During pregnancy, fluid leaks. What is leakage of amniotic fluid and what are the consequences? What is the effect of leakage of amniotic fluid?

Throughout pregnancy, the baby in the uterus is surrounded by amniotic fluid. Many pregnant mothers worry whether they are leaking amniotic fluid, because during this period, vaginal discharge becomes much more, and it is quite difficult to truly assess whether it is leaking or not.2. Determining leakage at home
3. Test for leakage of amniotic fluid at home
4. Diagnostics on an outpatient basis
5. Signs and symptoms of amniotic fluid leakage
6. The main causes of amniotic fluid leakage
7. What consequences await a pregnant woman if water leakage is suspected?
8. Preventing leakage
9. Treatment

Let's figure out what amniotic fluid is, what is its main function, the main causes of rupture of the amniotic sac, risk groups, symptoms, signs of rupture, and most importantly, how to determine leakage of amniotic fluid at home.

Amniotic fluid is a natural, normal environment for the full growth, development and intrauterine existence of the fetus. It performs three main functions in the pregnant woman’s body:

1. Protection– water protects the baby from unintentional influences from the external environment (unexpected shocks, blows when a pregnant mother falls), and from pathogenic microorganisms that can, if the integrity of the fetal membrane is damaged, penetrate to the baby along the ascending tract through the vagina through the cervical canal (you need to know that amniotic fluid is sterile!). 2. Cord safety– amniotic fluid surrounds the entire intrauterine space, creating optimal blood flow in the umbilical cord, relieving its compression by the fetus. This helps in providing the baby with adequate nutrition and oxygen supply through a huge vessel.3. Natural environment is a biological fluid. Metabolic processes take place in it between the baby and the mother (secretion of fetal secretions, self-purification of the liquid or filtration by excretion through the blood with the mother’s urine).

The rupture of amniotic fluid is a normal physiological process, but if this occurs during a full-term pregnancy (more than 37 weeks of pregnancy) at the end of the first stage of labor with sufficient dilatation of the cervix. During the process of the next contraction, under the pressure of the baby's head, the amniotic sac ruptures, and all the liquid comes out. The normal amount of water by 39 weeks of pregnancy reaches 1000-1500 milliliters.

If effusion or leakage occurs in the second trimester of pregnancy (in the first trimester leakage is impossible, since the amount of water is too small), or during the third, but not reaching 37 weeks, this is very dangerous for the unborn baby.

Pathogenic microorganisms can easily penetrate through a tear in the placental barrier and lead to the formation of infectious processes, unless, of course, preventive measures are taken in a timely manner.

Determining leakage at home

It is important for every pregnant mother to know the main symptoms of amniotic fluid leakage.

How to reliably determine leakage of amniotic fluid for a pregnant woman at home: In case of premature rupture of amniotic fluid, at least 400 ml of fluid is released. Water trickles down your legs, and it’s impossible not to notice it.

But if there is a high tear or a small crack, in this situation it is more difficult for a pregnant woman to find out about the integrity of the membrane.

In the absence of precious time and the opportunity to purchase a test to determine water leakage, at home, you can perform the following measures: A woman needs to completely empty her bladder, even if there is no urge to urinate, then perform a thorough toilet of the external genitalia and wipe the perineal area dry with a towel.

Lay on the bed, preferably a white cotton sheet or piece of cloth, a diaper. Lie down on a clean sheet, and after 10-20 minutes, look for wet spots on the dry fabric. If spots are present, the possibility of leakage of amniotic fluid cannot be ruled out.

But what if it’s not amniotic fluid, but say, heavy vaginal discharge? In such situations, the expectant mother needs to be able to distinguish amniotic fluid from vaginal discharge or urine.

The waters normally have a transparent color and consistency resembles ordinary water. Sometimes the water may have a greenish or brown tint - this indicates a serious pathology and requires immediate hospitalization.

Urine has a slightly yellowish color and a specific smell. As for the discharge, this depends on its nature, but it is thicker in consistency; in most women it is whitish in color and mucous.

Test for leakage of amniotic fluid at home

But if you have a test for determining water leakage, purchased in advance at a pharmacy, or someone close to you can provide it in the next hour, then of course you need to use it. There are two types of dough - in the form of strips and pads.

The first and second types of tests have the same effect.

