Aificial rupture of membrane (ARM) is contraindicated in:

Correct Answer: Intrauterine death
Description: Amniotomy or aificial rupture of membrane is done by fracturing the membranes with a sterile plastic instrument guided between the two gloved fingers. Amniotomy is usually avoided in intrauterine fetal death because of the increased risk of fetal sepsis within the necrotic intrauterine tissues. Indications for amniotomy are: To visualize the amniotic fluid for quantity and evidence of meconium or blood. For gaining direct access to the fetus for placement of internal fetal monitors. For attempting to induce labor or restore progress in labor. In impending second stage of labor where the provider wants to minimize the risk of exposure to body fluids during bih. Complications associated with amniotomy: Rupture of fetal vessels traversing the vasa pre at the site of amniotomy. Prolapse of the umbilical cord. Ref: Manual of Obstetrics edited by Ahur T. Evans, 7th edn page 30. Munro Kerr's Operative Obstetrics: Centenary Edition By Thomas F. Baskett, page 78.
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