During pregnancy for female body Various types of discharge are typical. The reason for this is changes in hormonal levels, the presence of diseases, colds. The discharge may be clear, watery, or thick. It is quite natural to have beige or brown clumps. This phenomenon can seriously frighten the expectant mother, who does not yet know how to recognize their character, which is quite logical.
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baby inside measurements
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Very often, discharge indicates the development of a pathology that requires urgent medical intervention. This type of pathology includes leakage amniotic fluid.
What is dangerous and does smell matter?
What is amniotic fluid? Amniotic fluid or amniotic fluid is a biologically active substance located inside the fetal membranes. It provides protective, shock-absorbing and other functions and is fully responsible for the vital functions of the fetus.
It is normal for amniotic fluid to leak before starting natural birth according to established deadlines. During contractions, the cervix dilates and the membranes burst, after which the waters break. Rarely can the process begin without contractions. In this case, the pregnant woman is immediately sent to the maternity ward.
When the situation is not happy
There are cases when amniotic fluid is released in small amounts long before labor begins. This phenomenon indicates that the integrity of the fetal bladder is compromised. As a result, the sterility inside it is at risk. The closer to birth a pathology is detected, the less threat it poses to the child, which means the medical prognosis will be better. It is important to know how to distinguish leakage of amniotic fluid from pathological discharge, sexually transmitted infections and other diseases.
Leakage of amniotic fluid contributes to the development of infection, which can reach the baby through cracks in the bladder. Failure to provide medical care in a timely manner when amniotic fluid is released into the later pregnancy leads to premature birth, termination of pregnancy, fetal death in utero. In addition, the pathology leads to weak labor at the onset of labor, as well as the development of infectious complications in the mother.
Causes of amniotic fluid discharge
Determining the cause, as well as understanding how the pathology occurs, is difficult. There are several main reasons for this phenomenon. These include the following.
- Infections affecting the genitals. This reason often occurs during premature pregnancy, in particular at 39 weeks.
- The cervix develops rapidly, as a result, enzymes are released that have a stratifying effect on the placenta. The fetal membrane softens. Lack of medical intervention can lead to fetal hypoxia during labor, as well as severe bleeding from the uterus.
- Incorrect presentation of the fetus or narrow pelvis expectant mother. In this case, the pathology develops in the first stage of labor, the opening of the uterus occurs very slowly.
- Cervical insufficiency leading to rupture of membranes and leakage of amniotic fluid at 40 weeks of pregnancy. This pathology occurs in approximately a quarter of all pregnant women in the last trimester. As a result, the amniotic sac protrudes, making the fetus vulnerable. Viruses that enter the amniotic fluid lead to rupture of the membranes with minimal physiological impact.
- Bad habits, chronic diseases. This includes women with alcohol addiction, smokers, anemia, dystrophic pathologies, and connective tissue diseases.
- When carrying two or more babies.
- Anomalies in the development of the uterus. This includes a shortened uterus, isthmic-cervical insufficiency and the presence of a uterine septum. Diseases such as colpitis, endocervicitis, tumors of various kinds also cause pathology. The use of invasive methods of prenatal diagnosis is indicated, that is, amniotic fluid sampling and biopsy.
It is very important for a woman to know how to determine leakage of amniotic fluid at home using special tests.
Examination by a doctor
Symptoms of pathology development
There are cases when the amniotic fluid comes out all at once when the amniotic sac ruptures. Then the selection becomes obvious. However, there are cases of periodic leakage of a small volume. At the same time, it is difficult for a woman to determine the development of pathology.
Many women mistakenly confuse the signs of amniotic fluid leakage during the third trimester with urinary incontinence. In rare cases, pathology is normal in late pregnancy. During pregnancy, the amount of vaginal discharge increases, which is quite possible in the early stages. Thus, the presence of colpitis, mistaking amniotic fluid for normal discharge, causes the development of symptoms of amniotic fluid leakage in the third trimester.
Mommy is worried
The symptoms of amniotic fluid leakage are simple. However, not everyone knows how to recognize them correctly. Many women wonder what amniotic fluid leakage looks like. There is only one rule for determining them. Amniotic fluid is odorless and colorless.
Many women wonder what amniotic fluid smells like? There is only one answer - the discharge has no odor.
If at any month of pregnancy a woman detects discharge of an unknown nature, even if it is a false suspicion of leakage of amniotic fluid, she must immediately seek help from a doctor. It is difficult to independently determine the presence/absence of pathology even with the help of a special test. Medical attention will be required here. The photo shows what amniotic fluid leakage looks like.
Diagnosis of amniotic fluid discharge
Only a doctor confirms the presence/absence of amniotic fluid in the third trimester. To do this, an examination is carried out on a gynecological chair. During examination, a pregnant woman should cough to increase pressure on the intra-abdominal area. So, if the bladder ruptures, a new portion of amniotic fluid will be released.
This is what intrauterine development of the fetus looks like
Additionally, a smear is taken on the water elements, and a test is performed for the presence of leakage of amniotic fluid. How to check for leakage of amniotic fluid at home using medical supplies? A test pad for determining the leakage of amniotic fluid, the price of which starts from 2000 rubles, is based on the determination of placental microglobulin. If the strip changes color upon contact, it means there has been a leak. To determine what amniotic fluid looks like when leaking, an ultrasound is performed.