Methods determine the vaginal environment. Normally, a healthy mother has an acidic environment, and the waters have a neutral environment. These diagnostic methods do not have one hundred percent reliability, because not all pregnant women have an acidic vaginal environment; the change occurs due to the presence of infectious processes in the vagina, which lead to an alkaline or neutral environment. However, it is important for a pregnant woman to independently verify the reliability of all methods, especially when it comes to the health of her baby; it is better to contact a specialist in advance for qualified help at the first suspicion.

Diagnostics on an outpatient basis

An outpatient doctor diagnoses amniotic fluid leakage using:

Amniotest- a test to determine the leakage of amniotic (amniotic) fluid. An amnio test shows the presence of a special protein in the vagina, which is found only in amniotic fluid. Accordingly, the protein enters the vagina in only one way when the amniotic membrane ruptures. The test is completed in a matter of seconds, you just need to blot the contents of the vagina and the test is painted in a certain color, indicating the presence or absence of protein.
Cytological examination– research that requires more time. It is necessary to collect the vaginal contents. A laboratory assistant observes the structure of the secretion under a microscope. If a pattern appears that is similar in structure to fern leaves, this is amniotic fluid.
Ultrasound examination– with this type of study, the integrity of the fetal membrane is not visible, but the doctor will be able to determine the amount of amniotic fluid. If there is less amniotic fluid - oligohydramnios, there is a possibility of rupture.

Signs and symptoms of amniotic fluid leakage

What symptoms can a pregnant woman observe when amniotic fluid leaks?

The discharge became similar in consistency to water.
The expectant mother will clearly feel the release of fluid from the genital tract when she changes her body position, moves, or if she pushes slightly.
The abdominal circumference or uterine fundus indicators have decreased in size.
If there is a large rupture of the fertilized egg, the liquid will flow down the legs in a trickle.

The main causes of amniotic fluid leakage

Firstly, the presence of infectious processes in the body in a pregnant woman. Pathogenic microorganisms produced by waste products lead to thinning of the amniotic membrane, and therefore there is a risk of cracking or rupture of the membrane.
Secondly, cervical insufficiency. The cervix opens several centimeters under the gravity of the growing fetus, and the amniotic sac sags into the cervical canal, where it may crack under light load.
Thirdly, diagnostic measures that were carried out during the initial stages of pregnancy according to indications. For example, amniocentesis, cordocentesis.
Fourthly, the pregnancy is multiple. Any multiple pregnancy increases the risk of amniotic fluid leakage.
Fifthly, indirect causes of pathology are bad habits of the mother, injuries, and malpresentation of the fetus.

What consequences await a pregnant woman if water leakage is suspected?

The most insidious complication is intrauterine infection of the unborn baby.

The formation of infectious and inflammatory complications in the mother herself (inflammation of the layers of the uterus, inflammation of the membranes of the fetus). The effusion provokes the appearance of premature birth, or weakness of labor

Placental abruption As labor progresses, a premature baby develops distress syndrome (the baby’s lungs cannot independently participate in the act of breathing, due to their unpreparedness, they stick together and further independent gas exchange is impossible).

Preventing leakage

Preventive measures for leakage of amniotic fluid can be carried out by the expectant mother:

1. Treatment of a source of infection in a pregnant woman.

2. If cervical incompetence is detected, it is necessary to take care of the emerging pathology in advance. To do this, sutures are placed on the cervix (sutured), and an obstetric unloading pessary (ring) is inserted.

3. Carrying out therapy aimed at maintaining pregnancy.

4. Lead a healthy lifestyle.

Treatment

Treatment of a pregnant woman with premature leakage of amniotic fluid includes:

In the event of a premature pregnancy, doctors take all possible measures to preserve the health of the mother and her baby (expectant management), but provided that infection has not occurred. During this time, doctors prepare the respiratory system for its main function, using special medications for treatment.

Mommy is prescribed antibiotics to prevent the formation of an infectious process.

The pregnant woman is on bed rest with daily CTG monitoring (monitoring the absence of fetal hypoxia).

When a full-term pregnancy is achieved and the fetus's lungs are mature, either operative delivery or spontaneous delivery is prescribed; the choice depends on the indications and assessment of the fetal condition.

Treatment for each pregnant woman is individual.

In a full-term pregnancy, if labor does not occur, a water-free period of more than 5 hours is dangerous for the baby, so the doctor begins to stimulate labor.

