Open Access
AJP Rep 2011; 01(02): 099-104
DOI: 10.1055/s-0031-1285983
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Amnioscope Strikes Back as a Useful Device for Pinhole Amniotomy in the Management of Polyhydramnios

Shinsuke Koyama
1   Division of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
2   Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Osaka, Japan
,
Takuji Tomimatsu
1   Division of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
2   Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Osaka, Japan
,
Takeshi Kanagawa
1   Division of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
2   Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Osaka, Japan
,
Tateki Tsutsui
1   Division of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
2   Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Osaka, Japan
,
Tadashi Kimura
1   Division of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
2   Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Osaka, Japan
› Author Affiliations
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Publication History

Publication Date:
02 August 2011 (online)

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Abstract

Polyhydramnios is associated with many serious maternal complications such as placental abruption or cord prolapse at rupture of membranes, uterine dysfunction at delivery, and postpartum hemorrhage. When considering uterine dysfunction caused by overstretched uterine muscles, active artificial amniotomy for more efficient labor seems to be a preferred obstetric management, but the potential adverse complications make obstetricians hesitate to perform this procedure. In such a challenging situation, a new strategy is required. We recently performed pinhole artificial amniotomy using an amnioscope in four women with polyhydramnios, not only to accelerate of labor but also to more slowly and safely reduce amniotic fluid volume. We had no complications using this procedure, and all women were able to have a vaginal delivery without postpartum hemorrhage and neonatal asphyxia. Pinhole artificial amniotomy using an amnioscope may be more convenient and safer than conventional artificial amniotomy. The significance of the amnioscope has been practically nil in modern obstetric management. In this pilot clinical study, we identified a new value for the amnioscope as a promising device for safer amniotomy in women with polyhydramnios.