How to prevent water leaks
When treating amniotic fluid leakage at 34 weeks or any other period, there is no specific technique or single therapy that would help all women equally. All treatment is aimed at eliminating the problem that caused this type of pathology, as well as maintaining the health of the fetus and mother within the framework of safety. The time of the last exit plays an important role; a safe period is considered to be no more than six hours. A pregnant woman is prescribed antibiotics to prevent infection of the fetus.
Leakage of amniotic fluid, as in the photo of the pad, in the long term indicates imminent birth. If after three hours there are no contractions, stimulation is carried out medically. For this purpose, a pre-created hormonal background for cervical ripening. An alternative is a caesarean section.
If the pregnancy is premature, expectant management is generally used. It is very important to monitor the viability of the fetus. The woman is under the supervision of doctors at all times and is on bed rest.
At the slightest signals from the body, consult a doctor
To prevent the release of amniotic fluid at week 25, it is recommended to carry out antiseptic treatment of the genital tract, as well as other mucous membranes to prevent and remove infection. To determine the leakage of amniotic fluid, there are special pads for home use, the Amnishur test. The test pad shows, depending on the color of the inner shell, the presence/absence of pathology.
When amniotic fluid is released future mommy remains powerless. Therefore, it is important to prevent the development of pathology in advance. Do not neglect testing and hygiene. If you detect suspicious discharge, you should immediately consult a doctor. As support, you can visit forums of mothers who share their experiences, you can find friends who have had the pathology, and read a lot of reviews.
: Borovikova Olga
gynecologist, ultrasound doctor, geneticist
A pregnant woman is probably the most beautiful thing that nature has created. However, a pregnant woman is the most restless creature. And this, of course, is completely normal - after all, the expectant mother bears the burden of double responsibility - responsibility for the life and health of not only herself, but also her baby.
Women try to get as much different information as possible, one way or another relating to the characteristics of the course of pregnancy, the development of the child, and possible complications. And the closer the cherished “hour X” approaches, the more anxiety the expectant mother has. Nowadays, it is easy to find a wide variety of information about pregnancy and childbirth.
However, a pregnant woman does not always receive answers to all her questions. In particular, this applies to amniotic fluid. It is very difficult to find anything sensible about amniotic fluid on the Internet, and women’s knowledge is limited only to the fact that the discharge of amniotic fluid indicates the onset of labor, and the symptoms of leakage of amniotic fluid are very vague.
In fact, amniotic fluid plays a huge role in the development of the baby and can tell a lot about how the pregnancy proceeded and what can be expected during the birth process. Of course, obstetricians have all this information. However, most often they do not devote the pregnant woman to all the details, preferring to silently do their job. But nothing scares more than ignorance.
Volume of amniotic fluid
There are constantly heated debates about what the volume of amniotic fluid should be. However, the opinions of doctors converge on the following figures. At the tenth week of pregnancy, the average volume of amniotic fluid (amniotic fluid) is about 35 milliliters. By the fourteenth week of pregnancy, this figure triples and is already approximately 100 milliliters. And by the twentieth week of pregnancy, the volume of amniotic fluid reaches 400 milliliters.
The largest volume of amniotic fluid occurs, as a rule, at 38 weeks of pregnancy - about one and a half liters. But then, immediately before childbirth, its volume can drop significantly, decreasing to 800 - 1000 milliliters. It is this factor that is one of the most unpleasant during post-term pregnancy - amniotic fluid.
Purpose of amniotic fluid
Many women mistakenly believe that amniotic fluid is ordinary water, in which the baby is located. However, this is not quite true. Indeed, approximately 98% of amniotic fluid consists of ordinary distilled water. However, amniotic fluid is a biologically active environment for the baby. Amniotic fluid contains a large number of active substances, lipids, proteins, fats, carbohydrates, etc.
During early pregnancy, amniotic fluid is colorless and completely transparent. However, as pregnancy progresses, the composition of amniotic fluid changes greatly. Potto - fatty secretions, dying upper layer epidermis (skin), tiny vellus hairs. Because of this, the amniotic fluid is cloudy.
In addition to the shade of the amniotic fluid, as the baby grows, its chemical composition also changes. The only thing that remains unchanged is the pH level. It always matches the baby's blood pH levels. This is what allows the pregnancy to proceed correctly and the baby to develop normally.
The amniotic fluid itself is also regularly renewed throughout pregnancy, since in the body of a pregnant woman the so-called circular metabolism does not stop for a single minute, affecting not only the mother’s body, but also the baby. It is with the help of this circular exchange that the fetus is nourished - nutrients from the mother’s body enter the baby’s body with the participation of the placenta, waste products are removed from the fetus’ body and oxygen is transported to the baby’s cells. And it is this process of circular metabolism that ensures the regular renewal of amniotic fluid.
The speed of this process is amazing. If the pregnancy proceeds well, and the expectant mother does not suffer from any chronic diseases and feels well, the rate of circular metabolic processes reaches approximately half a liter of amniotic fluid per hour. It is easy to calculate that with the volume of amniotic fluid at 38 weeks of pregnancy, when its amount is equal to one and a half liters of water, its complete replacement occurs in about three hours. Metabolic processes occur with the direct participation of both the placenta and fetal membranes.
In addition, the child also takes a direct part in the renewal of amniotic fluid. In the first half of pregnancy, amniotic fluid easily penetrates the fetus's body, and only by about the 23rd week of pregnancy does the baby's skin reach a stage of its formation at which the skin becomes impermeable to amniotic and any other fluid. This completes the stage of skin metabolism in the fetus.
