Amniotic fluid is leaking. Leakage of amniotic fluid or discharge: how to understand? Signs of amniotic fluid leakage

Pregnancy is one of the most important events in the life of every woman. However, this period is not always carefree. Expectant mothers often face various complications. Fortunately, many problems are often exaggerated by women in position and do not lead to anything serious. Others pose a danger to both the pregnant woman and the child. For example, leakage of amniotic fluid or amniotic fluid can cause premature birth and infection of the amniotic sac.

What is the role of amniotic fluid?

The established opinion that amniotic fluid is ordinary water in which the baby is located has long been outdated. Yes, indeed, amniotic fluid is 98% pure water. However, her role is much more important than expected. The amniotic fluid contains useful microelements that are necessary for the normal existence of the fetus in the womb. Among them:

• carbohydrates;
• lipids;
• fats;
• proteins, etc.

The waters completely fill the amniotic sac, creating an environment favorable for the development of the unborn child throughout pregnancy. Thanks to the amniotic fluid, the fetus can move freely, and the mother’s sensations when the baby collides with the walls of the uterus are softened.

In addition, sterile waters take an active part in the nutrition of the unborn child and prevent foreign microorganisms from entering the amniotic sac. It should be noted that the liquid has the ability to renew itself without changing its chemical composition.

The main functions of amniotic fluid:

1. Ensuring the correct formation of the fetal circulatory system.
2. Isolation from infections.
3. Ensuring proper physical development (fluid prevents the baby’s body parts from merging).
4. Umbilical cord protection.
5. Thermoregulation function.
6. Protection from mechanical influences.
7. Support of material metabolism.
8. Prevention of bleeding during pregnancy and childbirth.
9. Immune protection.
10. Significant relief of the birth process.

In the last stages of pregnancy, the volume of amniotic fluid is 1.5 liters. Normally, the bubble bursts and the water flows out after 38 weeks. However, there are situations when this happens much earlier, which can lead to danger for both the mother and the fetus.

Symptoms of amniotic fluid leakage

When the process of outflowing amniotic fluid begins, it cannot be confused with something. But in rare cases, an imperceptible puncture of the amniotic sac occurs. The shell is damaged in the lateral or upper area. In such a situation, liquid is released in small quantities. Often this process goes unnoticed by the expectant mother. To prevent this from happening, the pregnant woman should understand: what is this – leakage of amniotic fluid or discharge?

So, the first sign indicating danger is discharge, which increases with a change in position, sudden movement, coughing, sneezing.

Many expectant mothers confuse amniotic fluid leakage with urinary incontinence. This phenomenon often occurs, especially in the third trimester. The uterus begins to put more and more pressure on the bladder, thereby causing involuntary urination. Are there any other signs of amniotic fluid leakage?

An important symptom indicating a problem is constantly damp underwear or wet spots on the sheets discovered after a night's sleep.

Remember: if fluid leaks in a significant amount, a decrease in the size of the pregnant woman’s abdomen may occur. In rare cases, there is a decrease in the height of the uterine fundus.

Also, if there is significant damage to the membranes, the amniotic fluid begins to flow. Even with strong tension in the pelvic muscles, a pregnant woman will not be able to maintain the flow of water.

Diagnostics

If copious fluid discharge can be noticed, then scanty leakage is determined only with the help of medical tests. Most often, a cytological analysis of a smear from the posterior vaginal fornix is ​​prescribed. The study will reveal the presence of amniotic fluid in the discharge.

In case of significant discharge, a routine gynecological examination and a cough test are sufficient.

If the studies do not show results, and the condition of the pregnant woman is alarming, the doctor may resort to amniocentesis. The study consists of introducing a non-toxic staining liquid into the amniotic sac and a sterile tampon into the vagina. When it stains, we can talk about leakage of amniotic fluid. However, this method is carried out in extreme necessity and is considered unsafe, since in the process of its implementation the membrane of the amniotic sac can be damaged.

Is it possible to detect amniotic fluid leakage at home?

If a pregnant woman detects signs of leakage of amniotic fluid, then the diagnosis can be confirmed as follows.

1. The "white diaper" method. To implement this method, a pregnant woman needs to completely empty her bladder and toilet her genitals. Then the expectant mother should lie down on a white sheet for 1 hour. If a wet spot is found on the surface, you must urgently visit an obstetrician-gynecologist.
2. If you want to understand what caused the discharge, use a pharmacy test. It consists of a tampon, a strip and a bottle with a special solution. The tampon is placed in the vagina for the time specified in the annotation, then - in a bottle with a reagent. The test strip is also placed there. It is used to determine whether there is damage to the amniotic sac. One strip indicates the absence of a gap, the second indicates its presence.
3. If symptoms of amniotic fluid leakage are detected, the “dark tissue” method can be used. A clean piece of black cloth is placed on the pregnant woman's underwear. If whitish residues are detected, we can talk about vaginal discharge. A wet pad without odor or color indicates leakage of amniotic fluid.

Symptoms of amniotic fluid leakage can lead to danger for the mother and baby. This especially applies to the second trimester of pregnancy. Therefore, you should not expect that the problem will be eradicated on its own - you need to urgently consult a doctor.

