In what case is the amniotic sac pierced? Why do they puncture 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 the child? Not knowing why this procedure is performed, many expectant mothers are negative in advance. Information about the indications, contraindications and possible consequences of amniotomy will help you understand whether your fears are justified.

Amniotomy is an obstetric operation (translated as amnion - water membrane, tomie - 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 influences 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.

The manipulation of opening the amniotic sac is carried out with a special tool in the form of a hook at the moment when the bubble 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

Opening the amniotic sac, 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 inducing labor;
early amniotomy – performed when the cervix is dilated to 7 cm;
timely amniotomy - the amniotic sac is opened at a cervical opening of 8-10 cm;
belated amniotomy - opening of the amniotic sac on the birth table, when the head has already dropped to the bottom of the pelvis.

When is it needed?

Basically, an 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, puncture of the amniotic sac is performed even in the absence of contractions. Indications for it are:

Post-term pregnancy. A normal pregnancy lasts up to 40 weeks, but if the period is 41 weeks or more, the question arises about the need to induce labor. During a post-term pregnancy, the placenta “grows old” and can no longer perform its functions in in full. Accordingly, this affects the child - he begins to experience a lack of oxygen. If there is a “mature” cervix (the cervix is soft, shortened, and allows one finger to pass), the woman’s consent and there are no indications for a cesarean section at the moment, a bladder puncture is performed to induce labor. In this case, the fetal head is pressed against the entrance to the pelvis, and the volume of the uterus decreases slightly, 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 labor and tire the woman. During this period, the child experiences intrauterine hypoxia, which resolves the issue in favor of prenatal amniotomy.
Rhesus conflict pregnancy. When the mother's blood is negative and the fetus's is positive, a conflict arises regarding 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. If the antibody titer increases and signs of hemolytic disease of the fetus appear, 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 increased blood pressure. In severe cases, preeclampsia and eclampsia are added. Preeclampsia negatively 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 expectant mother, you will also have to resort to opening the fetal sac. Indications for which amniotomy is performed during childbirth:

Flat amniotic sac. The amount of anterior water is approximately 200 ml. A flat amniotic sac is practically the absence of anterior waters (5-6 ml), and the membranes are stretched on the baby’s head, which prevents normal labor and can lead to a slowdown and cessation of contractions.
Weakness of generic forces. In the case of weak, short and unproductive contractions, the dilation of the cervix and the advancement of the fetal head are suspended. Since in amniotic fluid contains prostaglandins that stimulate the dilatation of the cervix; in order to enhance labor, 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 birth 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 amniotomy, the fetal head is pressed against the pelvic inlet, thereby preventing bleeding.
Polyhydramnios. The uterus, overstretched by a large amount of water, cannot contract correctly, which leads to weakness of 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 rupture of water.
High blood pressure. Preeclampsia, hypertension, heart and kidney diseases are accompanied by high blood pressure, which negatively affects the course of labor and the condition of the fetus. When the amniotic sac is opened, the uterus, having decreased in volume, frees nearby vessels and the pressure decreases.
Increased density of the amniotic sac. Sometimes the membranes are so strong that they cannot break open on their own even with the cervix fully dilated. If an amniotomy is not performed, the baby may be born in the amniotic sac with water and all membranes (in the shirt), where it can suffocate. This situation can also lead to premature placental abruption and bleeding.

Are there any contraindications?

Although in many situations opening the amniotic sac facilitates 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 leg, pelvic, oblique or transverse presentation;
the placenta is located too low;
umbilical cord loops do not allow the procedure to be performed;
Natural childbirth is prohibited for a woman for one reason or another.

In turn, a contraindication to childbirth naturally This is due to the incorrect location of the fetus and placenta, the presence of scars on the uterus and abnormalities in the structure of the birth canal. They are also prohibited in case of 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 amniotomy is an operation, the presence of a surgeon and anesthesiologist is not required. The opening of the amniotic sac (puncture) is performed by an obstetrician during a vaginal examination of the woman in labor. The manipulation is absolutely painless and takes a few minutes. A puncture during pregnancy is performed with a sterile plastic instrument that resembles a hook.

The procedure consists of the following steps:

Before amniotomy, the woman in labor is given No-shpu or another antispasmodic drug. After its action begins, the woman should lie down on the gynecological chair.
Then, the doctor, wearing sterile gloves, dilates 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. After this, an outpouring of water occurs.
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 prolapse of the umbilical cord loops or fetal limbs into the vagina.