However, at the beginning of the 24th week of pregnancy, the baby begins to regularly swallow amniotic fluid. He does this for a very specific purpose - ingesting amniotic fluid allows both the digestive and excretory systems of the fetus to be trained. During the day, the baby thus processes up to one and a half liters of liquid. In addition, amniotic fluid enters the baby’s body in another way - during the baby’s breathing movements. Thus, about 800 milliliters of amniotic fluid passes through the baby’s lungs in just one day.
Amniotic fluid - what is it for?
Very often women ask the question of what amniotic fluid is needed for? Is it really necessary for the development of the baby? The answer is unequivocal - yes. Amniotic fluid performs many different functions - protective, developmental, and obstetric. Below we describe each of them in more detail:
- Thermostatic function
From the very first days, amniotic fluid creates in the uterus an ideal temperature for fetal development - 27 degrees Celsius. And any external factors - hypothermia of a pregnant woman or a slight increase in temperature as a result of any disease will not affect the baby, since the temperature inside the fetal bladder is regulated by the amniotic fluid. Of course, amniotic fluid is not able to contain radical changes in temperature, but for the most part they successfully cope with their task - regulating the temperature.
- Immune protection
As mentioned earlier, amniotic fluid contains a huge amount of various biologically active substances. Among these substances are varieties of many immunoglobulins. It is these immunoglobulins that reliably protect the fetus from possible damage by various pathogenic microflora. And there are a lot of pathogenic bacteria that can harm the baby’s health and even endanger his life, even in the body of an absolutely healthy woman. Amniotic fluid in pregnant women reduces the risk to almost zero.
- Mechanical protection function
Amniotic fluid is a wonderful natural shock absorber for the baby. They reliably protect the crumbs from mechanical influences. After all, no matter how careful the expectant mother tries to be, anything can happen in life - they can be pushed on the bus, and sometimes you can simply slip and fall. Amniotic fluid will significantly soften the mechanical impact on the baby and protect it.
- Cord protection function
Another very important function of amniotic fluid is to protect the umbilical cord. Thanks to the presence of amniotic fluid, the situation in which the umbilical cord is compressed between the walls of the uterus and the baby’s body is almost completely eliminated. Such compression is extremely dangerous, as it can lead to disruption of the proper development of the fetus due to lack of nutrients, to hypoxia due to lack of oxygen, and even fetal death.
- Hermetic isolation from infectious agents
In addition to immunoglobulins, the amniotic sac reliably protects the baby from the penetration of infectious agents. All necessary substances and oxygen are easily delivered to the baby through the placenta, but infectious agents are prohibited from getting there.
- Preventing the fusion of baby's body parts
Due to the fact that the amniotic fluid is contained in the fetal bladder, a situation in which the fetal membranes themselves grow directly onto the baby’s body is excluded.
- Ensuring harmonious development
The presence of amniotic fluid in sufficient quantities ensures proper development internal organs and entire systems of the baby. For example, with the help of amniotic fluid, the correct formation and subsequent development of the entire respiratory system occurs. Immediately after the baby's chest is formed and movement becomes possible, amniotic fluid allows the fetus to imitate breathing movements, thereby helping the development and training of the lungs. If a child does not perform such exercises daily, he will not be able to breathe on his own when he is born.
Almost the same applies to the digestive and excretory systems. By swallowing amniotic fluid, the baby trains its stomach and intestines to digest food, and the excretory system to get rid of waste products. This is extremely important for the successful intrauterine development of the baby and life after birth. The baby begins to swallow amniotic fluid from about 14 weeks of pregnancy. And from about the same age, the baby’s kidneys begin to produce urine, which is still sterile.
- Metabolism Support
Amniotic fluid is most directly involved in metabolism. The amniotic fluid also contains a huge amount of oxygen and nutrients, which are so necessary for the normal development of the baby. It is the amniotic fluid that fully supplies the baby with proteins, fats and carbohydrates, enzymes, hormones, glucose and other substances.
- Providing conditions for physical development baby
Amniotic fluid is a kind of pool for the baby. The child has the opportunity to move around inside the uterine cavity as he wants without any difficulty. The exception is during advanced pregnancy, when the baby becomes too large and does not have enough space in the uterus. However, even in this case, amniotic fluid gives the baby the opportunity to change body position without much effort.
- Ensuring the correct formation of the fetal circulatory system
Another very important function of amniotic fluid is the correct formation of the fetal circulatory system and its subsequent functioning, including this indicator. Like normal blood clotting. This occurs due to the substances contained in the amniotic fluid - in particular fibrinolysin and thromboplastin.
- Prevention of bleeding during pregnancy and childbirth
Thanks to its enzymes, amniotic fluid has the ability to clot blood, thereby effectively preventing bleeding, both during pregnancy and during childbirth. This feature of amniotic fluid has saved more than one thousand lives, both babies and their mothers.
- Facilitating the birth process
In addition to all of the above, amniotic fluid is of no small importance during childbirth. Thanks to them, the fetus takes correct position in the lower part of the uterus. And the cervix itself, under the pressure of the fetal bladder filled with amniotic fluid, opens much faster and more painlessly than in cases where the waters have already broken.
What can amniotic fluid tell you?
As is already clear from all that has been said, amniotic fluid is a biologically active habitat for the baby, so it reacts very sensitively to the slightest changes in the child’s physical condition. Doctors use this feature of amniotic fluid for diagnostic purposes. By assessing the condition and composition of amniotic fluid, doctors can monitor the condition of both mother and baby, detecting deviations from the norm in time.
Even the volume of amniotic fluid, which is easily determined using ultrasound examination, can say a lot. There are such deviations from the norm as oligohydramnios and polyhydramnios. These deviations must be detected as quickly as possible and corrective therapy prescribed, because the amount of amniotic fluid is also very important.