Causes of amniotic fluid discharge

Typically, the causes of leakage of amniotic fluid are:

• multiple pregnancy;
• diseases of the pelvic organs of inflammatory or infectious origin;
• endocervicitis (an inflammatory process occurring on the mucous membrane of the cervical canal);
• presence of colpitis;
• the cervix does not completely close - for this reason, a small part of the amniotic sac may protrude from the cervical canal, which is more susceptible to infection and external influences;
• the presence of neoplasms in the uterine cavity;
• abnormal structure of the uterus;
• smoking, alcohol abuse;
• isthmic-cervical insufficiency (insufficiency of the isthmus or cervix);
• physical activity, falls of a pregnant woman, abdominal injuries.

The discharge of amniotic fluid can cause premature birth and infection of the amniotic sac. In this regard, the baby becomes vulnerable and defenseless from external influences.

Treatment

If the gestation period is more than 38 weeks, then if the expectant mother is in normal condition, there is a chance to wait for a natural birth. The anhydrous period plays an important role. If it lasts more than 6 hours, then doctors prescribe antibiotics to the expectant mother to prevent infection of the fetus.

If the pregnancy is premature, up to 35 weeks, and there are no signs of infection, the doctor will resort to expectant management.

The task of doctors at this stage is to prepare the child’s undeveloped airways. To prevent infection of the fetus, antibacterial therapy is often used, which consists of taking drugs based on glucocorticoids.

Doctors will advise the pregnant woman to stay in bed. In addition, regular monitoring of the condition of the fetus will be carried out (ultrasound, Doppler, etc.). The discharge of amniotic fluid indicates the beginning of the labor process.

Prevention

To avoid leakage of amniotic fluid, a woman should take care of her health. It is better to eliminate infectious and inflammatory diseases before planning pregnancy. The psychological state of the expectant mother should also be taken care of.

During pregnancy, it is recommended that a pregnant woman avoid excessive physical exertion and injury. During this period you will also have to give up bad habits.

If any alarming symptoms are detected, you should immediately contact an obstetrician-gynecologist. Also, a pregnant woman should not skip routine examinations with a doctor. This will allow you to identify the problem in time and eliminate it without harming the fetus and the expectant mother.

Leakage or early rupture of amniotic fluid is a problem for many pregnant women. Delaying treatment often poses a danger for both the unborn child and the mother.

What is amniotic fluid?

Amniotic fluid (amniotic fluid) is a clear, pale-straw-colored fluid that surrounds the fetus, providing it with protection and a supply of nutrients. It also helps in the development of the muscular and skeletal system of the unborn child.

Amniotic fluid is located in the fetal bladder (amniotic sac), the walls of which consist of two membranes: amnion and chorion. These membranes hold the unborn child in this sealed sac containing amniotic fluid. The bladder begins to fill with it a few days after conception. The baby will regularly release small amounts of urine into the amniotic fluid from the tenth week of pregnancy (when the kidneys begin to work).

Together with the placenta and umbilical cord, this is a natural support system for the life of the embryo.

How important are they?

Amniotic fluid allows the baby to breathe properly. He begins to swallow liquids in the second trimester. Its main function is to protect the unborn child from injury.

The liquid contains essential nutrients that help in the development of the fetus's digestive system, lungs, muscles and limbs. This allows the baby to kick and move without any hindrance. It also provides protection against infections.

The fruit uses this fluid for many functions. The water level will rise every day. Their number will increase from a few cubic milliliters to about a thousand as pregnancy progresses, and reaches its highest level at the thirty-sixth week. The amount will then begin to decrease from the thirty-eighth week until the day of delivery.

Premature loss of amniotic fluid is a serious threat to the unborn child and the mother herself.

What is premature rupture or leakage of amniotic fluid?

Normally, spontaneous rupture of membranes and rupture of amniotic fluid occurs during childbirth, i.e. with complete or almost complete dilatation of the cervix and the presence of regular contractions.

If the discharge (leakage) of water occurs earlier, then this condition is premature and is a pregnancy complication. In medicine, this is called premature rupture of membranes (PROM). This can happen at any stage of pregnancy and can be either a stream of fluid or a slow leak. This problem is a common cause of premature birth or miscarriage, depending on the term.

If premature rupture occurs before the 24th week, the fetus is still completely unable to survive outside the mother's womb. But even before the 37th week, this puts mother and fetus at great risk of complications.

Premature rupture of amniotic fluid is a problem that is often ignored by many pregnant women. The effusion is usually felt as a painless stream of fluid, but may also appear as a small stream or slight discharge.

Symptoms

It can be difficult to determine whether vaginal discharge is amniotic fluid when there is not a complete rupture of the membranes of the sac, but cracks in them. However, there are a few differences.

Amniotic fluid:

• Usually odorless
• Mostly transparent. May sometimes have mucus, streaks of blood, or white discharge
• Leaks continuously. Has a very steady flow at times
• Unable to control leakage
• Have to change pads and underwear frequently because leakage is persistent
• Some discomfort and cramping may occur

It may not be amniotic fluid if:

• There is a yellow tint, like urine
• Smells like urine
• Sudden leakage accompanied by movement of the baby in the uterus, but which was short-lived and stopped.
• The discharge has a mucous consistency, which requires changing pads for hygienic purposes. Such leakage will not seep through the gaskets. This is a sign that you simply have.

Symptoms of slow leakage

We can talk about leakage of amniotic fluid during pregnancy if:

• You notice a sudden flow of liquid moving along the length of your legs
• Your underwear is wet
• Slight discharge or trickle

The cause of a small leak may be difficult to determine. Therefore, it is better to go and consult with a gynecologist on this issue. Continuity of flow indicates leakage.

