OBSadvanced
Arrange the steps for performing an amniotomy (artificial rupture of membranes) in the correct chronological order:
Answer
Confirm that the fetal presenting part is engaged and well applied to the cervix, Guide the amniohook along the examining fingers through the cervix, Hook and rupture the amniotic membrane, Inspect the amniotic fluid and immediately reassess the fetal heart rate
Explanation
The procedure begins with fetal and pelvic assessment, including confirming engagement and good application of the presenting part. The amniohook is then guided through the cervical os along the hand and fingers to rupture the bulging membranes. The nature of the liquor and FHR after the procedure are recorded.
**Key takeaway:** Assess before rupture and document both fluid and fetal status afterward.
**Glossary:** **Amniohook**: an instrument used to rupture membranes. **Liquor**: amniotic fluid.
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