 cm, flat fetal bladder)
The presence of Rhesus conflict

IMPORTANT! Mandatory conditions for the implementation of the puncture of the fetal bladder is a full-term pregnancy and the weight of the fetus in the head presentation is more than 3000 grams. Despite the simplicity of the procedure at first glance, amniotomy is a kind of surgical intervention, therefore it is carried out only after obtaining the consent of the woman in labor in writing.

Puncture of the amniotic sac without contractions

It happens that an amniotomy is performed long before the onset of labor. As a rule, the main purpose of such manipulation is the excitation of labor activity. Opening the amnion in the absence of contractions is performed in the case of preliminary preparation of the birth canal with special preparations, as well as in the pathological preliminary period in the mature birth canal.

Puncture of the amniotic sac during childbirth

Amniotomy during active labor is performed more often than others, as it is aimed at accelerating the birth process and increasing the effectiveness of contractions. The opening of the amnion during labor activity is divided into: earlier, timely and late. An early puncture of the amniotic sac is done when the opening of the uterine os is less than 7 cm, in case of weakening of contractions. Timely amniotomy occurs when the amnion does not open spontaneously with almost complete cervical dilatation. A belated puncture of the fetal bladder is carried out when the baby's head is already lowered into the exit cavity from the small pelvis, to facilitate birth.

Amniotic sac puncture: risks and consequences

Almost all women in the position are interested in the safety of the amnion opening procedure. As a rule, if the manipulation is carried out correctly and all the necessary conditions are met, the amniotomy does not carry any risk. It should be noted that the presence of polyhydramnios and other factors that contribute to the overstretching of the uterus during the opening of the fetal bladder can lead to arbitrary prolapse of the umbilical cord loops, which is an indication for emergency operative delivery. In order to avoid the development of this complication, as well as to prevent bleeding during the manipulation, the main condition must be met - the fetal head is lowered into the small pelvis.

If, after an early amniotomy, labor activity has not begun, with a long anhydrous period (more than 24 hours), there is a risk of developing infectious complications.

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 the normal birth of a baby must be called out with their 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 for various 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 drugs 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 membrane. 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.