title: The amnioscope strikes back as a useful device for pinhole amniotomy in the management of polyhydramnios.
abstract: Polyhydramnios is associated with many serious maternal complications such as placental abruption or cord prolapse at rupture of membranes, uterine dysfunction at delivery, and postpartum hemorrhage. When considering uterine dysfunction caused by overstretched uterine muscles, active artificial amniotomy for more efficient labor seems to be a preferred obstetric management, but the potential adverse complications make obstetricians hesitate to perform this procedure. In such a challenging situation, a new strategy is required. We recently performed pinhole artificial amniotomy using an amnioscope in four women with polyhydramnios, not only to accelerate of labor but also to more slowly and safely reduce amniotic fluid volume. We had no complications using this procedure, and all women were able to have a vaginal delivery without postpartum hemorrhage and neonatal asphyxia. Pinhole artificial amniotomy using an amnioscope may be more convenient and safer than conventional artificial amniotomy. The significance of the amnioscope has been practically nil in modern obstetric management. In this pilot clinical study, we identified a new value for the amnioscope as a promising device for safer amniotomy in women with polyhydramnios.
authors.affiliation: Division of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan ; Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Koyama
authors.forename: Takuji
authors.initials: T
authors.lastname: Tomimatsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kanagawa
authors.forename: Tateki
authors.initials: T
authors.lastname: Tsutsui
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
keywords: Amnioreduction; amnioscope; amniotomy; polyhydramnios