Page 6 - WJOLS - Surgery Journal

World Journal of Laparoscopic Surgery, January-April 2009;2(1):4-6
Masoumeh Fallahian et al
Amnioscopy Revival as a Fetal

Surveillance Tool

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1 M Fallahian, P Taherzadeh, E Neisani Samani, MP Moghadam, Z Taheri
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1 Professor Department of Gynecology and Obstetrics, Taleghani Hospital, Shahid Beheshti University(MC), Iran

2 Assistant of Gynecology and Obstetrics, Taleghani Hospital, Shahid Beheshti University(MC), Iran
3 Obstetrician and Gynecologist, Tehran, Iran
4 Assistant Professor , Department of Gynecology and Obstetrics, Taleghani Hospital, Shahid Beheshti University(MC), Iran
5 Midwife, Department of Gynecology and Obstetrics, Taleghani Hospital, Shahid Beheshti University (MC), Iran
Correspondence: Masoumeh Fallahian, MD-MPH, Taleghani Hospital, Ward of Obstetrics and Gynecology, Shahid Beheshti
University(MC), Tehran, Iran, Tel and Fax: 9821-22432558, e-mail: m_fallahian@yahoo.com

Abstract meconium passage. 1-5 Amnioscopy is a form of obstetric
Background: This study was carried out to explore whether endoscopy employed to visualise the forebag of the amniotic
amnioscopy could help us to management of the uncertain date fetus sac and to determine the characteristics of amniotic fluid such
to differ the prematurity from growth-restriction and assessment of as color, consistency, presence of meconium, etc. 1,4,5 The
post-term pregnancies as well. Notify the meconium staining of amniotic accuracy and reliability of amnioscopy in predicting fetal distress
fluid is another aspect of amnioscopy, too.
is uncertain.The precise incidence of usage and indications of
Study design: This was a descriptive study of 80 pregnant women amnioscopy is unknown. Although it is still apply in some of
from 2007 to 2008 at a university hospital, Tehran, Iran. The the obstetric units, there is controversy surrounding this
characteristics of amniotic fluid were documented on admission by method. 1-3
inspection with transcervical amnioscopy, in all singleton pregnancies.
Data were analyzed statistically. Serial amnioscopy can be used to monitor the fetus in the
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last weeks of pregnancy. Levran et al, evaluated the value of
Results: Eighty women were admitted in labor during the study period amnioscopy in surveillance of 289 postdate pregnancies. They
and fulfilled the study inclusion criteria and had amniotic fluid evaluation
available. Three pregnancies were uncertain date that managed according showed that amnioscopy failed to detect the presence of
to amnioscope findings. Amniotic fluid were meconium stain in 22.5% meconium antenatally in most cases (57%), and positive
(n = 18) and were clear 58.7% (n = 47) at amnioscopy and it was amnioscopy for meconium was unrelated to the incidence of
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confirmed after delivery. fetal distress. Raboni in Italy, suggested that amnioscopy is
Conclusion: This study suggests that amnioscopy is an easy and safe an invasive exam with many limitation such as rupture of
procedure for assessment of amniotic fluid characteristics. It could membranes in 1.4% and serious infections that maybe leading
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help us to differ prematurity (with vernix) from growth restriction(with to fetal death. Although, amnioscopy is not popular in modern
yellowish or meconium staining) . Further analysis will determine its obstetrics, the goal of this study is to define it as a safe method
role in the perinatal outcome. to recognize fetuses in whom timely intervention will prevent
perinatal morbidity and mortality.
Keywords: Amnioscopy, amniotic fluid, perinatal outcome.
We conducted present study to show more light to the
significance of amnioscopy in labor. Todays, scopies have been
INTRODUCTION
utilized to improve our vision in the field of gynecology such as
Prediction and diagnosis of antepartum hazards threaten the hysteroscopy, vaginoscopy, … so we can restore and expand
life of fetus, is the major obstacle in obstetrics. Nowadays, the amnioscopy for evaluation of amniotic fluid details as well.
fetus’ health is evaluated by assessment of the fetal heart-rate Therefore present study has been conducted to show more
(FHR), nonstress test(NST), stress test, ultrasonography, light to assess this method at the field of obstetrics.
biophysical profile (BPP) and Doppler velocimetry, etc. There
is no evidence from comparative trials on which to base a MATERIAL AND METHODS
recommendation for use of one method of fetal assessment A descriptive study was carried out during 2007-2008 at
over another. 1-3 Taleghani teaching hospital in Iran.
Traditionally, amnioscopy that was proposed by Saling in The study protocol was approved by the institutional ethics
1962, had been used as a first line intervention for detection of advisory committee. Eighty women with a singleton cephalic

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