Puncture in pregnant women. How is the amniocentesis procedure performed? When you need it

19.04.2019

Amniotomy during childbirth, or opening the fetal bladder is a fairly common procedure in maternity hospitals. For some women, this action seems absolutely normal if necessary, others may see a danger in a puncture and be against it. One way or another, but for an amniotomy, the doctor must obtain consent from the pregnant woman.

What is the fetal bladder for?

The fetal bladder is important not only throughout pregnancy, but also during childbirth. At the beginning generic process it actively promotes the opening of the cervix. It happens like this: during a contraction, the pressure inside the uterus increases, under the influence of which amniotic fluid move down and, resting on fetal membranes pressing on the cervix. After the opening of the cervix reaches its maximum, the membranes of the fetus rupture and the baby's head moves into the pelvis. This happens when normal course childbirth.

The essence and meaning of amniotomy

It happens that the membranes do not burst on their own or it becomes necessary to artificially induce labor, then medical intervention in the form of an amniotomy is required. Puncture of the fetal bladder performed by a doctor using a special tool with a sharp hook at the end. Cutting fetal bladder, the doctor, under personal supervision, releases water that is directly in front of the baby's head, which is good incentive for the occurrence or intensification of contractions.

Indications for an amniotomy

In fact, an amniotomy is an operation, despite the fact that it is completely painless and does not require anesthesia. Therefore, the bladder should be punctured on the basis of reasonable indications. An amniotomy can be performed before the onset of labor in order to induce labor, if the reasons for this arise even during pregnancy, or already during the labor process. Exists whole line indications for its implementation.

Prerequisites for an amniotomy

An amniotomy is possible only when the birth canal is clearly ready for childbirth. The neck should be softened, shortened and ajar and the baby's head positioned in the correct direction.

Bladder puncture is usually contraindicated:

with multiple or premature pregnancy;
at pelvic position fetus;
with low fetal weight;
if the size of the child and the woman's pelvis does not match;
in the presence of scars on the uterus.

Amniotomy procedure

An amniotomy can be performed on a gynecological chair while examining a pregnant woman. The doctor preliminarily assesses the condition of the birth canal and the degree of their readiness for childbirth, and mainly the maturity of the cervix. The whole procedure is carried out in compliance with the rules of antiseptics, so that no infection from the outside penetrates to the fetus. The doctor makes a puncture of the bladder and the removal of amniotic fluid under the control of fingers inserted into the cervix. After the procedure, it is necessary to monitor the fetal heartbeat for some time in order to understand its reaction to a bladder puncture. Complications, although rare, are possible.

Possible complications

Violation placental blood flow and general condition fetus.
Weakness of the birth process.
Rapid labor.

The reason for such complications can be a very rapid outpouring of water and abrupt change pressure in the uterus. That is why it is important to monitor the condition of the fetus after an amniotomy. It should be noted that such disorders are observed quite rarely after amniotomy. At the same time, amniotomy is the most harmless way to stimulate labor and thereby preserve the health of the woman in labor and the baby.

If the piercing was done long before the pregnancy was planned and the wound had time to heal, then there is no danger in this. Moreover, it is quite safe for both the mother and the unborn child. It's a different matter if the wound is fresh. The tummy begins to grow and it is somewhat difficult to heal the puncture, which can lead to the penetration of infection.

With an increase in the uterus, the skin on the abdomen also begins to stretch, this can lead to a change in the diameter of the puncture and its displacement. This usually brings a lot of inconvenience. Moreover, the high probability infection. If the wound begins to swell and rot, it is necessary to see a doctor immediately.

Metal jewelry can bring a lot of inconvenience to a woman in labor due to a rapidly growing tummy. Therefore, the metal should be replaced with flexible polytetrafluoroethylene. Usually it is not rejected by the body and does not cause discomfort. Before the birth itself, the jewelry must be removed.