Leaking amniotic fluid may also be indicated if you continue to experience wetness even after you have emptied your bladder.

Early leakage of amniotic fluid

A miscarriage is the loss of a fetus in the early weeks of pregnancy. According to the American Pregnancy Association, many miscarriages occur in the first thirteen weeks. About 10-25% of all confirmed pregnancies usually end in miscarriage.

It is important to recognize the signs so that you can seek medical attention as soon as possible.

It is important to pay attention to:

• Discharge of gray or light pink substance
• Leaking an unexpectedly large amount of fluid
• Passage of large pieces of tissue
• Pinkish discharge

Losing tissue or fluid during early pregnancy may be a sign of miscarriage, according to the Mayo Clinic. The tissue or fluid that comes out may or may not contain any blood.

The above symptoms may be normal signs of hormonal changes in your body. But they can also indicate problems during pregnancy. You should always keep in touch with your gynecologist.

Leakage in middle pregnancy

Amniotic fluid leakage at 16 weeks

The water usually breaks at the beginning of labor. Any leakage that occurs earlier is considered premature. Leaks that occur between the 15th and 16th weeks usually require urgent medical attention.

Treatment includes:

• Admission to a medical facility for a thorough examination
• Checking for the possibility of miscarriage
• After monitoring you for a while, your doctor will discuss next steps.

Leakage of amniotic fluid in the 2nd trimester

Leaking in the second trimester means you have a ruptured amniotic sac. The rupture may heal over time, or it may not heal.

A scan should be performed to determine what may be causing the leak. It is important to note that many different and unusual changes occur in the body during pregnancy, so it is difficult to establish what is normal and what is not.

Regular examinations with a gynecologist will help the expectant mother to be calm. Some tests must be performed to determine what is behind the leaking amniotic fluid.

Leakage of amniotic fluid at 37-38 weeks

If rupture of the membranes occurs 37 weeks after the last menstrual period (called the fetal gestational age), then the risks of complications are minimal and contractions usually begin soon after.

But still, such a break is premature and, like earlier cases, may be associated with the following factors:

• Bacterial infection
• Cases of premature rupture of water in previous pregnancies
• The presence of a defect in the development of your fetus
• Infection in the vagina, uterus, or cervix.
• Bad habits such as smoking, drugs and alcohol abuse
• Amniotic sac tension due to large baby or twins
• Poor nutrition
• Preliminary operations in the cervix or uterus

Leak tests

The best thing to do is contact a gynecologist, and he will conduct an examination and prescribe the necessary tests to confirm leakage of amniotic fluid if there is suspicion. But it will also be useful to have simple pharmacy tests on hand to be on the safe side or to reassure yourself. They can sometimes give a false positive result, but when used correctly they should not give a false negative result.

pH strip test

Litmus strips are the simplest and cheapest test. You can even use strips designed for aquarium water to save money.

To determine water leakage at home, you can use litmus test strips, which are sold in almost every pharmacy and have an affordable price. Litmus paper helps determine the pH level of suspicious secretions.

The strip is applied to the vaginal wall after opening and will then show the acidity level (pH). Normal vaginal pH is between 4.5 and 6.0. Amniotic fluid has a higher level - from 7.1 to 7.3. Therefore, if the lining of the sac is ruptured, the pH of the vaginal fluid sample will be higher than normal. This will be indicated by a change in the color of the strip, which must be compared with the scale that comes with the test. Increased acidity levels will indicate that you have an infection or leaking amniotic fluid.

Test strip for determinationThe pH of the water in the aquarium is also suitable for testing for amniotic fluid leakage, and they may cost less.

Nitrazine test

The most common type of tests. Price for one tampon from 2 dollars.

Popular brands are AmnioTest, Amnicator. It requires applying a drop of vaginal fluid to paper strips containing nitrazine, a substance more sensitive than litmus, as an indicator. Such tests are commercially available in the form of special tampons or pads, which make it easier to carry out.

The indicator changes color depending on the acidity of the liquid. They will turn blue if the pH is greater than 6.0. This means that there is a high probability that the bubble shells have ruptured.

However, this test can also give false positive results. If blood gets into the sample or there is an infection in the vagina, the acidity level may be higher than normal. Men's semen also has a higher pH, so recent intimacy may affect the results.

Alpha-1-microglobulin test

The most accurate, but also the most expensive test - more than $30

This is a modern and more accurate test, but its cost is several times more expensive (more than 30%). It also does not require special laboratory conditions, but is more often performed by an obstetrician-gynecologist on an outpatient basis. The point is to detect a biomarker such as placental alpha-1-microglobulin. This substance is found in amniotic fluid and is not normally present in the vagina. To take a sample, a swab is used, which is then placed in a test tube with a special liquid, and then a test strip is placed in its place. Based on the number of stripes that appear on it (1 or 2), we can say with 97% accuracy that there is leakage of amniotic fluid.

Other tests that may be done in the hospital

The so-called “fern” symptom is marks on a microscope slide after the amniotic fluid has dried. After the urine dries, there are no such traces

Examination of liquid under a microscope. If leakage occurs, the amniotic fluid mixed with estrogen, when dried due to salt crystallization, will create a "fern" symptom (resembling fern leaves). To carry out this procedure, a few drops of liquid are placed on a microscope slide for examination.