It is important to remember that if you have or suspect premature leakage of amniotic fluid, you must immediately seek qualified help. The health of your baby is in your hands.

Amniotic fluid surrounds the baby in the womb, providing him with development, nutrition, and protection. If the pregnancy is without pathologies, the water breaks a few hours before birth. This is one of the signs of active labor. Leakage of water ahead of time is a threat to the health of mother and baby.

How to distinguish premature leakage of amniotic fluid from natural discharge? How much and how does amniotic fluid flow? What are the causes and negative consequences of the pathology? How can a woman find out on her own if amniotic fluid is leaking? Can this be determined at home? What to do to save the child?

What is amniotic fluid?

During the entire 9 months of gestation, the fetus resides in the uterine cavity. Its protective shell is a bladder filled with odorless and colorless amniotic substance. The liquid substance is 97% water. A special biological environment is secreted by the amnion, the inner layer of the bladder. In addition to water, the liquid includes the following nutrients: carbohydrates, proteins, enzymes, hormones, minerals, vitamins, oxygen, immunoglobulins, lipids, skin lubricant.

Amniotic fluid creates favorable conditions for fetal development. They provide it with nutrients and protect it from shock and injury. The shell is completely sealed and a constant temperature is maintained inside. What does amniotic fluid look like? This is a liquid transparent substance that is odorless.

Functions of a bladder filled with liquid nutrient medium:

nutrition;
protection from premature contact with the environment, germs and bacteria;
shock absorption;
maintaining a comfortable temperature;
preventing compression of the umbilical cord, which ensures normal blood flow and oxygen supply;
enlargement of the uterus to provide space for the growing fetus.

Amniotic fluid increases in volume as the fetus grows, reaching a maximum of one and a half liters by 36 weeks. The protective fluid barrier is not broken until the birth process begins.

Why can water leak in pregnant women?

Dear reader!
This article talks about typical ways to solve your issues, but each case is unique! If you want to know how to solve your particular problem, ask your question. It's fast and free!
The factors that provoked the early discharge of amniotic fluid are not always determined unambiguously. The doctor assesses the woman’s health status in a comprehensive manner. The effectiveness of treatment depends on how correctly the causes of the pathology are identified. Why do the walls of the amniotic sac rupture? The reasons are as follows:
Inflammation, infections in the mother’s genitourinary system (colpitis, endocervicitis). The walls of the shell become thinner and lose elasticity. The cervix matures ahead of schedule, and sometimes the placenta exfoliates. This condition is dangerous due to uterine bleeding and lack of oxygen.
Carrying more than one child.
Isthmic-cervical insufficiency is a pathology in which the cervix does not close completely. She cannot withstand the increasing pressure, which provokes effusion.
Blows to the stomach, physical activity.
Polyhydramnios.
Benign and cancerous formations of the reproductive system of a pregnant woman.
Narrow maternal pelvis, abnormal fetal position. If carried out correctly, childbirth is not dangerous, but it can cause complications. There is no threat to the health of the mother and baby, since such a course occurs immediately before childbirth.
The mother has a harmful addiction to alcohol, nicotine, and drugs.
Inaccurate collection of material during invasive diagnostics: chorionic villus biopsy, puncture of the amniotic sac to collect water, amniocentesis.
The development of infection in the amniotic sac (chorioamnionitis), which disrupts the structure of the bladder tissue.
Diseases and congenital pathologies of the mother (anemia, anorexia, uterine septum, shortened cervix) (see also:).

First signs and general symptoms
How do amniotic fluid leak? This happens in small quantities. It is often difficult to distinguish the secreted amnion from urine and female secretions. You can tell by the feeling of moisture in the perineum. Underwear has to be changed up to ten times a day - it is constantly wet. The use of sanitary pads helps the situation for a short time. With tension or physical effort, the leakage becomes stronger. This occurs when lifting weights, laughing, coughing, or sudden movements.
How can amniotic fluid leak when the cervix is closed? This happens when the membranes rupture. Signs of leakage depend on the size of the damage. When a medium or large volume of fluid is released, the woman feels it flowing down her legs. The pads do not cope with the absorption function. There may be little leakage even with a large tear if sections of the shell are layered on top of each other at the point of damage.
The photo shows what amniotic fluid looks like. It is transparent, colorless. The discharge does not smell. The presence of a strong stench indicates an infection. This is dangerous for the life of the woman and baby. Traces of blood are a sign of placental abruption. Meconium is detected - the fetus lacks oxygen. Leaks can occur periodically, be regular, and be accompanied by contractions.

