Pregnancy stages

What is amnioscopy for in pregnancy?


During pregnancy, the woman is subjected to many examinations, tests, analyzes in order to evaluate the well-being of the mother and the baby, and of course to assess that the pregnancy passes without any complications.

One of the tests that many women undergo when labor begins is amnioscopy, controversial technique according to different scientific studies.

Amnioscopy it is an invasive test and consists of introducing a hollow tube through the cervix, through which we introduce a cold light, and observe the amniotic fluid through the vagina. In order to perform this test, the cervix must be dilated one or two centimeters. This dilation can be obtained manually prior to testing.

The goal of the test is to detect the presence of meconium in the amniotic fluid. Meconium is a dark, viscous substance that forms in the intestine of the fetus and is expelled as the first stool.

The presence of meconium in the amniotic fluid is usually associated with problems before delivery, since the expulsion of feces by the fetus is often attributed as a consequence of hypoxia (lack of oxygen), and after delivery the baby could aspirate meconium to the lungs.

However, it is necessary to explain to the woman that the fetus in a physiological way already performs many of the functions that it will do when it is born, and one of them is to swallow amniotic fluid, digest it and expel it in the form of dark and viscous stools that we call meconium.

The usefulness of amnioscopy is currently questioned, since only allows to assess the presence of meconium in the lower pole and not in the whole of the amniotic fluid sac. Furthermore, the presence of meconium, by itself, does not necessarily indicate fetal distress; This suspicion must be confirmed with a cardiotocographic record (the monitors that they put us in the hospital).

According to Clinical Practice Guide for Attention to Normal Delivery, 'amnioscopy is a procedure performed to evaluate the amount and / or color of amniotic fluid (LA) in order to detect alterations that could indicate fetal compromise. However, it is an invasive intervention not free of complications and with a significant number of false results. These circumstances determine that the benefit-risk balance is doubtful '.

Amnioscopy has risks: During the amnioscopy, the amniotic fluid sac may rupture, or the membranes may detach. Rupture of the bursa carries a risk of infection, and the detachment of membranes can cause dilation of the cervix, infection, bleeding, or accidental rupture of the amniotic sac. It is also a test that is very annoying for women.

Currently it is not indicated to perform this test routinely, unless we have suspicion of meconium. Even so, to check the baby's well-being, it is indicated to carry out cardiotocographic monitoring, which will provide us with more data.

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