Minor obstetric surgeries include:
1) artificial rupture of membranes (amniotomy);
2) dissection and repair of the perineum in delivery (perineotomy, episio-tomy):
• midline dissection - perineotomy;
• lateral dissection - episiotomy (lateral, medio-lateral);
3) repairing of perineal incision (perineorrhaphy, episiorrhaphy).
All obstetric surgeries, including minor ones, are performed only according to medical indications in compliance with prerequisites.
7.1. ARTIFICIAL RUPTURE OF MEMBRANES (AMNIOTOMY)
Obstetric operation for artificial rupture of membranes is called amniotomy. Amniotomy is performed during pregnancy and labor. Indications for artificial rupture of membranes during pregnancy:
► induction of labor during pregnancy, preeclampsia, antenatal fetal demise;
► extragenital diseases, conditions, or obstetric complications when further prolongation of pregnancy is dangerous for the health of pregnant woman and her fetus (bronchial asthma, arterial hypertension, placental insufficiency).
Indications for early artificial rupture of membranes (4 cm uterine dilatation):
► polyhydramnios. In case of untimely rupture of membranes, a large amount of amniotic fluid suddenly spills out which can cause prolapse of umbilical cord, arms, legs and fetal asphyxia. In case of artificial rupture of membranes, amniotic fluid is slowly discharged so that the fetal head is gradually and firmly pressed to the pelvic inlet;
► functional incompetence of amniotic sac: flat, membranes are pulled over the fetal head and the amniotic sac does not play the role of "hydraulic wedge" that facilitates cervical dilation;
► multiple pregnancy, when it is advisable to perform artificial rupture of membranes of the second fetus 5-7 minutes after the delivery of the first fetus;