Diagnostic measures
If you suspect POV, you should consult a gynecologist as soon as possible. The further course of pregnancy and the birth of a healthy baby depend on this. How to recognize a leak? Testing methods available for use at home may initially confirm concerns. There are several methods based on the reaction of indicator strips. The leak test is based on the elevated pH of the leaking water. Only a specialist will be able to reliably distinguish whether amniotic fluid, urine or vaginal discharge is leaking.
In a hospital setting
A gynecologist examines a pregnant woman. The doctor asks the woman to move on the chair and cough. With POV, fluid will appear from the vagina. This is a primary diagnostic method with low efficiency. More reliable methods are a cytological smear of the posterior vaginal vault, amniotest, frautest.
A gynecological smear helps determine POV. When amniotic fluid dries on a glass slide, it forms a pattern of crystals. It resembles a fern leaf.
The amniotest has a high degree of reliability. The procedure involves intramuscular injection of dye into the abdominal area. A white tampon is placed in the vagina. If it changes color, it means POV. Such a test is not only expensive and painful, but also risky, so it is rarely used. In one case out of 200, puncture of the bladder leads to internal bleeding and infection. The most terrible consequence is termination of pregnancy.

A lack of amniotic fluid at a certain stage of pregnancy is sometimes detected during a routine ultrasound examination. This indirectly indicates a leak. In some cases, on the ultrasound monitor screen you can see damage to the membrane surrounding the fetus, their size and location. A small gap will be difficult to detect.
A laboratory test for leakage of amniotic fluid is based on the detection of specific proteins. A gynecological smear is taken with a sterile swab. It is placed in a test tube with the reagent. The laboratory technician evaluates the result, identifying premature rupture of the amnion.
Home Leak Tests
Pharmacological companies produce special tests with instructions. With their help, you can independently determine the POV. The test is attached to underwear like a regular pad. You need to wear it for 12 hours. The indicator embedded in the pad will react to the presence of amniotic fluid by changing color (we recommend reading:). The normal pH of vaginal discharge is up to 5.5, and that of amniotic fluid is up to 7. The test for water leakage contains an indicator. Upon contact with amniotic fluid, it will become a bright green or blue color.
There are pads that can be removed after getting wet. They are placed in a special container for half an hour. When the indicator changes color to yellow-green, this means that liquids are leaking from the bubble.

What is the danger of leakage?
Rupture of the membrane and loss of amniotic fluid cause serious consequences. The most dangerous and common complications:
rupture of the membrane protecting the fetus prematurely;
infection;
premature delivery, which is dangerous due to asphyxia, unpreparedness of the newborn’s lungs to function, and cerebral hemorrhage.

The severity of the consequences for mother and child depends on the period of gestation at which the leakage occurred. This factor also determines the possibility of further pregnancy.
In the early stages
Leakage, release of amniotic fluid before 20-22 weeks is considered early. In most cases, the baby’s life cannot be saved. The rupture of the membrane is accompanied by infection of the protective environment, which is not comparable to the vital activity of the fetus. If the amount of leakage is small, after a full examination, a conclusion is made that it is permissible to continue the pregnancy. A newborn may be born with a number of congenital pathologies: paralysis, blindness, lung problems, heart failure.
If the fetus or membrane is infected, further pregnancy is impossible. This causes inflammatory processes in the mother's reproductive system, which is dangerous for her life. To prevent possible complications, the uterine cavity is cleaned.
In the 2nd and 3rd trimesters
There are no medications that can be used to repair membrane rupture. If there is leakage after the second trimester, the pregnant woman is sent to the hospital under constant medical supervision. The lining of the bladder is examined using an ultrasound machine. No therapeutic measures are carried out. Doctors monitor the woman’s condition over time. Regular gynecological examinations are carried out.
A pregnant woman should be in a calm atmosphere. Bed rest and lack of physical activity are indicated. Leakage of amniotic fluid in the later stages (from 35 weeks) does not threaten the life of the child and mother (see also:). The condition is met if the woman seeks medical help immediately after detecting signs of POV. When the water breaks out at 39-40 weeks, this means the beginning of labor.