Dye test. A special dye is injected into the amniotic sac through the abdominal cavity. If the membranes are ruptured, colored fluid will be found in the vagina within 30 minutes.

Tests to measure levels of chemicals that are present in amniotic fluid but not in vaginal secretions. These include prolactin, alpha-fetoprotein, glucose and diamine oxidase. High levels of these substances mean that a rupture has occurred.

Amniotic fluid, urine or vaginal discharge?

Three main types of fluid can come out of the vagina: urine, and amniotic fluid. While noting the differences between them, you can use the following tips to identify one.

Leakage of amniotic fluid

It will have the following properties:

• May contain clear or whitish mucus patches
• Odorless and colorless. In some cases it may have a sweetish odor
• Presence of bloody spots
• Does not smell of urine

Constant discharge means that the fluid is indeed amniotic.

Urine

Urine usually has the following properties:

• Ammonia smell
• Dark or clear yellowish color

Bladder leakage will occur mainly in the second and third trimester. The fetus will already put pressure on the bladder at this stage.

Vaginal discharge

Vaginal discharge during pregnancy is also not uncommon. They have the following properties:

• The smell may or may not be present. However, they do not have an ammonia-like odor similar to urine.
• May be yellowish or whitish
• Have a denser consistency than urine or amniotic fluid
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The first pregnancy is like a new life, in which a woman faces unfamiliar and sometimes unexpected phenomena. Once you get used to growing body size and weight, changes in mood and taste preferences, new discoveries begin. Some of them are pleasant and encouraging, brightening up the 9 months of waiting for the baby. It’s better to learn about others early, preferably only in theory, without encountering them in practice. For example, about how amniotic fluid leaks and what needs to be done in this case. For most pregnant women, leakage of amniotic fluid is a nightmare with which they scare themselves and each other.

In fact, amniotic fluid does not leak in everyone and not as often as it might seem if you stress yourself out. But every woman should know what to do in case of leakage of amniotic fluid - at least just in case. This will help determine whether amniotic fluid is actually leaking or not. Moreover, leakage is possible not only during the first pregnancy, and the information will be useful to you or your loved ones in the future. As you know, fear has big eyes, but in everything related to pregnancy and health in general, you cannot rely on intuition and fragmentary information. It is necessary to clearly understand how amniotic fluid leaks and what to do in this case.

Amniotic fluid and its leakage
Amniotic fluid is the fluid surrounding the embryo. Amniotic fluid, or amniotic fluid, surrounds the child throughout intrauterine development and protects him from all infections, physical and any other dangers. The chemical composition of amniotic fluid is rich in vitamins, salts, hormones, amino acids, and also contains waste products, vellus hairs and particles of fetal skin. This determines the functions and capabilities of amniotic fluid:

• Fetal nutrition in the early stages of development occurs by absorption of substances from the amniotic fluid directly through the skin. At later stages, the baby takes in amniotic fluid in small sips.
  
• Protection from external physical influences based on the principle of shock absorption. Amniotic fluid is protected from chemical threats and infections due to the tightness of the amniotic sac plus active immunoglobulin proteins in the fluid itself.
  
• Creating an environment that is comfortable for the embryo: free “swimming” in a liquid, under conditions of constant pressure and constant temperature. In addition, amniotic fluid muffles noise and other harsh sounds coming from outside.
  
• Perinatal diagnostics: by analyzing samples of amniotic fluid, diseases (genetic, congenital), possible disorders and the condition of the fetus as a whole are determined. In addition, amniotic fluid allows you to find out the sex and blood type of the embryo.
  

As you can see, amniotic fluid is necessary for both the child and doctors. And they only cause trouble for a pregnant woman, although, according to nature’s intention, they should not cause trouble. During the normal course of pregnancy, amniotic fluid is released only during childbirth, and before that it is securely held by the amnion (amniotic sac). Amniotic fluid sometimes leaks a little after 37 weeks of pregnancy. But if leakage of amniotic fluid occurs earlier than that, this may indicate pathologies during pregnancy, fetal development, and even cause premature birth.

How and why do amniotic fluid leak?
Normally, amniotic fluid is released at the end of the first stage of labor, when the cervix opens. Premature rupture, which began long before the onset of labor, and especially at less than 37 weeks, is called leakage of amniotic fluid. The reasons for leakage are different:

• Physical trauma.
  
• Weak cervix that cannot withstand the pressure of the weight of the fetus.
  
• Incorrect position of the fetus due to the mother's body type or other problems.
  
• Infection.
  
• Excess amniotic fluid (so-called polyhydramnios).
  
• External intervention during diagnostics.
  

Sometimes leakage of amniotic fluid can be a sign of multiple pregnancy, but in any case this phenomenon cannot be ignored. True, many women, due to excessive suspiciousness, tend to independently diagnose leakage of amniotic fluid and other disorders. This is also strictly prohibited, because it causes stress both for the expectant mother and for the child inside her.

Signs of leakage of amniotic fluid. How amniotic fluid leaks
It is important to promptly notice and identify water leakage, but not to confuse it with other natural body secretions, urination, etc. It's not hard to make a mistake, especially with the excitement associated with pregnancy. Therefore, remember how amniotic fluid leaks:

1. Premature rupture of amniotic fluid occurs profusely, approximately half a liter in volume. You cannot help but notice the release of clear liquid in such quantities. It indicates rupture of the amniotic sac.
   
