Amnioscopy is a test that is performed towards the end of pregnancy, from week 37 or when delivery is delayed. With it, the state of the amniotic fluid is checked and if there is fetal hypermaturity. Using the color of the amniotic fluid, they observe if there is any meconium present, which could be harmful to the baby.
According to the Clinical Practice Guideline for Normal Childbirth Care, “ amnioscopy is a procedure performed to assess the quantity and/or color of amniotic fluid (AF) in order to detect alterations that could indicate fetal compromise. However, it is an invasive procedure that is not without complications and with a significant number of false results. These circumstances determine that the benefit-risk balance is doubtful”.
Meconium is a dark, viscous substance that forms in the intestine of the fetus and is expelled at birth as the first feces. Its presence in the amniotic fluid is a risk for the baby, because the baby could breathe it in and this substance would enter his lungs.
Meconium aspiration syndrome (MAS) is a respiratory disorder caused by inhalation of meconium from amniotic fluid within the bronchial tree. As a consequence, it could cause serious complications such as infection and even suffocation in the baby.
How is amnioscopy performed?
The test involves inserting an amnioscope through the vagina and through the cervix. It is like a tube with a hole through which a beam of light passes that illuminates the bag of amniotic fluid, obtaining a direct vision of it to see if it is clean and crystalline.
To perform it, the cervix must have a dilation of at least one or two centimeters. It is an uncomfortable test for the mother, similar to vaginal touch.
If the amniotic fluid has a non-transparent color (yellow, brown or green), it warns of a possible risk to the fetus if the pregnancy continues, and in this case the possibility of causing labor must be studied.
Risks of amnioscopy
Amnioscopy can have complications such as premature rupture of the amniotic fluid bag while the test is being performed, as well as detachment of the placental membrane.
For its part, it is a questioned practice since it is quite subjective. Its main drawback is that only the lower part of the amniotic sac can be seen and not its entirety. Furthermore, the presence of meconium alone does not imply fetal distress, and the test should be supplemented by recording the baby’s heartbeat.
Currently, amnioscopy is not indicated as a routine practice during childbirth.
Contraindications to amnioscopy
Amnioscopy is not indicated if there is a placenta previa, in gestations of less than 35 weeks, due to the risk of triggering premature delivery, or in those cases in which there is bleeding or active infection.
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