What to do?
If you suspect water leakage during pregnancy, you should immediately do a test. The results should be reported to the gynecologist immediately. This is exactly the case when it is better to play it safe and raise a false alarm than to put the life of a child at risk. It is advisable that during pregnancy a woman always has a test pad on hand to detect leakage. If you feel moisture, you should use it immediately. If there is a bubble rupture, the clock counts. The task of doctors is to prevent the spread of infection and provide inpatient monitoring.
In the third trimester, labor is induced during POV. Previously, an ultrasound machine analyzes the degree of maturity of the fetal life support systems outside the mother’s womb. If the lungs are not ready to breathe on their own, efforts are directed toward prolonging pregnancy. To prevent the spread of infection, the woman is prescribed antibacterial drugs. Fetal blood flow and the presence of movements are assessed daily. The mother is prescribed bed rest. Body temperature is constantly monitored. Its increase may indicate the development of an infection.
When do you need to see a doctor urgently?
The release of water at any stage of gestation requires immediate contact with a gynecologist. If the pregnant woman’s well-being allows, on a weekday she should immediately go to the consultation where the woman is registered. On a weekend or when there is a significant amount of fluid being released, it would be a good idea to call an ambulance.
Doubts regarding the origin of the discharge can be checked using the dry diaper method. If after lying for half an hour a wet spot appears on the fabric, a visit to the doctor cannot be postponed. Dangerous symptoms are pain in the lower abdomen, chills, temperature 38 and above, discharge mixed with pus or blood.

Often, leakage of amniotic fluid becomes a cause for concern for the expectant mother. However, not all pregnant women understand what it is and how to distinguish amniotic fluid from vaginal discharge. Let's take a closer look at the situation, name the reasons and ways to eliminate the violation.

Amniotic fluid - what is it?

Amniotic fluid is a vital environment for the embryo. By filling the amniotic sac, it prevents trauma to the fetus, creating favorable conditions for it. So, directly thanks to it, the baby’s body temperature is maintained at the same level. The protection that amniotic fluid provides to the unborn baby is also important.

Its volume is not constant, increasing as the gestational age increases. This process is observed throughout the entire gestation period, but water is produced unevenly. The volume is increasing every week. The maximum is reached around gestation. At this stage, the volume of amniotic fluid is 1000-1500 ml. At the same time, immediately before the birth process, its quantity decreases.

Why is leakage of amniotic fluid dangerous?

Amniotic fluid during pregnancy is vital for the unborn baby. Reducing its volume can lead to irreversible consequences. Among these, doctors identify:

infection of the baby inside the womb;
development of infectious complications in the expectant mother: , chorioamniotonitis (inflammation of the membranes of the fetus), ;
premature birth;
weak labor activity.

Causes of amniotic fluid leakage

When amniotic fluid leaks during pregnancy, a woman should consult a doctor. The main task for doctors is to determine and eliminate the cause of the disorder. At the same time, a comprehensive assessment of the situation is carried out. Possible reasons include:

Diseases of an inflammatory and infectious nature in the reproductive system. As a result of such pathogenic processes, the membranes of the bladder in which the fetus is located become thinned. Due to loss of elasticity, integrity is compromised. This is possible with colpitis, endocervicitis.
Isthmicocervical insufficiency. With this type of disorder, incomplete closure of the cervix is noted. Due to excess pressure, which is caused by an increase in the size of the fetus, the amniotic sac protrudes into the cervical canal. This leads to a violation of its integrity.
Multiple pregnancy. This phenomenon is considered as a contributing factor to the development of the disorder. Due to the increased load on the walls of the fetal bladder, they cannot withstand and become damaged, causing leakage of amniotic fluid.
Developmental anomalies, benign or malignant formations in the uterus. Incorrect size of the reproductive organ, the presence of cysts and tumors in it interfere with the normal growth of the baby and amniotic membranes. As a result, injury to the walls may occur.

Leakage of amniotic fluid in the early stages

Leakage of amniotic fluid during pregnancy, in its short stages, can interrupt the process of bearing the baby. If the disorder develops before 20 weeks, it is not possible to save the baby’s life. In this case, infection of the membranes occurs, vital processes are disrupted, as a result of which the baby dies. A woman has her uterine cavity cleaned to prevent infection and life-threatening complications.

