The method of amnioscopy is the study of amniotic fluid in the lower parts of the fetal sac and the determination of the state of the amniotic sac in this area. To do this, an instrument called an amnioscope is used, which is inserted through the vagina and the cervical canal.
Indications for amnioscopy:
suspicion of chronic fetal hypoxia;
postponed pregnancy;
determination of fetal condition in pregnant women at risk with arterial hypertension, diabetes mellitus, etc.;
determination of the adjacent part of the fetus;
Rh- or ABO-incompatibility between maternal blood and fetus (hemolytic fetal disease);
suspicion of premature fetal death.
Contraindications to amnioscopy:
inflammatory diseases of the vagina and cervix;
inflammation of the fetal membranes (chorioamnionitis);
placenta previa.
Technique of execution. The procedure is performed in the last stages of pregnancy. The vagina opens with the front and rear shaft and is cleaned. An amnioscope is inserted through the cervical canal, the lower part of the fetal sac is examined and the type of amniotic fluid is determined.
Results of the procedure:
transparent, light amniotic fluid with or without vernix caseosis - occurs during normal pregnancy;
amniotic fluid of a greenish color - indicates meconium. This may be a sign of fetal hypoxia, but meconium can also be reflexed without damaging the fetus.;
yellow amniotic fluid - due to the presence of bilirubin in it. Occurs with hemolytic disease of the fetus with incompatibility of the blood group between the mother and the fetus;
black or bloody amniotic fluid - with intrauterine fetal death or premature placental abruption.
Examination of the lower part of the amniotic bladder allows you to determine its condition:
if it is damaged in its lower part, the researcher will see a violation of the integrity of the bladder and leakage of amniotic fluid;
if its surface has no visible disturbances, but amniotic fluid flows under pressure on the abdominal wall, then a crack occurs in the upper parts of the fetal bladder;
if the amniotic fluid does not flow out when pressure is exerted on the abdominal wall, and the adjacent part of the fetus is slightly displaced, then the amniotic bladder does not burst.
Complications:
mechanical injury of the cervix and bleeding;
rupture of the amniotic bladder and premature leakage of amniotic fluid;
fetal injury;
introduction of infection into the uterine cavity due to the presence of bacterial flora in the vagina. nuru near me