Another method for examining amniotic fluid is amnioscopy. Amnioscopy means a visual examination and examination of the lower part of the amniotic sac. If the data obtained is not enough for doctors, they can resort to another diagnostic method - amniocentesis.
Amniocentosis is a diagnostic puncture of the membranes to take a sample of amniotic fluid to assess its color and composition. To do this, a woman is given a puncture (puncture) with a special needle either in the lower part of the abdominal wall or in the posterior fornix of the vagina. This procedure is performed under local anesthesia and does not cause any harm to the baby or his mother.
Another important test of amniotic fluid that can save a child's life is a study that determines the presence and level of phospholipids in the amniotic fluid. In order for the lungs to fully open during inhalation, the correct optimal ratio of the level of sphingomyelin and lecithin in the baby’s blood is necessary. Only if this condition is met will the child be able to breathe on his own.
In addition to the maturity of the respiratory system, the degree of maturity of the urinary system, in particular the kidneys, is no less important for the survival of a newborn baby. Based on the analysis of amniotic fluid, it is also possible to determine the degree of maturity of the baby’s kidneys - this is reliably indicated by the level of concentration of a hormone such as creatinine in the amniotic fluid. Its low content indicates that the child’s kidneys are not yet mature enough and will not be able to fully cope with the functions assigned to them.
This information, which amniotic fluid can provide, is very important if deviations occur in the normal course of pregnancy and the condition of the pregnant woman is serious and can even threaten not only her health, but also her life - for example, a severe form of gestosis, in which delivery needed as soon as possible. Doctors use the state of amniotic fluid to assess the maturity of the fetus and its readiness to exist outside the uterine cavity - and this is why analysis of amniotic fluid sometimes saves lives.
Gynecologists, if the fetus is not yet mature enough and the woman’s condition is such that continuation of pregnancy becomes impossible, begin to administer to the pregnant woman medications, which accelerate the maturation of both the lungs and kidneys of the fetus. By the way, doctors also calculate the dose of these drugs and the duration of treatment based on laboratory testing of amniotic fluid.
Many women sometimes refuse proposed studies, believing that doctors are simply playing it safe, or fearing for the health of their baby, because they believe that these studies can harm the baby. Often these fears are artificially fueled by various fables about the supposedly terrible danger of these procedures, which in most cases lead to the loss of the child. These stories are passed on from mouth to mouth among expectant mothers. Moreover, they completely distort reality.
In fact, in no case should you refuse them, since they are carried out strictly according to certain indications in cases where the doctor believes that there is a real threat to the health and life of the mother or her baby. Believe me, not a single doctor will prescribe such studies just like that, without good reason.
Leakage of amniotic fluid
Nature is very wise - she provided for the fetal membranes to be airtight until the very beginning of the birth process. Normally, during pregnancy, amniotic fluid does not leak under any circumstances. However, sometimes, under the influence of some external factors, such as a fall or other rough physical impact, can lead to tears in the amniotic sac and, as a result, leakage of amniotic fluid of varying intensity, depending on the degree of damage to the amniotic sac. Leakage of amniotic fluid begins, the signs of which are noticed by pregnant women.
However, very often expectant mothers begin to panic terribly when they find wet spots on their underwear. Women believe that they have started leaking amniotic fluid. However, in most cases, these spots are in no way related to leakage of amniotic fluid, but are explained by completely different factors. Firstly, the longer the pregnancy, the more profuse a woman’s vaginal discharge becomes. And secondly, during long periods of pregnancy, the muscles of the pelvic organs, including the bladder, relax, which is why mild urinary incontinence is possible.
In order to clarify the situation on her own, a woman needs to do a test for leakage of amniotic fluid at home: go to the toilet and completely empty bladder, wash yourself and dry yourself. Lie down on the bed, having first laid down a clean, dry sheet. Monitor your condition - if a wet spot appears on it in the next 15 minutes, immediately call an ambulance - doctors know exactly how to detect leakage of amniotic fluid.
Leakage of amniotic fluid is a very alarming signal if the pregnancy has not reached its logical conclusion. And if the baby’s due date has come, the leakage of amniotic fluid is a signal to the mother that the due date has arrived. That is why it is unacceptable to ignore this phenomenon under any circumstances.
Indeed, if the gestation period is not long enough for the baby to be born, damage to the amniotic sac can lead to the penetration of pathogenic microflora into the membranes, infection and death of the fetus. In this case, doctors will take amniotic fluid to assess the degree of maturity of the baby’s lungs and kidneys.
If they are mature enough for the baby to exist outside the uterus, doctors will stimulate the onset of labor to avoid infection of the fetus. In the same case, if the lungs have not reached the minimum possible degree of maturity, doctors will try to prolong the pregnancy as long as possible. For a baby, even one extra day spent in the mother’s tummy can be decisive if the discharge of amniotic fluid cannot be stopped.
All this time, both mother and baby will be under the strictest control of medical personnel. To prevent infection of the baby, which has lost its natural habitat - amniotic fluid, doctors will carry out special antibacterial therapy aimed at destroying foreign pathogenic microflora. At this time, the woman must strictly observe strict bed rest - the successful outcome of the pregnancy depends on this.
As a rule, in this way, doctors manage to gain one to two weeks, during which the light crumbs have time to mature. However, doctors do not only take a wait-and-see approach - throughout this time, the pregnant woman receives special injections of a hormonal drug, which significantly accelerates the process of maturation of the baby’s respiratory and urinary systems. As a rule, such tactics for preserving pregnancy bring very, very good results if a pregnant woman leaks amniotic fluid.
