Updated: Oct 07, 2021
  • Author: Nan G O'Connell, MD; Chief Editor: Christine Isaacs, MD  more...
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Amniotomy (also referred to as artificial rupture of membranes [AROM]) is the procedure by which the amniotic sac is deliberately ruptured so as to cause the release of amniotic fluid. Amniotomy is usually performed for the purpose of inducing or expediting labor or in anticipation of the placement of internal monitors (uterine pressure catheters or fetal scalp electrodes). It is typically done at the bedside in the labor and delivery suite.


Indications and Contraindications

Amniotomy is indicated in the following situations:

  • When internal fetal or uterine monitoring is needed [1]

  • For induction of labor, usually in conjunction with an oxytocin infusion [2, 3, 4, 5, 6, 7] ; a meta-analysis showed that routine early amniotomy after cervical ripening does not increase the risk of cesarean delivery [8]

  • For augmentation of labor, in that amniotomy leads to an increase in plasma prostaglandins [9] ; data on the effectiveness of labor augmentation are mixed [10, 11]

Amniotomy may be contraindicated in the following situations:

  • Known or suspected vasa previa

  • Any contraindications to vaginal delivery

  • Unengaged presenting part (although this obstacle may be overcome with the use of a controlled amniotomy or the application of fundal or suprapubic pressure)