ARM is contraindicated in:
Ans. is b i.e. Hydramnios ARM is a method for inducing and augmenting labour. It involves rupturing the membranes overlying the cervix using a Kocher's forcepdeg. It is applicable when cervix is paially dilated and bishiop score is high Contraindications Intrauterine fetal deathdeg * Maternal AIDS Genital active herpes infection * Chronic hydramniosdeg (In chronic hydrominos controlled ARM is done and not just simple ARM -- as sudden decompression can lead to abruptio placentae) Advantaper Promotes labour by stimulating release of endogenous prostaglandins. Encourages application of the fetal head to the cervix. Colour of the liquor can be observed and meconium staining ruled out. Permits the use of fetal scalp electrode for intrapaum fetal surveillance. Disadvantages : If performed before the presenting pa is well fixed, so it can lead to cord prolapse. ARM can lead to-infection if frequent vaginal examinations are performed. It can cause abruption in case of polyhydramnios. Also Know Stripping of Membranes is the digital separation of membranes from the wall of the cervix and lower uterine segment. Immediately after ARM fetal hea sounds should be auscultated. Transient changes in the fetal hea rate, can occur due to resettlement of the cord after the liquor flows out. Early and variable decelerationdeg of fetal hea rate is relatively common with amniotomy.
Placenta pre
Hydramnios
Accidental Hemorrhage
Twins