Prerequisites

Following a number of rules allows you to avoid complications during manipulation. Mandatory conditions without which amniotomy is not performed include:

cephalic presentation of the fetus;
birth 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, and allow 1-2 fingers through.

Complications and consequences

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

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

There is also a risk that opening the amniotic sac will not give the desired result and labor will not become active enough. In this case, the use of drugs that stimulate contractions or caesarean section, since a child’s prolonged 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 conditions for amniotomy allows you to reduce the risk of complications to a minimum. Therefore, if there are indications, you should not refuse to open the amniotic sac and other necessary manipulations during childbirth.

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

Olga Rogozhkina

midwife

Childbirth does not always take place according to the classic version, as described in books. Sometimes amniotomy is necessary - forced opening of the amniotic sac to induce 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. If the indications and requirements for manipulation are observed, the procedure does not have negative consequences.

I like!

There is no pregnant woman who does not worry about the birth of her baby. Everyone is looking forward to his appearance and is afraid of pain. Sometimes women who have given birth report that they had their bladder punctured before giving birth without contractions. Gynecologists call this procedure amniotomy. Up to 10 percent of women in labor experience it. Those who learn about this situation begin to get scared. They do not have specific ideas and knowledge about the need this process and have a negative attitude towards themselves. There is no reason for fear, since it is organized for the good and will not bring harm to the baby.

The breaking of your water sometimes precedes the onset of labor. It can occur partially or completely, which occurs in approximately 12% of all women. This deviation is considered premature rupture of amniotic fluid. This is a very noticeable phenomenon because it is due to their large volume.

They are normally light or pink and should have no odor. If a brown, green, or black color is detected, this indicates the presence of newborn feces in them. This means that the fetus is oxygen starved and needs a quick delivery. When a yellow tint is mixed in, there is a Rh conflict. Here, too, prompt action is needed.

If the water breaks at home, the woman in labor should urgently go to the maternity 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 membrane - the amnion. It is this that is filled with amniotic fluid. Protects the baby from shock and penetration of vaginal infections. It is a kind of “shelter” for the baby. If it is opened or a rupture occurs naturally, the uterus begins to expel the fetus. As a result, contractions increase and the baby is born.

Surgical intervention - puncture of the bladder before childbirth without contractions is organized with a special device similar to 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.

Types of amniotomy

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

Prenatal. It is organized before the onset of contractions to induce labor.
Early. It is carried out when the cervix is opened by seven centimeters.
Timely. When there is a dilation of up to 10 cm.
Belated. Done during the process of expulsion of the fetus. The procedure is needed to prevent hypoxia in the baby or bleeding in the woman in labor.

Childbirth proceeds without changes and in accordance with the natural state. The baby’s well-being is monitored using a CHT device.

Bladder puncture before childbirth without contractions

Carried out in the following cases:

Post-term 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 suffers due to oxygen starvation.
Preeclampsia is a disease characterized by edema, high blood pressure and the presence of protein in the urine. Has a negative impact on the health of the fetus and mother.
Rhesus conflict. Brings complications and causes stimulation of labor.
Hypertension, diabetes mellitus in a pregnant woman.
Weakness of contractions, impossibility of independent delivery.

When wondering why the bladder 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 the mother.

If labor has begun, then the operation is performed when there is:

the cervix is dilated by six to eight centimeters, but the water does not break. Preserving them does not make sense, since the bubble does not fulfill its purpose;
powerlessness during childbirth. As the contractions fade, the cervix slows down and, to prevent labor from stopping, the bladder is punctured. Observation of the woman in labor is organized. If there is no 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 due to gestosis, liver and kidney diseases, has a negative effect on childbirth and the fetus;
flat amniotic sac. In this condition (low water), there is almost no frontal water. This contributes to the difficulty of labor and its complete cessation;
low location of the placenta. May cause detachment and bleeding.

Carrying out the procedure

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

Before the operation, the woman’s genitals are treated with antiseptic agents and offered to take an antispasmodic or no-shpa. After the effect of the medicine begins, she is placed on a gynecological chair and must lie still and not interfere with the doctor’s manipulations.
The healthcare professional puts on gloves and carefully inserts the instrument into the vagina. Hooks the amniotic sac with a hook and pulls it until it ruptures. The amniotic fluid begins to leak.
After the action is completed, the woman in labor remains in a horizontal position for another half hour. The fetal condition is monitored using a CHT device.

Autopsy is performed 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. A child's risk of infection increases 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 lasted up to fourteen hours;
in multiparous women from five to twelve.