Leakage of amniotic fluid in the second trimester

Leakage of amniotic fluid is often detected long term. It is provoked by increased pressure on the membranes of the fetus, the mass of which increases several times. When a complication of this kind developed in the first half of the 2nd trimester (up to 22 weeks), doctors are forced to interrupt the gestational process. This helps to avoid complications that negatively affect a woman’s health.

If leakage of amniotic fluid begins after, then in most cases it has a favorable outcome. The pregnant woman is sent to a hospital, where she is monitored. Doctors carry out dynamic monitoring by performing an ultrasound and examining the condition of the bladder shell in a gynecological chair. However, there is no specific treatment. The efforts of doctors are aimed at improving the condition of the pregnant woman. It all depends on how much time has passed since the start of leakage caused by a breach of the shell.

How to determine leakage of amniotic fluid?

To protect herself and her unborn baby, a pregnant woman should imagine the signs of this disorder. Leakage of amniotic fluid, the symptoms of which may be mild, has an increasing character - as it progresses, the volume of fluid increases. If the membranes are broken in a place located high from the neck, the water flows sparingly. In such cases, pregnant women may not pay attention to this phenomenon, mistaking it for vaginal discharge. Among the obvious symptoms of leakage, it is worth highlighting:

sudden, heavy vaginal discharge;
change in the nature of the discharge - it has become watery and increased in volume;
reduction in abdominal volume;
appearance .

How to distinguish discharge from leakage of amniotic fluid?

In order to be able to distinguish a violation from the norm, every pregnant woman must clearly understand what leakage of amniotic fluid looks like. Among the main manifestations:

an increase in the amount of fluid released during physical activity, movement, change of position;
tension of the pelvic muscles does not lead to the cessation of discharge (unlike spontaneous urination).

When the bladder rupture is very small, determining the pathology is only possible using a special test or smear. Women can diagnose larger tears on their own, at home. To do this:

Go to the toilet and completely empty your bladder.
Wash thoroughly and wipe everything dry.
Lay a dry and clean sheet on the sofa and lie down on it without underwear.
If wet spots appear on the sheet after 15-20 minutes, there is a high probability of leakage. The effectiveness of such a simple test exceeds 80%.

What color is amniotic fluid when leaking?

The color of amniotic fluid when leaking may vary. This complicates the ability to diagnose the disorder. In most cases, the waters are clear and uncolored, so it is difficult to identify them based on marks on a sanitary pad. Occasionally, the amniotic fluid acquires a pinkish tint. When amniotic fluid becomes infected, it may become greenish, yellow, or cloudy. However, in such cases, another clinic is also noted, which helps diagnose the pathology.

Test to determine leakage of amniotic fluid

A pregnant woman can diagnose a pathological condition using special means. There are gaskets for detecting leakage of amniotic fluid. Their action is based on the color of the indicator changing depending on the medium with which contact occurred. Initially it is yellow in color (corresponds to a vaginal pH of 4.5). Other liquids give it a greenish-blue color. Amniotic fluid has the highest pH. This allows you to diagnose leakage of scanty amniotic fluid.

Tests for leakage of amniotic fluid

Talking about how to recognize leakage of amniotic fluid, doctors note that it is difficult to do this when the volume is small. In such cases, the violation is diagnosed using laboratory methods, including:

a smear of vaginal discharge - “fern effect” (drying liquid on a glass slide forms a pattern similar to the named plant);
a smear from the posterior vaginal fornix is a reliable method of diagnosis;
amniotest - is based on the intramuscular injection of a dye into the abdomen, which colors the amniotic fluid released outside (rarely used due to the high risks and cost of the reagent).

Does ultrasound detect leakage of amniotic fluid?

Leakage of amniotic fluid, the signs of which are mentioned above, can also be diagnosed using ultrasound. In such cases, on the monitor screen the doctor assesses the extent of the disorder and the location of the rupture of the amniotic membrane. For mild disorders, this technique is ineffective due to impossible visualization and the difficulty of detecting a defect in the amniotic sac.

Before birth, the baby, while in the mother's womb, “swims” in the amniotic fluid. Pregnant women call it amniotic fluid. By the end of pregnancy, their volume is about one and a half liters. During childbirth, the amniotic sac bursts and water flows out. But in about 15 percent of cases, this process begins long before birth. This is fraught with serious consequences for the woman and child. Every expectant mother should know how to recognize this pathology and what to do in such a situation.