As for the essence of the question itself, you can wear piercings during pregnancy, but with extreme caution. If the wound did not have time to heal, it must be carefully monitored and constantly processed. special means, even peroxide will do. This will prevent infection from entering the body. In general, each woman decides on her own whether to wear jewelry or not. But still, it is recommended to consult a doctor about this.

Navel piercing during pregnancy

V recent times piercing has become very fashionable and popular. So much so that many women do it during pregnancy, thereby trying to decorate their growing tummy. It is important to observe special rules, thanks to which wearing jewelry will only bring positive emotions and will not hurt.

So, a pierced navel should heal completely before pregnancy, this will significantly reduce the risk of entering the body dangerous infections through the existing wound. With the enlargement of the uterus, the skin on the abdomen also begins to stretch. This phenomenon leads to a shift in the diameter of the wound. As a result, healing is almost impossible.

It must be understood that the immune system the woman is greatly weakened. Therefore, it will take a lot of time for the puncture to heal. This also carries the risk of infection. Wearing comfortable jewelry is important. Metal earrings bring a lot of inconvenience. They are usually rejected by the body, which can lead to inflammation and decay. Before the birth itself, the earring is removed.

It is not worth piercing the navel directly during pregnancy. After all, as described above, a woman's body is weakened, so any infection can freely enter it. Moreover, due to the decrease protective functions the body there is a risk that the wound simply cannot be overgrown, and the constantly changing tummy size will not allow this to happen. Therefore, the risk of infection remains at high level... It is up to each woman to decide whether to pierce the navel or not. But you need to weigh all the possible risks.

How does navel piercing affect pregnancy?

It is necessary to understand that navel piercing is not like that important procedure to do this directly during pregnancy. It should be recognized that for normal wound healing, all protective conditions must be observed. During the period of carrying a baby, this is almost impossible. The body is very weakened, and it is not so easy to make sure that nothing gets into the wound. This entails a lot of negative consequences. It is for these reasons that experts highly discourage piercing directly while carrying a child.

It is worth giving up jewelry because there is a possibility of infection. various diseases that are transmitted through blood. Yes, you can cure such a problem by any means, but do not forget about the risk to the baby. Piercing during pregnancy is also not worth it because many specialists in this case treat the future puncture site with antibiotics, and this is fraught with serious consequences for developing organism baby.

Some mothers are not afraid of this information at all. It is worth noting that in addition to the threat to the baby's life, the puncture site itself can be deformed. Therefore, such a desired decoration will bring exclusively negative emotions... In any case, the piercing should be moved to more favorable time... Do not rush to pierce the navel and put it in danger. own health and baby.

Harm of piercing during pregnancy

Legitimate excitement in mom can cause puncture sites themselves. After all, it is through the umbilical cord that the baby "communicates" with his mother. There were many cases when the puncture hole was stretched and thereby brought a lot of inconvenience to the woman. Indeed, such an effect has a very negative effect on the body. Weakened immunity, the impossibility of protection - all this leads to the penetration of harmful infections into the body. Yes, they can be cured, but only most drugs during pregnancy are prohibited. All of this can have serious consequences. Is piercing worth it? There may not be any harm from it. But the risk of developing unfavorable situation increases every day.

In addition, the earring will have to be removed all the time. You cannot do an ultrasound scan with her, and she will cause a lot of inconvenience during childbirth. At long periods of pregnancy, the tummy grows, the puncture is deformed, the wound is constantly restless. The risk of developing inflammation or decay is great. Therefore, it is worth abandoning this idea. Piercing is good and beautiful, but it is not comparable to motherhood. You should always weigh the pros and cons. Yes, it is beautiful, but not appropriate during the period of carrying a baby.

From women giving birth, you can hear about such a concept as a puncture of the bladder before childbirth without contractions. This procedure is called an amniotomy. Usually about 7-10% of women in childbirth encounter it. Many pregnant women are frightened when they hear about an amniotomy. Having no idea about the correctness and necessity of this procedure, women set themselves up negatively.

What happens if the fetal bladder ruptures before contractions?