2. The amniotic sac may not rupture, but only slightly tear, then the leakage of fluid is scanty, but constant. You can distinguish it from other secretions by smell and color, but not always.
   
3. If the smell and color of the discharge are clearly expressed, then, without a doubt, this is a sign of a disruption in the progress of pregnancy. Reddish, brown, or green-tinged liquid requires immediate medical attention.
   

What to do if amniotic fluid leaks
What to do if amniotic fluid leaks? First of all, do not panic and soberly assess the situation. You may need to confirm the diagnosis, but this is best done by a doctor. Leakage of amniotic fluid cannot be ignored or “observed” longer. But what exactly to do depends on the circumstances, your well-being and the duration of your pregnancy. Here is a list of basic actions when detecting leakage of amniotic fluid:
The main thing a pregnant woman needs to do when amniotic fluid leaks is to consult a doctor, in no case waiting for a routine routine examination. If you act quickly and correctly, you will be able to avoid bad consequences. Timely diagnosis and treatment for leakage of amniotic fluid increases the likelihood of normal labor and protection from infections.

The safety of amniotic fluid leakage is directly proportional to the duration of pregnancy. The longer the period, the less risk to health and life. In any case, now you know how amniotic fluid leaks and the strategy for dealing with this. And we sincerely wish you not to encounter this problem and give birth to a healthy, beautiful and happy baby!

The period of bearing a baby is not only the most wonderful time, but also the most responsible. Now you are responsible not only for your life, but also for the life of your baby. We all know that if there is the slightest change in sensations or discharge, you should consult a doctor. But there are situations that we may overlook or not attach importance to.

One such situation is leakage of amniotic fluid. It is quite difficult to diagnose such a complication in yourself. However, let's still try to figure out what symptoms of leakage of amniotic fluid should alert you. If you find them in your possession, you shouldn’t scroll through the entire Internet looking for a confirming photo.

Contact your obstetrician-gynecologist immediately to clarify the situation. With this complication, every minute counts, and the sooner you get to the doctor, the greater the likelihood of giving birth to a healthy and strong baby.

Amniotic fluid, or amniotic fluid, is a substance that is produced by the amniotic membranes. Amnio is one of the membranes that formed during the development of pregnancy to protect the baby from drying out. What does amniotic fluid look like? They are usually transparent, slightly cloudy. It may contain flakes of the baby's skin, particles of vernix and the first fuzz. Therefore, when the expectant mother does an ultrasound using high-resolution devices, such elements will be visible. In addition, amniotic fluid contains proteins, fats, carbohydrates, salts, vitamins and other necessary elements to maintain the vital functions of the fetus.

Such a liquid performs several functions, such as:

• Fetal nutrition. Initially, all the beneficial substances are absorbed by the baby through the skin, and from about the 12th week of pregnancy, the baby tries to swallow it on his own.
• Maintaining a certain temperature and pressure. The baby's body temperature in utero reaches 37°. In addition, the waters create a unique environment in their structure for the fetus to live.
• Protecting the child from mechanical influences. Blows, jolts and other similar impacts do not harm the baby.
• Protecting your baby from loud noise. Amniotic fluid muffles sounds that come from outside.
• Ensuring free movement of the baby inside the mother.
• Protecting your baby from infections. This is achieved due to the fact that the water contains a large amount of immunoglobulins, as well as the tightness of the bladder.

Features of the pathology

In order for the baby to fully develop and the pregnancy to proceed normally, the amount and chemical composition of amniotic fluid must meet certain standards. Any deviations from these norms lead to the emergence of two main pathologies: low water and high water.

High water– a pathological condition in which the level of amniotic fluid can reach 2 liters. The main symptoms include: general weakness, dizziness, shortness of breath, increased heart rate, swelling of the legs, increased gurgling inside the abdomen, increased number of stretch marks on the skin of the abdomen.

The consequences that cause this kind of complications include:

• Premature termination of pregnancy.
• Chronic hypoxia may develop and, as a result, fetal death.
• Possible disturbances in the functioning of the central nervous system and gastrointestinal tract.
• If this is the result of an infectious process, then infection of the fetus is possible.
• The appearance of late gestosis in a pregnant woman.
• —Premature birth—, provoked by early rupture of water.
• Due to the fairly large space that surrounds the baby, he often assumes a transverse or breech presentation, and this is an indication for a caesarean section.

Low water– in this condition, the level of amniotic fluid does not reach the specified norm.

Pathology of this kind also carries with it a number of complications, such as:

• Painful contractions, slowly dilating cervix, general weak labor process.
• When there is very little fluid, the walls of the uterus are pressed tightly against the fetal sac and can hinder its movement. In addition, it bends in an uncomfortable position, and this can lead to curvature of the spine and the development of clubfoot. In addition, the baby's skin becomes dry and wrinkled.

The main ways to study this condition are: Ultrasound, amnioscopy, amniocentesis.
During an ultrasound, the doctor must assess the transparency of the fluid, its quantity and the general condition of the baby.

Amnioscopy– visual examination of amniotic fluid. On the gynecological chair, the woman is inserted into the cervical canal with an amnioscope tube. Using illumination, the doctor can assess the structure of amniotic fluid, the presence of blood, meconium, and vernix flakes. This procedure is carried out only with a mature, smoothed cervix and a intact bladder.

Amniocentesis- a study that is carried out to obtain a small amount of amniotic fluid for biochemical, cytological and hormonal analysis. Similar tests are carried out to identify chromosomal pathologies.

