Maternity Nursing: Intrapartum Q 54
A client arrives at a birthing center in active labor. Her membranes are still intact, and the nurse-midwife prepares to perform an amniotomy. A nurse who is assisting the nurse-midwife explains to the client that after this procedure, she will most likely have:
A. Less pressure on her cervix.
B. Increased efficiency of contractions.
C. Decreased number of contractions.
D. The need for increased maternal blood pressure monitoring.
Correct Answer: B. Increased efficiency of contractions
Amniotomy can be used to induce labor when the condition of the cervix is favorable (ripe) or to augment labor if the process begins to slow. Rupturing of membranes allows the fetal head to contact the cervix more directly and may increase the efficiency of contractions.
Option A: Amniotomy is usually performed for the purpose of inducing or expediting labor or in anticipation of the placement of internal monitors (uterine pressure catheters or fetal scalp electrodes). It is typically done at the bedside in the labor and delivery suite.
Option C: It is commonly felt that relieving the amniotic sac of amniotic fluid induces uterine contraction activity, increases the strength of contractions, and may augment labor by allowing direct pressure from the fetal scalp on the uterine cervix which may assist in dilating the cervix.
Option D: The nurse has a very important rule in the assessment and continuous monitoring of pregnant women in labor. The nurse should be very vigilant and report any untoward change in the hemodynamic status of the pregnant woman to the clinician at all times.