Contraindications and consequences

The procedure has some restrictions and is not performed when:

a pregnant woman has herpes on the genitals in an acute stage;
umbilical cord loops create obstacles for surgery;
natural childbirth is not recommended;
there is a low location of the placenta;
the fetus is in an oblique, transverse, or pelvic presentation;
pelvic narrowing of category 2-4, tumor in the pelvis;
the baby weighs more than 4.5 kg;
deformation of the vagina or cervix due to rough scars;
conjoined twins, triplets;
high myopia;
acute suffocation of a baby.

There is a ban for heart disease.

Possible complications

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

injury to the umbilical cord vessel when attaching it to the sheath. This will lead to blood loss;
deterioration of the baby’s well-being;
loss of arms or legs;
baby's heart disease;
troubled labor and its secondary weakness;

Such completion is rare, but sometimes there is a danger that when the amniotic sac is punctured, the desired result will not occur. As a result, doctors may use drugs that cause contractions. There are cases when they resort to caesarean section. Because keeping a child without water for a long time will have a negative impact.

What sensations does a woman experience during amniotomy?

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

The woman in labor should simply relax and lie down in a comfortable position. If the procedure is carried out correctly, she only feels the water flowing out. They have a warm temperature. If the muscles become tense, discomfort and unfavorable outcomes may occur, such as damage to the vaginal walls.

Compliance with the rules

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

cephalic presentation,
pregnancy is at least thirty-eight weeks,
giving birth on your own and the absence of prohibitions in this,
readiness of the birth canal,
the presence of only one fetus.

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

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

Each operation, which includes puncture of the bladder before childbirth without contractions, does not always lead to a positive outcome. 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 their bladder pierced before giving birth. Many even believe that this is a routine procedure that must be included in the delivery plan. Why do obstetricians resort to such manipulations? Does it hurt and could the child get hurt? How do former women in labor assess the need for such actions and their consequences?

Mandatory stage or last resort: why do an amniotomy?

Nature has programmed it so that the discharge of amniotic fluid during childbirth occurs without outside intervention. Normally, the bubble bursts when the cervix is almost completely dilated and the baby is ready to leave the mother’s tummy. But in reality, many women undergo an artificial bladder puncture before giving birth. Such manipulations are usually resorted to if contractions are already in full swing, pushing will soon begin, but the water has not yet broken.

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, makes it possible to do without stimulation, and examine the amniotic fluid for the presence of meconium or blood.

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

When is it really necessary?

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

the walls of the bladder are too strong, which is why the fetal membrane is not able to rupture on its own, even if the cervix is fully dilated;
labor activity is very weak. Amniotomy will help strengthen 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 fluid begins to drain on its own, the umbilical cord may fall out or the contractions will be too sluggish;
low attachment. The placenta may come out ahead of schedule, which 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 end still does not come. Artificial opening stimulates labor;
flat bubble. If there are no anterior waters or there are too few of them, then the membrane tightly clasps the baby’s head, which is fraught with the development of premature placental abruption, and this is an emergency cesarean section;
high blood pressure;
the bubble burst at the site of its contact with one of the walls of the uterus, which caused a slow leakage of fluid.

Puncture of the bladder before childbirth without contractions to induce labor, 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 causes partial compression of the umbilical cord and a decrease in the amount of oxygen the baby receives. But it is necessary if the woman is past her due date (the puncture will “start” labor).

Important! If the bubble does not burst on its own 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 is simply in the way.

Who can't?

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

Will it hurt?

For such manipulations, a special tool is used - a jaw, 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 a 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 the water. No painful sensations occur, because nature does not provide nerve endings in the sheath.

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

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

Usually no one asks a woman in labor whether she agrees to such a procedure, and the moment is not the most appropriate. 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, she will not be able to determine on her own whether there is evidence for this. In addition, some women note that after the puncture the water was already green, so this was definitely a necessary measure. But some strongly disagree. They believe that they can challenge the obstetrician’s decision, ask what the threat is in this situation, 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 labor exhausts a woman, and she may not have enough strength to give birth herself. But some write that the puncture did not speed up the matter. After such manipulation, 5-12 hours passed - and nothing. As a result, I had to give oxytocin;
It doesn’t hurt to get a puncture; 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 protects it from external irritants. With the onset of labor, with each contraction of the uterus, compression of the amniotic sac occurs, which in turn puts pressure on the internal os of the uterus, promoting its opening. Normally, with complete or almost complete dilatation of the uterine pharynx, the fetal bladder ruptures, followed by the release of amniotic fluid. In some cases, there is a need for amniotomy - surgical puncture of the amniotic sac.