Amniotic fluid color
However, pregnant women should not focus on premature rupture of amniotic fluid - although this phenomenon does occur, it is not very common - no more than one case in 30 thousand pregnancies. Most often, amniotic fluid drains at the most appropriate moment provided by nature - from 38 to 40 weeks of pregnancy, when the development of the baby is completely completed and he is ready to be born - it is at this time that amniotic fluid begins to leak before birth.
However, amniotic fluid that breaks on time can tell the doctor and the expectant mother a lot of information regarding the baby’s condition. Very often, assessing the color and transparency of amniotic fluid helps doctors make the right decision and determine the tactics of labor management. So, what can this water traffic light – the color of amniotic fluid – tell us? However, when assessing the condition of a pregnant woman by color, remember that suspended amniotic fluid is a physiological norm.
- Amniotic fluid is yellow
In the event that a pregnant woman’s water breaks, which is yellow and slightly cloudy, there is no cause for concern. This is approximately how they should be during a normal pregnancy. Mommy can calmly get ready and get to the maternity hospital, from which she will return with her long-awaited little happiness.
- Amniotic fluid is yellow with red specks
Sometimes amniotic fluid has a natural yellow tint, however, upon closer inspection, a pregnant woman may notice red veins in them. If you feel well, nothing bothers you, and you begin to feel contractions, you should not be afraid. In 99% of cases, these veins are only a consequence of the fact that the cervix has begun to open and only indicates that the birth process is going according to plan.
- Green color amniotic fluid
But if the amniotic fluid that has passed is green, the woman and doctors should sound the alarm, as this is a signal of serious problems for the baby. The green color of amniotic fluid occurs in two cases - if intrauterine bowel movement occurred, or if there was too little amniotic fluid. Meconium in the amniotic fluid can lead to the development of congenital pneumonia in the baby.
In addition, in both cases, the baby suffers from hypoxia - intrauterine starvation. A woman who notices that there is amniotic fluid green tint, should get to the maternity hospital as quickly as possible and be sure to inform the doctors that the amniotic fluid is green, since timely measures taken will help preserve the health and even the life of the baby.
- Dark brown color of amniotic fluid
The amniotic fluid is dark brown, alas, the color of great misfortune. This color in almost all cases indicates intrauterine death of the baby. And in this case we are talking about saving a woman’s life. However, in our time, such cases are so rare that it makes no sense to talk about it. With regular monitoring by a gynecologist, all problems are detected in a timely manner and amniotic fluid during pregnancy reflects the woman’s condition.
- Red amniotic fluid
The red color of amniotic fluid is the color of serious danger for both mother and baby. Most often, a red or pink tint to amniotic fluid occurs as a result of blood entering during bleeding in either the mother or the baby. You understand how dangerous this is for mother and child. If a similar situation overtakes you, your actions should be as follows - immediately take a horizontal position and do not move under any circumstances. Relatives should immediately call an ambulance.
For normal intrauterine development, a baby requires a harmonious environment that will provide him with warmth, nutrients and protect him from negative external influences (infections, temperature changes, physical impact, loud sounds, etc.).
All these functions are performed by amniotic fluid. But quite often pregnant women experience leakage. You will learn in this article how to identify pathology in a timely manner and why it is dangerous.
What is amniotic fluid
OM is a liquid that is located inside a sealed bladder (fetal membranes) and serves as the first habitat and life activity for the unborn baby. This substance contains everything that the fetus needs for nutrition and growth.
How to distinguish and independently determine leakage of amniotic fluid from discharge: symptoms and signs
It can be difficult to independently determine fluid leakage, and this is due to the fact that the liquid can easily be confused with natural discharge or urine leakage, and besides, the volume of discharge can be very meager.
Smell
Some women note that the aroma of the agent is a little sweetish, and at the same time very light, but there is no clear specific smell, so it is very difficult to identify leakage solely on this basis.
What does it look like
In terms of consistency and viscosity, OM actually resembles water.
Color
Normally, OBs have no color. Towards the end of pregnancy, slight turbidity of the fluid is allowed due to the accumulation of various impurities in it that are formed during the development of the baby (epithelial scales, vellus hair, secretions of the sebaceous glands, etc.).
Sometimes there is a greenish, brown, red tint - all this is an alarming sign, because... may indicate disturbances in the physiological state of the baby.
Quantity
The amount of OM increases as the baby grows. But by the prenatal period it gradually decreases. On average, the amount of OM per different terms have approximately the following picture:
- 10 weeks 30 ml;
- 20 weeks 400 ml;
- 35 weeks 1200 ml;
- 40-41 weeks 700 ml.
Water can leak drop by drop, or it can gush out in a torrent. If, after a sudden change in body position, a woman notices an increase in discharge, then this should alert the expectant mother.
Reasons for leakage of amniotic fluid at different stages
The main reason for leakage is a violation of the integrity of the fetal membrane. There are several factors that can lead to this condition:
- Urogenital infection. Under its influence, many pathological changes are triggered. More often, leakage occurs in women who suffer from colpitis, cervicitis, adnexitis, etc.
- Injury. Intense mechanical impact on the abdomen (fall, blows) can lead to rupture of the amniotic sac.
- Features and pathologies of pregnancy. Multiple pregnancy, abnormal intrauterine position, polyhydramnios, etc. create increased pressure on the walls of the membrane, which can cause its rupture.
