Artifical membrane rupture

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This is the artificial breaking of the membranes surrounding the baby, releasing the amniotic fluid.

When is it necessary?

• To assist in the induction of labour (usually used in conjunction with oxytocic drugs).
• To speed up labour which has started naturally (augmentation).
• To check the colour of the amniotic fluid if fetal distress is suspected.

How is it done?

The mother is asked to lie on her back with legs open. A long plastic tube with a sharp hook on the end (similar to a crochet hook) is introduced through the vagina and cervix. A small nick is made in the membranes and the fluid is allowed to escape.

Effects on the mother
Advantages:

1.

Research has shown that labour may be shortened by an average of up to one hour.

Disadvantages:

	1.	As the cushion of fluid between the baby's head and the cervix is removed, the fetal head presses firmly on the cervix. This has the effect of causing very strong contractions, due to direct pressure on the cervix by the hard head.
	2.	The increased intensity of the contractions may cause rapid dilatation and extra pain and discomfort. If early in labour, the intense contractions may lead to an increased use of pain-relieving drugs. If late in labour, then the mother may be suddenly thrown into transition without warning
	3.	With the membranes ruptured, there is an increased risk of infection. Time limits may be placed on the length of labour from that point to avoid further complications.
	4.	Once the fluid is reduced there is an increased risk of compression of the umbilical cord, which may reduce the flow of blood and oxygen to the baby from the placenta.

Effects on the baby
Advantages:

1.

The labour may be shorter.

Disadvantages:

	1.	The extra pressure on the fetal head may cause distress to the baby, and lead to further interventions to assist the baby.
	2.	The pain-relieving drugs required by the mother have side-effects on the baby.
	3.	Prolonged rupture of membranes may lead to infection in the baby.