What is a puncture of the amniotic sac?

Amniotomy is a procedure in which the doctor performs an instrumental opening of the amnion using a special surgical instrument that resembles a hook. After a vaginal examination, under manual control, the doctor carefully 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 “posterior”. After amniotomy, only part of the “front” waters pour out, so the stories about difficult “dry” births that are replete with forums are nothing more than fiction.

Puncture of the amniotic sac: main indications

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

If your pregnancy is over 41 weeks
In case of complicated pregnancy, for example, late gestosis, when it is necessary to speed up the progress of labor to alleviate the condition of the mother in labor
In case of development of a condition that threatens the fetus (partial placental abruption, low-lying placenta, umbilical cord entanglement, long anhydrous period)
Weakness of labor, as well as factors that may contribute to this (overstretched uterus with polyhydramnios, twins, physical fatigue of the woman in labor, cervical dilatation more than 7 cm, flat amniotic sac)
Presence of Rh conflict

IMPORTANT! Mandatory conditions for puncture of the amniotic sac are full-term pregnancy and the weight of the fetus in the cephalic presentation is more than 3000 grams. Despite the simplicity of the procedure at first glance, amniotomy is a kind of surgical intervention, and therefore is carried out only after obtaining the consent of the mother in writing.

Puncture of the amniotic sac without contractions

It happens that amniotomy is performed long before the onset of labor. As a rule, the main purpose of such manipulation is to stimulate labor. 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 case of a 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 labor process and increasing the efficiency of contractions. Opening of the amnion during labor is divided into: earlier, timely and late. An early puncture of the amniotic sac is done when the uterine pharynx is dilated to less than 7 cm, in case of weakening contractions. Timely amniotomy occurs when the amnion does not open spontaneously when the cervix is almost fully dilated. A belated puncture of the amniotic sac is carried out when the baby’s head is already lowered into the pelvic outlet cavity to facilitate birth.

Puncture of the amniotic sac: risks and consequences

Almost all pregnant women are interested in the safety of the amnion opening procedure. As a rule, if the manipulation is carried out correctly and all mandatory conditions are met, amniotomy does not carry any risk. It should be noted that the presence of polyhydramnios and other factors that contribute to hyperextension of the uterus during the opening of the amniotic sac can lead to arbitrary prolapse of the umbilical cord loops, which is an indication for emergency surgical delivery. 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 pelvis.

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

The period of waiting for a baby is the most wonderful period in the life of every woman. The expectant mother is really looking forward to the first meeting with her blood, because she really wants to hug this little bundle to herself and look at him as quickly as possible.

But, despite all the charm, there are also not particularly 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 begin and the doctor must be called personally in order for the baby to be born normally.

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 benefit of the child and will not harm him in any way.

Puncture without contractions

Very often, opening the organ in question in pregnant women causes great anxiety, 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 to puncture the bladder, then she should not refuse.

Often the bladder needs to be punctured because there is a certain threat to the baby’s life. Manipulation is carried out for various reasons, the most common ones include threat and... The bladder is also pierced if a woman has a disease such as diabetes, hypertension, or impaired kidney function.

Very often, doctors are forced to induce labor in this way in case of intrauterine death of a baby, during a pregnancy that is post-term, or during pregnancy.

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

Women want to know how this procedure is carried out. As noted earlier, there is no need to worry about puncturing the bladder. Initially, maternity hospital workers use antiseptic agents to treat the female genital organs and additionally give her a drink with an anesthetic effect.

After some time, after the painkiller has taken effect, the doctor expands the lumen of the vagina and slowly inserts a hook. With this special tool, grab the bubble and gently pull it towards you until the walls of the bubble burst. Next, the expectant mother is observed for 30 minutes. If everything was done correctly, then the contractions do not keep you waiting - they begin almost immediately.

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

This may be fetal hypoxia, infection inside the womb (occurs very rarely), bleeding, weak heartbeat in the baby, or prolapse of umbilical cord loops. And the most important thing is that after the bubble is opened, no more than 20 hours should pass until labor 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 bladder ruptures 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 mother’s fear turns out to be higher than the doctors’ explanations, and spasm of the vaginal muscles occurs. At this time, the woman should take one position and not move so that the doctor does not cause any internal damage.

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

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

Scratches on a baby after amniotomy

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

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

Typically, such traces remain during amniotomy. After all, it is in this condition that the membranes are on the baby’s head.