- Violation of uteroplacental blood flow. The risk of membrane damage increases with placental insufficiency, premature placental abruption, isthmic-cervical insufficiency, etc.
- Instrumental medical examination (chorionic villus biopsy, amniocetesis, abdominal ultrasound, etc.).
At what age can amniotic fluid leak?
Most often, OB leakage is encountered in the late stages of pregnancy, especially when there are several days left before the expected date of birth. It is much less common to encounter this problem in the early stages.
First trimester
It is very difficult to determine that water is leaking in the first trimester, because there is very little of it in volume, and accordingly they leak in tiny portions - drips. In this case, they can be mixed with natural vaginal discharge (which becomes more abundant in the early stages of pregnancy), which makes it impossible to suspect an existing problem.
Even an experienced gynecologist will not always be able to identify pathology.
If leakage is nevertheless diagnosed, doctors in most cases advise termination of pregnancy, because... There is a high probability that the baby will develop multiple pathologies.
Second trimester
The middle of the period is considered the safest, but pathological deviations can occur during this period. It is very important to determine how much time has passed since the integrity of the amniotic sac was damaged. This largely depends on further forecast pregnancy. If the pathology is identified at the very beginning, then by relieving the symptoms with special medications, doctors prolong the pregnancy as much as possible. But, unfortunately, due to the difficulty of diagnosis and the lack of timely treatment measures, pregnancy is often terminated.
Third trimester
A problem that arises in the later stages significantly increases the chances of maintaining the pregnancy. After diagnosing the pathology, the woman is kept under constant medical supervision and prescribed therapy aimed at:
- reducing the likelihood of infection with OB;
- rapid maturation of the fetal respiratory system;
- preventing increased uterine tone.
If it leaks before the birth itself
The later a woman encounters this problem, the more favorable the prognosis for her and the baby. After 38 weeks, this may indicate the onset of labor and is considered acceptable. In this case, doctors decide on emergency delivery by caesarean section or stimulation of natural childbirth.
How long can they leak?
Much depends on the amount of liquid released. The first 12 hours from the moment the waters completely break are not dangerous for the fetus. Further anhydrous stay in the womb is fraught with the development of complications for both.
How is it diagnosed in hospital?
Any alarming symptom should prompt you to consult a doctor. A gynecologist will be able to diagnose pathology using a comprehensive diagnostic examination, which includes:
- inspection;
- transabdominal ultrasound;
- taking a smear;
- amnitest;
- amniocentesis.
What tests are prescribed?
The test material (vaginal smear) is applied to a glass slide and examined in the laboratory under a microscope. After drying, the OM crystallizes and forms a characteristic pattern reminiscent of fern leaves.
How to do a test for amniotic fluid
A nitrosative test helps determine the presence or absence of leaking agents. Normally, the acidity of the vagina is increased; the OM has a slightly alkaline environment. When agents leak, the environment in the vagina approaches neutral and this is determined using a special litmus strip.
The accuracy of the test is also not absolute, because The results are influenced by infectious inflammatory processes, the presence of urine or semen.
Is it possible to determine leakage of amniotic fluid using a test at home?
You can determine the problem at home. Pharmacies sell a special test for determining fluid leakage - AmniSure. It is highly accurate regardless of the duration of OB leakage and gestational age.
The principle of the study is to insert a special tampon into the vagina, absorbing the woman’s natural secretions. The tampon is then removed and dipped into a solution, which removes the absorbed secretions from it. A special strip, subsequently dipped into this solution, is an indicator of the presence or absence of violations of the integrity of the membranes.
How to treat
Treatment depends on the gestational age and the amount of water released. Until the 22nd week, the fetus is not viable, the prognosis is unfavorable, so it is recommended to terminate the pregnancy.
After 22 weeks, pregnant women are advised to undergo hospitalization and maximum physical rest. Treatment tactics are expectant with regular monitoring of the condition of the child and mother. If necessary, additional treatment methods are added.
What is prescribed
- Antibiotics – to prevent bacterial infection.
- Medicines to prevent respiratory distress syndrome - to accelerate lung maturation and accelerate surfactant synthesis: glucocortioids.
- Tocolytic therapy - prevents uterine contractions by relaxing smooth muscles.
- Amnioinfusion - administration of isotonic saline solution into the amnion to increase OS.
How long does it take to treat
A pregnant woman should be under the supervision of doctors until specialists are sure that the fetus and mother are not in danger. Therefore, the duration of treatment is individual in each case.
The dangers of early breaking of water
Early passage of the OB carries a danger for both the mother and the child.
For mother
The danger for the mother is the high risk of infection. The result can be chorioamniosis - inflammation of the amniotic sac.
Due to the close connection with the uterine mucosa, this complication almost always develops into endometritis - infection of the uterine walls.
A single inflammation can cause a chronic process, resulting in miscarriage or infertility.
Also to serious complications relate:
- Formation of single or multiple polyps of the uterine cavity.
- Weakness of labor and prolonged labor.
For a child
With early discharge, the protective functions of the OM are significantly reduced, and as a result, the likelihood of infection increases. Pathogenic microorganisms quickly spread through ascending penetration and affect the decidua, placenta, chorion, and amnion. As soon as the OB is colonized by pathogenic microorganisms, the fetus becomes infected. Aspiration of infected OBs leads to the development of fetal pneumonia. Infection can also result in:
- uteroplacental blood flow disorder;
- intoxication, etc.
