AMNIOSCOPY

Amnioscopy is used to detect fetal danger during late pregnancy and the onset
of labor before rupture of the membranes. The forewaters are inspected through the
intact membranes after insertion of a conical tube (amnioscope) into the cervical
canal. Clear or milky amniotic fluid is a sign of normal fetal conditions, whereas
green or yellow amniotic fluid indicates impending danger.

Amnioscopy was done performed for cases with uncertain date pregnancy to
estimate whether they have vernix within clear amniotic fluid at sufficiently forbag or
they have meconium staining with scanty fluid. Selection of the cases was by
convenience non-randomized method all of cases with instrument (Amnioscope,
Light Protector 4000, 220 Volt, 50 Htz,German) as the following.

The patient is placed in the lithotomy position. According to the state of the
cervix, the largest suitable amnioscope is selected. The external diameters of the
amnioscope tubes available being 12, 20, and 25 mm. The suitable speculum applied,
then, the selected tube is guided into the cervical canal. The obturator is removed and
a light source is inserted so that the amnion sac could be inspected through the intact
forewaters. Patients were classified as amniotic fluid characteristics as follows:
1. Group A: clear
2. Group B: emulsification of vernix (indicate prematurity)
3. Group C: green or yellow, scanty that are signs of threatened danger to the
fetus.

Indications for amnioscopy are Toxemia, Postmaturity, intra-uterine

developmental errors, suspected placental insufficiency, and Diabetes Meternal. As
for the contraindications to the use of amnioscopy is Placenta Previa. For
amnioscopic complications there is a very small risk of amniocentesis complications
such as Iatrogenic Rupture, pain, premature delivery, cervical canal injury bleeding,
and ascending infection.

References

1. Fallahian, Masoumeh. 2015. Amnioscopy Revival as a Fetal Surveillance Tool.

(Online) (https://www.semanticscholar.org, accessed 12th August 2019).
2. Fanny, Fadhilah. 2015. Sectio Caesarea sebagai Faktor Risiko Kejadian Asfiksia
Neonatorum. (Online) (http://juke.kedokteran.unila.ac.id, accessed 12th August
2019).
3. Kaluarachchi, Athula, R., Augustus Keshala. 2018. Hyperechoic Amniotic Fluid
 in a Term Pregnancy. (Online) (https://www.ncbi.nlm.nih.gov, accessed 12th
August 2019).
4. S., Fatahillah Ihda Waud. 2018. Referat Amnioskopi. (Online)
(https://www.scribd.com, accessed 12th August 2019).
5. Vannuccini, S., Bocchi, Caterina. 2018. Diagnosis of Fetal Distress. (Online)
(https://link.springer.com, accessed 12th August 2019).