V individual cases labor begins with the outpouring of water. Moreover, it can be complete or partial. According to statistics, such a deviation can occur in 12% of all women. This process is called

Women immediately notice this phenomenon, especially if it happens with a large amount of water.

The amniotic fluid should be light or pink and odorless. If black, brown or green color, then this means that there is a newborn's feces in the waters. This suggests that the fetus has developed oxygen starvation, which requires rapid delivery. Impurity yellow color can mean the presence of a Rh-conflict, which also requires quick action.

When the water goes away at home, the woman in labor needs to urgently go to the hospital. In the hospital, a woman must accurately report the time of their departure.

If the body is completely ready for the birth of a child, contractions begin immediately or some time after the water has passed.

What is an amniotomy?

Amniotomy is an operation in which the amniotic fluid is opened. In utero, the fetus is protected by a special membrane - the amnion, which is filled with amniotic fluid. It protects the baby from blows and infection from the vagina.

If an autopsy or rupture occurs naturally, then the uterus begins the process of excreting the fetus. As a result, contractions develop and a child is born.

The operation to puncture the bladder before childbirth without contractions is carried out with a special device in the form of a hook at the moment of its greatest severity, so as not to affect soft tissue baby's head.

Amniotomy types

The bladder puncture before childbirth can be divided into several types, depending on the time of the operation:

Prenatal. It is carried out before the onset of contractions for the purpose of labor arousal.
Early. Done if the opening of the cervix is up to 7 cm.
Timely. If the neck is open to 8-10 cm.
Belated. Can be carried out at the time of expulsion of the fetus. The procedure is used to prevent fetal hypoxia or bleeding in women in labor.

The process of childbirth does not change at all and corresponds to the natural one. The condition of the fetus must be recorded using the KGT apparatus.

When is an amniotomy necessary?

Labor is stimulated by piercing the bladder in case of situations where emergency delivery is needed. The procedure can be carried out in the absence of contractions:

Postterm pregnancy. Regular pregnancy it takes 40 weeks, if the period is longer, then the question of the need for obstetric aid is raised. The placenta in this situation is aging and cannot perform its functions. As a result, the child suffers, experiencing oxygen starvation.
Gestosis. This disease is characterized by edema, high blood pressure, and the presence of protein in the urine. Gestosis negatively affects the health of the mother and fetus, therefore, an amniotomy is needed.
Rhesus conflict. Such a pregnancy is considered difficult, so this operation helps to stimulate labor.

If labor has begun, then the operation is resorted to following cases:

If the contractions do not intensify, but they are weakened, the cervix slows down the process of childbirth, and so that they do not stop, the bladder is punctured. The woman in labor is monitored for 2 hours, if there is no positive dynamics, then a decision is made to resort to "Oxytocin".
Polyhydramnios. The presence of a large amount of amniotic fluid makes the uterus unable to contract naturally.
High blood pressure. Diseases of the kidneys and heart, gestosis contribute to an increase blood pressure, which negatively affects the process of childbirth and the condition of the fetus.
Flat fetal bladder. In this situation, the front waters are almost completely absent, which makes it difficult to generic activity, and its termination may occur.
Low location of the placenta. This position of the placenta can lead to its detachment and bleeding.

In some cases, contraindications arise for this procedure.

Are there any contraindications?

Puncturing the bladder before childbirth helps to facilitate the process of giving birth, but in some cases there are some limitations of the procedure. An amniotomy is not performed if:

a pregnant woman has herpes on the genitals in an exacerbation stage;
the placenta is low;
the loops of the umbilical cord interfere with the operation;
natural childbirth is not recommended;
finding the fetus in an oblique, transverse and breech presentation.

The procedure for diseases of the mother's heart, with the existence of scars on the cervix and other pathologies is prohibited.

How is the bladder punctured?