Another common complication is prolapse of the umbilical cord or small parts of the fetus (such as the handle). Approximately 5% of cases of early OB ends with placental abruption. This condition requires immediate medical attention because... threatens the life of the baby (impaired cardiac function, development of severe hypoxia, etc.), as well as his mother, due to the high risk of uterine bleeding.
A pregnant woman should be as attentive as possible to her health and, if there is the slightest suspicion of a leak, immediately consult a doctor. The earlier the pathology is detected, the higher the likelihood of a favorable pregnancy outcome.
Useful video
Intelligent nature has thought of everything: when a woman becomes pregnant and carries her child under her heart for nine months, the baby grows and develops all this time in conditions specially created for it.
Since he is still very small and defenseless, in his mother’s belly he is surrounded by a thin membrane (fetal sac) filled with amniotic fluid (amniotic fluid).
This fragile structure is a serious protection for a child who is not yet ready for independent life.
Amniotic fluid prevents infection and negative impact environment, allow the baby to move freely, roll over, “swim”, soften possible blows or injuries (from falling, for example).
In addition, they are responsible for adequate nutrition of the child and supplying him with everything necessary for normal life, because they contain all the key substances: oxygen, proteins, carbohydrates, enzymes, vitamins, lipids, hormones, antigens, immunoglobulins, etc.
The volume and composition of amniotic fluid changes depending on the period of pregnancy, as the baby's needs change.
When the first stage of labor begins, the amniotic sac ruptures and the waters immediately recede, helping the cervix to open.
However, sometimes it happens that the amniotic sac may become thinner, and its walls may become covered with microcracks. Then a leak of amniotic fluid occurs, which poses a very great danger to the health and well-being of the child, as well as to the pregnancy in general.
If the leakage occurs on its own and is not accompanied by contractions, and childbirth is still far away, then it can provoke and cause infectious and other complications.
Suspicion of effusion: how to determine?
Expectant mothers should be very careful about their body and health, because often the causes of premature effusion can be simple infections, inflammatory or chronic diseases, mechanical injuries, etc.
It is sometimes difficult to recognize water on your own, since during pregnancy there is usually an increase in discharge and an increase in vaginal secretion.
However, you should undergo regular examinations with a doctor in a timely manner so that the problem does not take you by surprise.
There are other methods for determining pathology:
- a routine examination by a gynecologist with a specific complaint;
- cytological examination (smear taking);
- ultrasound procedure;
- rapid tests for self-determination;
- special test systems.
Of particular danger is rupture of the membranes, which occurs in the early stages or during premature pregnancy. If this happened before the 22nd week, then the pregnancy will not be maintained, but if at a later date, doctors will do everything possible to help you and the baby.
Another negative point is unnoticed leakage, when there is no overflow as such, but the liquid oozes out literally drop by drop. This means that there is a threat of infection and premature birth, but it is not noticed.
Possible diagnostic methods to help recognize leakage
If you suspect you have this problem, it is better to get examined and consult a doctor. There is no need for you to have unnecessary worries - if you are wrong, they will dissipate. And by recognizing the pathology in time, you can avoid its negative consequences and protect yourself and your baby.
Visual inspection with a mirror
During pregnancy, you have to visit your gynecologist regularly.
During these appointments, he conducts standard examinations, and you undergo tests to make sure that the pregnancy is progressing well and there is no reason to worry.
If you suspect leakage of amniotic fluid, be sure to inform your doctor.
True, a regular gynecological examination will not always be able to recognize the presence of a problem - it is difficult to diagnose effusion by eye.
The fact is that symptoms and signs are often very scarce (increased sensation of moisture in the perineum, incontinence when the vaginal muscles are tense), and the doctor’s point of view sometimes turns out to be extremely subjective, because amniotic fluid can be taken as copious vaginal discharge and even urine .
Moreover, in the later stages, many women experience urinary incontinence after laughing, sneezing or coughing.
The doctor may ask you to push, cough, or change your body position while he examines your cervix using a speculum.
The appearance of fluid should indicate the possibility of disruption of the amniotic sac.
However, you can make a mistake by eye. This method can only be truly informative if there is a visible abundant outpouring.
Therefore, in order to get more reliable results, the doctor will prescribe additional examinations or tests for you.
Laboratory research
To perform a cytological analysis of the discharge, the specialist will take it from the posterior vaginal vault onto a glass slide and transfer it to the laboratory.
- Smear microscopy.
The material will be examined experimentally under a microscope: when the amniotic fluid dries, it begins to crystallize. This is called the arborization phenomenon or fern symptom. It is based precisely on the fact that cervical mucus is capable of forming crystals when dried.
The reason for this is a change in its physicochemical properties, and they change because they are affected by hormones contained in the amniotic fluid. An assessment of crystallization will be given after examination under a microscope.
If it is indeed amniotic fluid leaking, then a pattern will appear on the glass, very similar to the leaves of a fern.
However, the information content of the method barely reaches 80%, because in order to correctly read the test results, real specialists are needed. In addition, both false positive and false negative results are possible.
Sometimes cervical canal secretions or even fingerprints are mistakenly mistaken for amniotic fluid if the material is collected incorrectly.
- Cytological examination of discharge.
The analysis consists of the fact that the taken material is stained using a special method for subsequent evaluation under a microscope.
As a result, the doctor may detect cells that will differ in color: among them may be rejected skin scales, cells of the sebaceous glands, urinary and genital organs, and the child’s hair.
The presence in the material under study of these elements, which are part of the amniotic fluid, will be reliable evidence that there really is damage.
- Nitrazine testing.
Normally, the environment in the vagina is acidic, while the amniotic fluid is slightly alkaline or neutral.