Symptoms of amniotic fluid leakage in the second and third trimester

There are several characteristic signs that help to recognize how amniotic fluid leaks. These include:

• An unusually large volume of discharge at one time, about 1 tablespoon.
• Discharge occurs when moving or even a slight change in posture.
• Most often, such discharge is transparent and odorless. But if you observe cloudy, green, pink or brown discharge, this is a reason to urgently consult a doctor.
• The number of fetal movements decreases.
• The abdomen decreases in volume.

Now there are tests to determine the leakage of amniotic fluid, they help to give an accurate assessment of your condition. These include:

• Test pads to determine leakage of amniotic fluid. You can purchase it at any pharmacy and perform this test at home. A change in the color of the indicator strip indicates that the result is positive. If the color change was short-term or did not change at all, the result is negative. The only disadvantage of such a test is that it reacts positively if there is thrush. Since such a pad is not very cheap, many women cut it into 2 or 3 parts and use each in turn.

• Test strip. This method is used by the doctor after collecting the material in a test tube. Usually the result is ready within 5 minutes.

• Clean diaper method. Place a clean cloth diaper and lie on it for 30-60 minutes. If the wet spot increases in size, this is a reason for urgent consultation with a doctor.

Causes

Doctors identify several reasons that lead to premature rupture of the membranes:

• Infectious or inflammatory processes that violate the integrity of the bladder.
• Hormonal changes.
• The beginning of labor.
• A strong blow or push.
• Benign or malignant neoplasms in the uterus.
• Research methods such as amniocentesis and chorionic villus biopsy can damage the integrity of the bladder. Both studies are aimed at identifying chromosomal developmental pathologies in the fetus.

Most often, such a pathology is observed in women with nicotine addiction, anemia, and systemic connective tissue diseases. In addition, many experts argue that such pathology is more common in patients with a low level of well-being. Poor nutrition and lack of essential microelements, physical and emotional exhaustion can lead to similar results.

Diagnosis and treatment

Diagnosing such a pathology is quite difficult, since the symptoms that accompany water leakage may indicate other complications. The most reliable result can be given by the doctor who is observing you. In order to make an accurate diagnosis, he may conduct a number of studies, such as:

• Ultrasound, which will help determine the condition of the fetus, possible placental abruption.
• Inspection in mirrors. This way the doctor will see a small amount of accumulated fluid, and when you cough, the amount will increase.
• Analysis of a vaginal smear under a microscope.
• Amniotest.
• Amniocentesis with dye. A small amount of dye is injected through the abdominal cavity, and the vagina is closed with a tampon. If after a certain time the tampon changes color, this indicates that the diagnosis has been confirmed.

After confirming the diagnosis, the doctor must decide: they will leave you in the hospital for preservation, or induce labor. What decision your doctor will make depends on how far along the pregnancy is, how mature and ready it is to be born, what condition the baby is in now, and what condition your body is in. Most often, before the 22nd week of pregnancy, the doctor recommends terminating the pregnancy to avoid other dangerous complications.

Already from 22 to 22, the doctor will most likely ask you to wait, and the best place for this is a hospital, where you can be completely provided with physical rest. Drug treatment is carried out under constant monitoring of both the pregnant woman and the fetus. The best decision at this stage is to calm down and trust your doctor. I'm sure he will find the best solution for you.

Consequences and complications

Unfortunately, the consequences of such a complication are quite sad. It poses a risk to the health and life of not only the mother, but also the baby, since premature bladder failure causes a 4-fold increase in infant mortality. The most common complications are:

• Respiratory distress syndrome. A very serious complication in premature babies. It is caused by the fact that the baby’s lungs have not yet fully developed and cannot independently perform their function. They stick together and prevent air from circulating. Such children require artificial ventilation and expensive injections.
• Infectious complications in the mother and/or fetus. It is the most common complication and can strike within 6-32 hours after the integrity of the bladder is broken. Sometimes cases are so serious that it is not possible to save the baby.
• Fetal hypoxia may occur due to impaired blood circulation in the uterus and placenta.
• Pregnant women with this complication experience weak labor and bleeding afterwards.

Prevention

As a preventive measure, you should avoid heavy physical activity, lifting heavy things, quit smoking, timely registration and constant monitoring of your situation by a specialist.

In addition, around 10:00 you may feel less confident as it becomes harder for you to find balance. This occurs due to the fact that due to the enlarged uterus, the center of gravity shifts. The main condition during this period is comfortable shoes. It shouldn't be big or small, you should feel comfortable in it. This way, you can protect yourself from accidental falls and abdominal blows.

Video

I suggest you watch a short video that describes in detail how to understand that amniotic fluid is leaking. In addition, you will be able to see several recommendations on how to check this fact at home. And also what to do if suspicions are confirmed.

Leakage of amniotic fluid is one of those complications that is difficult to diagnose independently. But, at the same time, if you have the slightest suspicion or concern, immediately contact your doctor for advice.

Share with me how your pregnancy is going. Were you able to diagnose a water leak in yourself, what symptoms alerted you? I will be glad to learn new and useful information for myself, so share your observations in the comments on the site.

In the absence of pathologies, pregnancy ends with delivery at 37-42 weeks. When the baby is formed, the body begins to prepare the birth canal. The uterus changes structure so that the cervix can open to the diameter of the fetal head, the tissues soften and stretch. Contractions of the walls put pressure on the amniotic sac, which soon bursts. If the rupture of the membrane occurs before the onset of contractions, premature rupture of amniotic fluid is diagnosed. At 37-42 weeks there is no danger if the mother gets to the maternity hospital in 2-3 hours.