Why and how is the bladder punctured before childbirth? Amniotomy equates to surgical intervention but the presence of an anesthesiologist and a surgeon is optional. After a vaginal examination, the doctor will open the bladder. The procedure includes several stages:

Before the operation, the woman takes No-Shpu or another antispasmodic. After exposure to the medication, the woman lies down on the gynecological chair.
Then the specialist, wearing gloves, inserts the instrument into the vagina. The amniotic sac is hooked and pulled by the doctor until it ruptures. After that, the amniotic fluid begins to pour out.
After the end of the manipulation, the woman is in horizontal position... The condition of the fetus is monitored by the KGT apparatus.

The bladder is necessarily opened in the absence of contractions, which leads to the convenience and safety of the operation.

What does a woman feel during an amniotomy?

Bladder puncture before childbirth - does it hurt or not? Any woman is afraid of such a procedure because of possible occurrence pain. However, in this case, unpleasant sensations are not observed, because in amniotic fluid there are no nerve endings.

A woman just needs to relax and accept comfortable position... All that she can feel after a properly performed procedure is only the flow of amniotic fluid.

When muscles are strained, discomfort and Negative consequences in the form of injury to the walls of the vagina.

Mandatory conditions

What are the conditions for a bladder puncture before childbirth? To avoid complications during the procedure, you must follow some rules. These include:

correct presentation of the fetus (head);
pregnancy, the duration of which is at least 38 weeks;
natural delivery and the absence of restrictions to this;
preparedness of the birth canal;
pregnancy with one fetus.

The importance lies in the readiness and maturity of the uterus. When carrying out the operation, it must correspond to 6 points on the Bishop scale.

Complications and consequences of amniotomy

With an error-free bladder puncture before childbirth, the whole process is safe. But there are a few exceptions where labor can be more difficult after an amniotomy. There are the following consequences:

trauma to the umbilical cord vessel, if it is attached to the sheath, which can lead to blood loss;
the child's condition worsens;
the loops of the umbilical cord or limbs of the fetus (arms, legs) fall out;
violation of the child's heartbeat;
violent labor activity;
secondary birth weakness.

There is a risk that a puncture of the fetal bladder will not lead to desired result and labor activity will not become active. Therefore, doctors resort to using drugs that cause contractions. In some situations, a woman is cesarean section, because a long stay of a child without water is fraught with negative consequences.

How long does labor last after a bladder puncture before childbirth? Reviews of women who have gone through this procedure are as follows:

for women who gave birth for the first time, childbirth took place within 7-14 hours;
in multiparous women, this can take 5-12 hours.

Any intervention, which can be attributed to the puncture of the bladder, sometimes leads to consequences that are not always positive. Amniotomy should be performed with all necessary conditions, which will reduce the risk of complications of different nature... Therefore, if this procedure is necessary, women should not refuse surgery and other manipulations necessary during childbirth.

Several years ago, piercing was a craze not only for young people, but also for people more mature age... And now this way to decorate your body has not lost its relevance.

How can piercing during pregnancy affect your health and the condition of your unborn child? Is there a difference between a piercing you already own and one that you want to get while pregnant?

What is piercing

Piercings are metal jewelry, like earrings, that can be inserted into different parts of the body. Most often, piercings are used to decorate the eyebrows, nose, lips, tongue and navel - that is, open areas of the body where it will be clearly visible.

Body piercing jewelry is usually made of surgical steel that does not rust or cause allergic reactions... There are also gold or silver jewelry- but it is undesirable to wear them constantly.

How does piercing affect pregnancy?

Pregnancy is not a reason to forget about current trends fashion, especially if you are young and beautiful. However, not all fashion trends turn out to be safe for the health of you and your baby. Consider piercings specifically.

First of all, let's evaluate its effect on your body in the event that you already had jewelry before pregnancy. It all depends on where the decoration was made. The safest place, oddly enough, is the face area - eyebrows or nose. The tongue and lips of a pregnant woman tend to swell a little. Therefore, wearing jewelry here can be quite painful.

For the same reasons, you will need to remove your genital jewelry:

Wearing piercings in these areas during pregnancy can be very painful;
The risk of infection of the puncture increases.

