When a woman goes to a hospital to give birth and is admitted, professionals begin to follow a protocol of action according to the type of birth the woman is having, with more or less standardized interventions and others that will arrive only if necessary.
As we have commented on other occasions, current studies are revealing that many of the things that have been done for a long time are not entirely necessary and therefore they are expendable and that many other things can even generate risks that did not exist.
With this entry today, in which we will talk about the amnioscopy (summarizing: it is the test that is performed to see how much amniotic fluid there is and what it looks like), we started a series of entries whose objective is to know the possible routine interventions that can be performed on a woman who goes to give birth to a hospital and know how Recommended are or how they can affect the birth process.
What is an amnioscopy?
It is a test that is performed by the introduction, vaginally, of a metal tube provided with a light (better known as an amnioscope), which allows to illuminate the membranes of the amniotic bag to assess the coloration of the amniotic fluid and consequently know the condition of the baby.
It can only be done when the woman has started labor, because there is a need for a minimum dilation (if not, it will not be possible to see the bag).
What can be observed?
As we have explained, amnioscopy is the visualization of the amniotic fluid through the illumination of the membranes through which a clear liquid can be seen under normal conditions, with some flaky vernix flakes floating. If a reddish liquid is observed it could mean the death of the fetus in the uterus. If it were greenish, there would probably be meconium that could cause fetal distress and if it were yellow it could mean the presence of bilirubin, which can occur when there are blood incompatibilities.
When it's made?
This is surely the crux of the matter. In many hospitals there have been protocols for some time in which it is established, routinely, performing an amnioscopy to the women who arrive admitted in order to know whether or not there is a problem.
In principle, said so, it seems that it is best to do it, however it seems that the current trend is the opposite for two reasons: one, that Although the test carries a relatively low risk of complications, it is not exempt from such risk. and two, that The test gives enough false results.
Does amnioscopy offer false results?
So is. To show it in data, in a study that analyzed 289 amnioscopies performed on women who had already left accounts it was observed that with said test it was not possible to detect the presence of meconium before delivery in 57% of cases (That is, out of every 100 cases with meconium, only 43 were detected with amnioscopy).
It was also seen that when the presence of meconium was observed, the incidence of fetal distress did not increase (perhaps because many of those who had meconium were not diagnosed and suffered the same as those detected) and it was evidenced that inducing labor did not improve either incidence of fetal distress.
The authors of this study concluded that even when the mother arrived, the amnioscopy was not recommended:
Amnioscopy is not recommended for the monitoring of postdate pregnancies.
Conclusions
The National Health Service, in its latest guide on Normal Delivery Care says that "Amnioscopy is not recommended in the initial assessment of low-risk women in labor". From this it follows that It should only be used if you suspect any problem and being aware that a large number of tests will offer a false result.