Norms and deadlines

During pregnancy, amniotic fluid protects the fetus from bacteria and infections, creating a sterile, safe environment. Once the integrity of the membranes is compromised, the baby becomes vulnerable to external harmful intrusions. Since the microflora of the genital tract is 30% infected with fungi (even if they do not appear externally), the risk of infection remains. Bacteria will penetrate the uterus in 8-10 hours. During this time you need to give birth.

Every third woman experiences premature rupture of amniotic fluid during a full-term pregnancy. After 2-3 hours contractions begin, the baby is born in 4-6 hours. The main thing is to be in the hospital in time to avoid complications.

Normal course:

1. uterine tissue loosens and softens;
2. the walls thicken (the fibers overlap each other);
3. the ligaments of the uterus are stretched, the cervix opens;
4. the fetus descends to the lower segment, pressing on the internal pharynx;
5. the hole opens and the plug is separated;
6. the head is inserted into the neck, stretching the bladder;
7. the shell breaks under pressure;
8. waters pour out.

If the bubble bursts before contractions occur, it means that the membrane has ruptured due to thin walls or infection on the tissue. At 37 weeks or older, labor will begin within 4-6 hours. If your water breaks at 6 months, or there is a risk of leakage, you need to lie on your left side, do not move, and call an ambulance. If complete rupture occurs early, there is no chance of saving the fetus.

9-12% of pregnant women need a puncture of the amniotic sac because the uterus is dilated and the waters have not broken. A wait-and-see approach is chosen, monitoring the diameter of the cervical canal.

At what dilation of the cervix does the water break? 7-10 cm if the pregnancy is full-term. If the cervix is ​​closed or poorly prepared, rupture of the bladder will manifest itself in the form of leakage.

Can my water break early? Yes, in any of the 3 trimesters. If the bladder ruptures before 22 weeks, termination of pregnancy is recommended. For example, if the water breaks at 4 months, the fetus will stop developing in the womb and die within 12 hours. After 23 weeks, there is a chance of salvation; emergency hospitalization is required.

The prognosis for the course of labor depends on the timing of premature rupture of amniotic fluid. Rupture of the bladder in the second trimester of pregnancy in 94% of cases means the death of the fetus. Continuing pregnancy during the period 22-24 weeks will affect the physical development of the child’s organs in the future.

For a period of 25-34 weeks, expectant management, pastel mode, regular CTG, and ultrasound of the fetus are recommended. Depending on the readiness of the child’s internal organs, a decision is made on further tactics. If the lungs are formed enough to adapt to direct oxygen, delivery is prescribed by cesarean section.

Before 37 weeks, the baby is born premature. In 63% of cases, the consequences of an early rupture of the bladder will manifest themselves on the mental and physical development of the child in the future.

Causes

The physiological structure of the amniotic membrane provides a dense structure that does not tear from the inside even under intense movements. Therefore, integrity is always violated due to an external stimulus.

A common cause of premature rupture of amniotic fluid is an infection of the genital tract in an advanced stage. The pathogenic organism penetrates the uterus, corroding the walls of the amniotic membrane.

It is believed that antibacterial drugs affect the lining of the bladder. Proven antimicrobial and anti-inflammatory drugs will not cause rupture of the amniotic membranes. In particular, amniotic fluid cannot drain from Depantol, since the components it contains act selectively on pathogenic organisms.

Why does premature water breakage occur?

• isthmic-cervical insufficiency (ICI);
• hormonal imbalance;
• blow to the stomach;
• multiple pregnancy;
• polyhydramnios.

ISN is the cause of water breaking prematurely in 10% of cases. Due to the weakened muscles of the uterine ring, the cervix opens, the fetus tends to the opening of the cervical canal. The shell stretches under pressure and bursts. More often, ICI occurs in the first and second trimesters, causing fetal death. After 26 weeks, the risk of developing pathology is 04-0.9%, the prognosis is favorable.

With a lack of progesterone, the cervix is ​​relaxed and the tissues soften. The greater the pressure on the cervical canal, the higher the risk of premature birth. If the waters break and the cervix does not dilate, induction of labor or a caesarean section is prescribed in the third trimester.

Before labor begins, patients feel a surge of energy, go shopping, carry heavy bags, and move the crib. In the 3rd trimester, it is better to postpone long-term physical activity. If after 37 weeks the water breaks and there is no dilatation, every fifth case is caused by walking for more than 2 hours in a row.

Symptoms of ICI, hormonal imbalances, and stretching of the membranes are little expressed or do not appear at all. Therefore, it is unacceptable to interrupt pregnancy observation by a gynecologist; sometimes a complication develops within 3-5 days, followed by death for the mother and fetus.

Symptoms and diagnosis

It is difficult not to notice the rupture of amniotic fluid. About 300 ml rushes out in a powerful stream. water, the woman feels flowing down her inner thigh. But if the membrane of the bladder is damaged, then the water drains slowly, the discharge is similar to secretion.

Signs:

1. the gasket is wet, but colorless;
2. no smell;
3. liquid discharge;
4. leakage stops in a horizontal position;
5. the abdomen decreases in diameter (up to 1 cm).

