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Artificial rupture of membranes (ARM)

Induction with favourable cervix, or slow progress in established labour.

Source: NICE NG207 · NG235

Steps

  1. Confirm cephalic, head engaged; check FHR; exclude praevia / vasa praevia.
  2. Consent; aseptic vaginal exam.
  3. Guide amnihook along your finger onto membranes between contractions.
  4. Hook and tear; keep finger in to control flow and feel for cord.
  5. Note liquor colour.
  6. Listen to the fetal heart immediately.
Risks: cord prolapse, infection, bleeding from vasa praevia, FHR changes.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.