So, to summarize - if you had a piercing before pregnancy, it can only be left in the nose or eyebrows. And this is subject to the most careful care of jewelry and puncture sites. When to remove piercings during pregnancy? The sooner the better.

You can do it or it is undesirable

Now we can talk about whether it is possible to get pierced for the first time if you are pregnant. We have already found out what it is:

This procedure involves piercing the skin with a special needle and installing jewelry;
You will be offered to do this in beauty salons, tattoo parlors and other similar institutions. There is practically no way to reliably find out how well the toolkit is processed. With any manipulations of this kind, you can bring not only an ordinary infection that will cause purulent inflammation, but also diseases such as HIV and viral hepatitis.

And if earlier you were responsible only for your health and could dispose of it as you like, now you are not alone. Your child is at risk of infection with you.

In this case, you will have to make a choice between the fashionable appearance and the health of the unborn baby. Moreover, in this situation, there are no dangerous and safe places for piercing during pregnancy. Even if it is simple inflammatory process somewhere in the eyebrow area. All the same, this will affect the condition of the baby, as well as the influence drugs which you will have to use.

As for the immunodeficiency virus and hepatitis, they do not care where they enter the body. With blood, these viruses can reach your child. Of course, not everyone who performs this manipulation has such complications. However, why would you risk it?

If you do decide to decorate your body, you should warn yourself as much as possible against infection. Choose only proven salons, where you will be given reliable information about the sterility of the instruments used;
It is also desirable that the masters have medical certificates confirming their health;
Choose areas of the body for piercing where there is the least risk of developing inflammatory complications. It is best to decorate the eyebrow or the wings of the nose. There is no need to make punctures on the stomach - after all, it will grow every month and the puncture site will be deformed. Likewise, the genital area should not be pierced;
The best material for decoration is surgical steel. It is the least allergic and can be thoroughly sterilized. After giving birth, it can be replaced with any desired material;
Be sure to carefully look after the puncture site. Treat it with antiseptic solutions twice a day. Lubricate with healing ointments - Solcoseryl, Bepanten. Antiseptic treatment should be done after the wound has healed.

Can piercing be worn during pregnancy? Nobody can forbid you to do it. but dangerous complications there is a lot of this procedure and there is a lot of risk. If you decide to get a piercing, be sure to take care of safety.

The need to puncture the amniotic bladder before childbirth is needed only by 10% of all women in labor. However, many, not understanding the specifics of such a procedure, are afraid of the painful puncture. Is it painful to pierce the bladder before childbirth, and why may such a procedure be necessary?

Bladder puncture during childbirth is carried out to stimulate labor in the absence of or with contractions. How long does labor last after a bladder puncture, and how does labor actually proceed, does it differ from normal labor without additional stimulation?

A bladder is pierced before childbirth without contractions if the pregnancy is prolonged. So, today, amniotomy (or puncture of the amniotic bladder) is performed for pregnant women if the pregnancy is more than 41 weeks, and labor activity is not observed.

After opening the bladder, contractions may begin in 60% of women in labor, the rest are given additional injections of oxytocin to start labor. Such methods are called stimulation, it is carried out only according to the testimony of a doctor, with constant monitoring of the child's condition.

Many pregnant women are interested in the question of how quickly a child is born with such a procedure, and how much differs from planned natural births with stimulation? When the bladder bursts, the uterus naturally (in the presence of oxytocin) begins to contract. There is not much difference between stimulated labor and natural labor. However, before performing such a procedure, the doctor must:

examine the birth canal at the time of readiness;
establish the degree of opening of the cervix (so, if there are no contractions, the period is 41+, and the cervix is worn out, soft and elastic, a puncture can be performed, if the uterus is rigid and the birth canal is not ready for childbirth, a puncture is not recommended);
notify the woman in labor that stimulation will be carried out.

Why do they cause labor, and why is a bladder puncture needed? In most cases, amniotomy is performed for those pregnant women who either are already experiencing contractions, and the degree of cervical dilatation is more than 6 cm, or those who "delay" the onset of labor.