Symptoms predict a successful birth if the period is 37 weeks or older. If you suspect a leak, you need to monitor for further signs, prepare the bag for the hospital, contractions will probably occur within 2-4 hours.

To determine the nature of the discharge, there are research methods that are carried out at home. This diagnosis of premature rupture of water is done using gaskets or litmus strips. The application scheme is the same. Inside there is a control tissue that changes color when amniotic fluid enters. Amniotic fluid consists of a unique protein that is not found in any other secretion of the female body.

Home diagnostics:

• the pad (strip) is inserted into the panties;
• analysis after 2 hours;
• if the color of the control fabric is blue (green tint), water is leaking;
• the color has not changed - vaginal secretion.

Tests do not provide a 100% guarantee. If infections develop in the genital area, the unique protein will oxidize and will not show up on the control tissue. The reason to go to the maternity hospital is the premature breaking of water during pregnancy without contractions (within 2-3 hours). Doctors will take tests for leakage and determine further tactics.

Diagnostics in the maternity hospital

• secret analysis;
• amnioscopic examination;
• manual inspection with a mirror.

Smear analysis determines the detailed composition of the secretion. When amniotic fluid leaks, the reagent will detect protein within 15 minutes. If the test is positive, if the cervix is ​​not dilated, stimulation with drugs will be prescribed.

Amnioscopy and manual examination determines damage only to the lower part of the bladder, when the cervical canal is opened by at least 2.5 cm. If infected, the wall can be damaged in any segment of the uterus, the rupture is not accessible from the outside. Methods are not used for periods up to 37 full weeks.

If the diagnosis is made in the first hour after the leak begins, the chances of a successful outcome are high. If there is no damage to the bladder, doctors maintain the pregnancy with drugs or allow childbirth (after 35 weeks).

Treatment and characteristics of childbirth

Therapy is selected depending on the duration of membrane rupture and the duration of pregnancy. If your water breaks completely before 37 weeks, you need to lie on your side, do not get up, and wait for an ambulance. Leakage allows more time for diagnosis and treatment determination.

Until 34 weeks, a wait-and-see approach is chosen, corticosteroids are prescribed, and the patient is in the pathology department. Goal: fetal development to minimum standards.

At a period of 34-37 weeks, the protocol for the management of labor in case of premature rupture recommends the expectant method, manual examination of the vagina is excluded. Staying in pathology. Observation every 4 hours: fetal heartbeat, uterine contractions, discharge, body temperature. Clucocorticoids are prescribed up to 36 weeks of gestation.

From 37 weeks of pregnancy, the fetus with prenatal rupture of amniotic fluid is considered full-term; tactics are selected based on the duration of the anhydrous period. For the first 4-8 hours, expectant management is prescribed, with an analysis of the condition of the fetus and the patient - CTG, body temperature, discharge, contractions. To ripen the cervix, prostaglandins and oxytocin are prescribed until the opening is 5-7 cm.

With expectant management, manual examination is unacceptable. Only hardware research and control of discharge. Antibiotics are prescribed for a water-free period of 18 hours (in practice, doctors do not wait that long) or if infection is suspected.

If premature and early rupture of amniotic fluid occurs, then in 70% of cases labor occurs within 24 hours. But maternity hospital doctors do not take risks and induce labor after 6-8 hours. This reduces the risk of dangerous consequences - infection, hypoxia.

Complications for mother and fetus

If the mother does not notice that the waters have broken, labor will begin at home and there will be no time to travel to the hospital. In 16-18% of cases, the amniotic sac bursts, but the cervix is ​​not ready, and more than 48 hours may pass before contractions. A long anhydrous period threatens abnormalities in childbirth and the development of the baby, so it is necessary to monitor the discharge on the pad.

Why is it dangerous for water to break?

1. hypoxia;
2. prematurity;
3. infection;
4. separation of the placenta;
5. prolonged painful labor (up to 24 hours);
6. ruptures of the birth canal.

If the baby is not yet fully formed, hypoxia in 45% of cases causes hemorrhage in the ventricles of the brain. Oxygen starvation of organs and tissues develops, work slows down due to swelling. The risk of cerebral palsy in the future increases.

A dangerous sign of prematurity, distress syndrome, is diagnosed in 80% of cases in infants born before 34 weeks. The lungs are not formed, the lobes do not collapse, oxygen is not processed. The respiratory organs swell, pneumonia develops, often with death.

Every 10th premature baby is diagnosed with retinopathy. Blood circulation in the vessels is impaired, resulting in loss of vision and hearing. The pathology appears a month after birth.

Bacteria come to the baby from the vagina. Even pathogenic organisms that are normal for the pH of the reproductive tract do not adapt to the sterile environment of the amniotic sac. The particle is perceived as dangerous, foreign, and defense mechanisms are activated, indicating infection. Every fifth patient develops endometritis.

Choriamnionitis is a common infection caused by early rupture of the amniotic sac and develops within 24 hours. It threatens vascular necrosis and funiculitis for the baby.

Premature placental abruption, which develops with early rupture of water, threatens uterine bleeding. Most often it is diagnosed 8-10 hours after the bladder ruptures. Often it is impossible to stop the flow of blood; only removal of part of the uterus or complete amputation of the organ can save.

The main role belongs to the medical reaction; much depends on the choice of tactics and the speed of decision-making. But a woman must also be conscious and proactive. Early diagnosis of leakage and emergency call of an ambulance even in critical situations save the lives of mother and baby.