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Gynaecology & Obstetrics Normal Labour e441ff1f

Benefits of surgical induction (ARM) are all except:

A
Lowers the blood pressure in preeclampsia
B
Relieves the maternal distress in hydramnios
C
Decreases incidence of amnionitis
D
Reduces the need of caesarean section
High-Yield Explanation
Ans. is c, i.e. Decreases incidence of amnionitisRef Dutta Obs. 9/e, p 487-488ARM is a method for inducing and augmenting labour.It involves rupturing the membranes overlying the cervix using a Kocher's forcepQ.It is applicable when cervix is partially dilated and bischop score is high.Advantages: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 intrapartum fetal surveillance.Disadvantages:If performed before the presenting part 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.Rarely it can lead to liquor amni embolismContraindications:Intrauterine fetal deathQMaternal AIDSGenital active herpes infectionChronic hydramniosQ(In chronic hydrominos controlled ARM is done and not just simple ARM -- as sudden decompression can lead to abruptioplacentae)Also Know:ARM and stripping of membranes are different. Stripping of Membranes is the digital separation of membranes from the wall of the cervix and lower uterine segment.Immediately after ARM fetal heart sounds should be auscultated.Transient changes in the fetal heart rate, can occur due to resettlement of the cord after the liquor flows out.Early and variable deceleration0 of fetal heart rate is relatively common with amniotomy.

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