Oversight of the child negatively affects his well-being:

oxygen deficiency of the fetus may develop;
the bones of the skull begin to harden after 42 weeks, which creates the risk of cerebral palsy during childbirth;
the child is missing nutrients because the placenta has depleted its reserves by this time;
amniotic fluid accumulates a large number of harmful substances.

It is for such understandable reasons that women in labor with pregnancy for more than 40 weeks are recommended to be hospitalized, observe the first 5-7 days, prepare the cervix, and then pierce the bladder for 42 weeks in the absence of labor.

Puncture of the amniotic fluid main indications

For amnotomy (manipulations to puncture the bladder with water), for obvious reasons, it is necessary clear readings... So, doctors may consider the need for a puncture in the following cases:

overmaturity of the child 41 weeks +;
probable fetal hypoxia (lack of oxygen);
complication during pregnancy (prenatal amnotomy);
when the uterus is opened by 8-10 cm (timely);
opening of the uterus up to 5 cm with weak contractions (premature).

Bladder puncture during childbirth, why and how a puncture is made

Why pierce the bladder before childbirth and can such a fate be avoided? Many pregnant women are simply afraid for the health of the baby, because the puncture is carried out directly in the vicinity of the baby's head. In fact, a puncture of the bladder does not pose any danger, does not bring painful sensations.

The thing is that the bubble with amniotic fluid, in which the child swims freely for the first months, does not have nerve endings... That is why the procedure is absolutely painless. A puncture is performed when the woman in labor is located in the gynecological examination chair, with the legs raised and apart on the sides.

The fears of mothers about the danger of access to the child are in vain: the gynecologist precisely establishes the place for the puncture, and the baby's head is much higher than the cervix, the pressure is not yet felt. Therefore, such a procedure does not pose any danger to the child and mother.

It is necessary to open the amniotic fluid in only two cases.

Actually, there can be a large number of reasons, as already indicated earlier, but the most important reason for which amnotomy is needed is:

stimulation of labor on later dates without contractions, but in the presence of an erased cervix;
a puncture during the opening of the uterus by all 10 cm, when it is already possible to carry out attempts for childbirth, and the fetal bladder has not burst.

The main requirement for the beginning of the manipulation is the readiness of the birth canal, the worn out cervix.

How is the puncture of the fetal bladder performed?

How and with what do they pierce the bladder during childbirth, how dangerous is it? After manipulating the cervix (the gynecologist stretches it with his fingers), a metal gynecological instrument is inserted into the vagina, which has a slightly bent end. This end engages the fetal bladder and sharp movement pulls on itself. At this moment, the fetal bladder bursts, water flows out, the uterus begins to contract.

After the bladder is punctured, before childbirth, the baby's heartbeat is monitored (the woman in labor is connected to the CT or periodically monitored) throughout all stages of labor. The puncture is performed only by a doctor, not an obstetrician, who will continue the delivery. Such a procedure does not pose a danger to the child and mother. On the contrary, the stimulation of labor activity accelerates the intensity of contractions, the baby is born faster.

What does a woman feel when the amniotic fluid is punctured

What does the woman in labor herself feel during this operation? How does it feel when piercing a bladder? Women in labor who have experienced amnotomy say that painful sensations are not present throughout the operation. Moreover, the most painful thing is stretching the cervix with fingers, which in mandatory is carried out by a doctor.

After puncturing the bladder, the woman will feel the outflow of fluid. The doctor pre-sets the basin at the bottom of the obstetric chair, roughly calculating the amount of fluid. In this case, the water should be light, translucent or transparent color, without admixtures of blood, mucus and putrid odor... There may be small flecks of white flakes, which are considered normal.

After the puncture, the woman is advised to walk more in order to enhance labor. If necessary, oxytocin is administered intravenously (droppers), which enhances the effect. Further, with the contraction of the uterus, oxytocin and endorphin are produced naturally, childbirth takes place in a normal rhythm, no different from non-stimulated contractions.