Understanding Arom In Pregnancy: What Does It Mean?

Amniotomy, or artificial rupture of membranes (AROM), is a procedure in which a healthcare provider manually breaks a pregnant person's amniotic sac to induce or expedite labour. The amniotic sac, also known as the bag of waters, is a fluid-filled sac that protects and cushions the foetus during pregnancy. While the amniotic sac typically ruptures naturally as labour progresses, some women require an amniotomy to speed up contractions and induce labour. This procedure is typically carried out with an amnihook, a thin, plastic tool resembling a crochet needle, which is inserted into the vagina to puncture the amniotic sac.

Amniotomy is a mechanical method for induction of labour

Amniotomy, or artificial rupture of membranes (AROM), is a mechanical method for induction of labour. It is a procedure in which the amniotic sac is intentionally ruptured to cause the release of amniotic fluid, which surrounds and protects the foetus during pregnancy. Amniotomy is usually performed to induce or expedite labour, or in preparation for the placement of internal monitors.

Amniotomy is typically carried out by an Amnihook, a long, thin, plastic tool with a hook at one end, which is inserted into the vagina and used to create a small opening in the amniotic sac membranes. The procedure is generally safe, but risks include umbilical cord prolapse, compression, and infection.

Amniotomy is often used in conjunction with an oxytocin infusion, as the combination of the two is considered the most effective induction method. However, the effectiveness of AROM is debated, and some studies suggest that it does not advance labour in low-risk pregnancies, with natural progression being preferable.

AROM is performed when the cervix is partially dilated and effaced

Amniotomy, or artificial rupture of membranes (AROM), is a procedure performed to induce or expedite labour. It involves rupturing the amniotic sac, a fluid-filled sac that protects and cushions the foetus during pregnancy. While the amniotic sac usually ruptures naturally as labour contractions progress, in some cases, it does not break on its own. This is when AROM is carried out to manually break the water.

The procedure is typically carried out using an amnihook, a thin, plastic tool that is inserted into the vagina to create a small opening in the amniotic membranes. Pads or towels are placed under the patient to absorb the fluid from the amniotic sac once it is broken. While AROM can help speed up labour and progress dilation of the cervix, it may not be suitable for everyone, and there are certain situations in which it is contraindicated.

The procedure is carried out by an Amnihook

Arom, or artificial rupture of membranes, is a procedure used to induce or accelerate labour. It can be carried out using an amnihook or amnicot, or by the proceduralist's finger. The amnihook is a sterile plastic hook that is inserted into the vagina and used to puncture the amniotic sac.

The Amnihook is held with one hand outside the vagina, while the fingers of the other hand are placed inside the vagina to guide the tip. The hook is pushed against the amniotic sac and then pulled through the membranes to create a hole. This allows the amniotic fluid to escape from the uterus and exit the vagina. The absence of a fluid buffer between the fetus and uterus stimulates uterine contractions and promotes the release of prostaglandins.

There are several reasons for performing an amniotomy, including inducing labour, monitoring the baby's heartbeat, checking the colour of the fluid, and preventing the baby from aspirating the contents of the amniotic sac during birth. While the procedure was once thought to be an effective means of inducing labour, there is now evidence that it may not be as effective as previously believed.

AROM can be performed safely if the presenting part is well-applied to the cervix

During pregnancy, an amniotomy, or artificial rupture of membranes (AROM), is a procedure to manually rupture the amniotic sac and induce labour contractions. AROM can be performed safely if the presenting part is well-applied to the cervix.

AROM is typically carried out by inserting an amnihook, a long, thin, plastic tool resembling a crochet needle, into the vagina to puncture the amniotic sac. To ensure the safety and effectiveness of the procedure, several precautions must be taken. Firstly, it is crucial to evaluate the cervix to ensure it is softened, thinned, and dilated, with the baby's head in the correct position, low in the pelvis, and pressed against the cervix. This favourable cervix position reduces the risk of umbilical cord prolapse, a serious complication where the umbilical cord drops through the vagina before the baby, cutting off their oxygen supply.

Additionally, the procedure should only be performed when the baby is in a vertex presentation, with the head well-applied to the cervix. This further minimises the risk of umbilical cord prolapse and ensures the baby can move deeper into the pelvis, facilitating cervical dilation.

Furthermore, the timing of AROM is critical. Performing the procedure too early in the labour process can increase the risk of intrapartum chorioamnionitis, an infection of the amniotic membranes. Therefore, it is essential to balance the benefits of expedited labour induction with the potential risks associated with prolonged exposure to ruptured membranes.

While AROM can be safely performed under the right conditions, it is not always necessary or beneficial. Some studies suggest that it may not significantly advance labour in low-risk pregnancies, and a natural labour progression is often preferred. Additionally, there are risks associated with AROM, including increased pain, umbilical cord compression, and a potential increase in the risk of Caesarean delivery.

In conclusion, while AROM can be safely performed when the presenting part is well-applied to the cervix, it is important to carefully assess each patient's unique circumstances and make an informed decision based on their pregnancy and medical history.

The effectiveness of AROM is often debated

Some studies show that AROM does not necessarily advance labour in low-risk pregnancies and that a natural labour progression is preferred. However, some data shows that it can speed up labour. For example, in a randomised controlled trial of nulliparous women in spontaneous labour, early amniotomy reduced the median length of time to progress to complete cervical dilation and reduced the rate of labour dystocia. There was no difference in maternal or neonatal outcomes, including infectious outcomes. Another recent randomised controlled trial of a similar patient population found that early amniotomy was associated with a lower rate of labour dystocia as well as CD.

AROM is used to induce or augment the labour process or to assist in the placement of internal fetal monitoring devices to provide a direct assessment of fetal status. Monitoring of the fetal heart rate, as well as uterine activity, can be easily obtained via external monitoring systems. However, in certain circumstances, a more direct evaluation of the fetal heart rate or uterine activity is required during labour. The amniotic membrane presents a physical impediment to this form of monitoring, and to place a fetal scalp electrode or intrauterine pressure catheter, the membranes must necessarily be broken first.

The American College of Obstetricians and Gynecologists (ACOG) recommends that labour and delivery teams opt to wait longer to perform this procedure in low-risk pregnancies where mother and baby are progressing normally.

Frequently asked questions