artificial rupture of membranes also known as amiotomy is a procedure to induce labor and to exclude the presence of meconium in the antionic fluid it is usually performed during the active phase of the first stage of Labor and the atomy should be done in a labor room and not in the antenatal ward before the procedure the mother should be positioned into the dorsal position and the person who performs amiotomy should scrub and wear a gown since this is a strict aseptic procedure at first explain the procedure to the mother then clean the vulva with five antiseptic swabs perform a vaginal examination to assess the cervical dilatation and effacement exclude chord presentation and identify the presenting part to assess the position and level of the presenting part and to feel the membranes amiotomy is usually done when the cervical dilatation is about five to six centimeters if the conditions are satisfactory then go for the amiotomy keep the fingers on the fetal head as you can see in this picture drive a blunt long artery forceps along the fingers until it meets the fetal head the forceps should not be opened until it reaches the fetal head then grab the membranes and pull if the membranes are ruptured amniotic fluid will come out normal amniotic fluid has a milk color drain the fluid slowly while keeping the fingers intact otherwise the cord will prolapse after amiotomy auscultate for fetal heart sounds and run a ctg to assess fetal welding it is important to keep in mind that aniotomy should be delayed if the presenting part is breech and in high head presentations finally the risks of amiotomy include cord prolapse sepsis tissue trauma and placental abruption