In which client situation could an amniotomy be safely performed?
a. G1 P0, 38 weeks' gestation, 20% effaced, closed cervix
b. G2 P1, 40 weeks' gestation, with fetus in a breech presentation
c. G2 P0, 39 weeks' gestation, 70% effaced, cervix dilated 2 cm
d. G3 P2, 41 weeks' gestation, early labor complicated with hydramnios
ANS: C
The cervix must be partially open to allow the membranes to be ruptured. An amniotomy cannot be performed when the cervix is closed. Breech presentation would be delivered by cesarean section and membranes would be ruptured at birth. Rupturing the membranes in a client with hydramnios can result in abruptio placentae.
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