Naturally, if amniotic fluid appears in the vagina, then the environment in it changes. To determine this, nitrazine testing is done. True, this method may have errors in indications, since a similar feature of vaginal pH is also observed in various infectious diseases.
In addition, the information content of such diagnostics always decreases if a lot of time has passed since the rupture.
An ultrasound procedure will be completely useful in case of suspicion. However, its information content is not entirely significant.
The fact is that this study will not be able to indicate a slight rupture, but can only detect a serious loss of amniotic fluid, that is, when a massive rupture has already occurred.
However, ultrasound is recommended to confirm the diagnosis. It is also worth undergoing a procedure to determine the exact amount of amniotic fluid.
The procedures will need to be done dynamically to eliminate the possibility that not only may indicate a long-term leakage of water, but in itself poses a danger to the mother and child.
Amniocentesis as the gold standard for diagnosis
This method is considered the most accurate and highly effective. First, the doctor may suggest performing an amnioscopy, that is, an examination and thorough examination of the lower part of the bladder itself.
If the data does not give a reliable result, the pregnant woman is referred for amniocentesis analysis.
In itself, diagnosis means a puncture or puncture of the membranes. This can be done either in the posterior vaginal fornix or in the lower abdominal wall.
The pregnant woman is given local anesthesia and a special needle is inserted to take a sample of the amniotic fluid, and then to evaluate its composition, the color of the amniotic fluid and other characteristics.
The analysis allows you to determine how mature the baby’s respiratory system, kidneys and other important organs are.
Knowing the maturity of the fetus and assuming its readiness to exist outside the mother’s belly, doctors can adjust preventive or drug therapy, as well as the management of pregnancy itself or premature birth.
Amniocentesis with dye is used as an additional method in cases where other diagnostics have not yielded any results, but the pregnant woman’s condition is considered dangerous. During the procedure, diluted indigo carmine (a harmless special dye) is injected through a puncture made on the surface of the abdomen directly into the cavity of the amniotic sac.
In this case, you will need to place a clean tampon in the vagina. After about half an hour, it will be absolutely clear whether there is a rupture, since if the tampon is stained, the diagnosis is confirmed unconditionally.
Among the disadvantages of the method, it is worth noting its expensive cost and high probability risk. The fact is that this procedure itself can provoke rupture or the development of other complications.
Methods for determining leakage of amniotic fluid at home
If you suspect that there has been a rupture or leakage, but there is no way to see a doctor at the moment, use, most of which can be done at home.
In the past, women were advised to use the “clean diaper method.” That is, you had to go to the toilet and do all the necessary hygiene procedures and wipe yourself dry, then lie down on a dry and clean cotton diaper or sheet. If after half an hour or an hour wet spots appear on it, it means that amniotic fluid is actually leaking.
Today there are special test pads that play the role of an improved diaper.
One such pad can be used for about 10-12 hours. It is impregnated with a special reagent that will not react to ordinary secretions or urine, but only to substances that have a high pH level (like amniotic fluid).
If the litmus strip changes color while wearing the pad, immediately consult a doctor for additional examination and diagnosis.
New methods
There is another method that is significantly better than the others, since it combines all the main advantages:
- high information content, reliability and accuracy (98.9% - it is compared with amniocentesis using dye);
- safety (relative to the same amniocentesis or other tests);
- speed of obtaining results (about 5 minutes);
- the ability to carry out diagnostics at home yourself.
This method is considered immunological, because it is based on detecting various substances that can only be in amniotic fluid.
There are several types of test.
- One variant is sensitive to placental α1-microglobulin.
It is considered more informative, as it is able to identify the problem even at early pregnancy or when a high lateral tear occurs and only traces of fluid may be present in the vagina. The test is able to show a reliable result, regardless of the elapsed time after the actual break.
- The second is designed to detect protein-1, which binds insulin-like growth factor. However, it has much less sensitivity. It should only be carried out within a time interval of up to 12 hours after the break.
To date, the first test is available for free sale only under the Amnisure® ROM Test brand (Amnishur).
The analogue of the second option is AmnioQUICK (AmnioKVIK). The diagnosis itself is very simple, and the test strip is similar in principle to a pregnancy test (plus, it comes with a bottle with a special reagent and a sterile swab):
- the vaginal tampon will need to be inserted inside the vagina (no more than 5-7 cm) after all necessary procedures personal hygiene;
- it should stay there for at least a minute, after which, remove the tampon and place it in a bottle with solvent;
- Place the test strip there too, and then shake the entire contents;
- in a few minutes you will be able to read the results. Two stripes in the test zone will indicate confirmation of a break, and one will indicate its absence. Even if one line has a faint tint, this indicates leakage.
Such diagnostics have gained great popularity all over the world because it eliminates unnecessary tests and studies and avoids unnecessary hospitalization or unnecessary treatment. At the same time, the test gives a woman the opportunity to detect a problem in time and seek the necessary medical help.
Conclusion
Pregnancy is often not only a joyful, but also a worrying process. At the slightest suspicion of pathology, it is better to do a test or undergo an examination so that doctors can provide you with timely and high-quality medical care. This way you can not only maintain your pregnancy, but also give birth to a healthy baby.
First pregnancy - how new life, in which unfamiliar and sometimes unexpected phenomena await a woman. 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 women during pregnancy, leakage of amniotic fluid is horrible dream 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. In terms of chemical composition, 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 sharp 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.
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.
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:
- 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.
- 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.
- 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? 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 the usual scheduled inspection. 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!