Leakage (outpouring) of amniotic fluid is one of the stages of normal labor, occurring at the end of the first period with complete or almost complete dilatation of the cervix. If leakage occurs before the onset of labor, and even more so during a premature pregnancy, it can cause infectious complications and consequences associated with these conditions. The rupture of amniotic fluid is distinguished depending on the time when it occurred:

Timely- occurs at the end of the first stage of labor with complete or almost complete opening of the cervix;
Premature - rupture of amniotic fluid before labor begins;
Early- leakage of amniotic fluid after the onset of labor, but before;
Belated- rupture of amniotic fluid after the complete opening of the cervix in the second period (this occurs due to excessive density of the amniotic membranes);
High rupture of membranes- rupture of the membranes above the cervical pharynx.

The ideal option is the timely release of amniotic fluid. However, under the condition of a full-term pregnancy (more than 37 weeks), any of these options is favorable if normal labor develops.

dangerous Dangerous for the child and mother premature leakage of amniotic fluid in premature pregnancy(up to 37 weeks).

In order to understand the consequences of premature rupture of amniotic fluid, it is necessary to understand their functions:

Protection against infection, which can reach the child vertically (through the mother’s genitals);
Prevents umbilical cord compression, thereby creating free blood flow to the child;
Mechanical- protects the fetus from adverse external influences (fall, shock, etc.), creates conditions for free movements;
Is a biologically active medium, in which there is a constant exchange between mother and child and the secretion of chemicals.

When effusion occurs, all these functions suffer, but the most dangerous of the complications is intrauterine infection of the fetus, because leakage occurs due to a violation of the integrity of the membranes, the tightness of the child’s protection from the external environment is lost, and its sterility is disrupted. An opportunity is created for the penetration of bacteria, viruses, fungi, etc.

Reasons

Most common causes of premature leakage of amniotic fluid are:

The mother has an infectious-inflammatory focus;
The so-called (when the cervix is not closed enough and cannot cope with the pressure of a growing child);
Mechanical injury during pregnancy;
Poorly compressed presenting part of the fetus (usually due to the woman and its other anomalies);
Multiple pregnancy and;
, (diagnostic procedures during pregnancy are performed according to genetic and other indications).

Important If there is an outpouring of water, you must call an ambulance!

How to recognize leakage of amniotic fluid

Most often, premature it can be determined immediately by the massive (about 500 ml) discharge of clear liquid. However, with a high rupture of the membranes, water may flow sparingly. This option must be distinguished from involuntary urination and normal discharge, because During pregnancy, secretion (excretory function) of the vaginal mucosa increases, and the tone of the pelvic muscles decreases. There are tests for home use, which help to recognize leakage of amniotic fluid. They can be bought at the pharmacy. If this is not possible, you can determine it yourself using the criteria presented in the table below. To do this you need:

It is good to empty the bladder and toilet the external genitalia;
Place a clean, dry cotton diaper (preferably white) and observe for 1.5-2 hours. When amniotic fluid leaks, the diaper will gradually become wet, because... Water leaks constantly until the baby is born.

Table 1: Difference between premature leakage of amniotic fluid and urine and discharge.

Sign	Amniotic Water	Vaginal discharge	urine
Duration of leakage	Constantly until the baby is born	-	-
Consistency of discharge	Liquid	Thicker, creamier	liquid
Smell	Peculiar smell of water	Depending on the nature of the discharge	Urine smell
Color	Transparent (normal), but may be greenish, brown, red, which is a bad sign - you need to call an ambulance!	Whitish	Yellowish

However, if you doubt the correctness of the definition, you need to consult a doctor who, using additional methods and examination, will help you figure it out. Additional methods include amino test and cytological examination. The amino test is based on the determination of a specific protein contained in amniotic fluid. With the cytological method, secretions are examined under a microscope. In the presence of amniotic fluid, fern-like crystals form on the glass.

Analysis for leakage of amniotic fluid

Only a specialist can reliably diagnose leakage of amniotic fluid. The following methods are used:

Gynecological examination. Its effectiveness is low, but as a primary examination it is quite acceptable. At the same time, the doctor asks the patient to cough or move. In the case of POV, liquid always appears after this. But it can easily be confused with any other possible substance.
Fern effect. If a smear of the released liquid, drying on a glass slide, has a crystalline appearance, similar in design to a fern leaf, then this is most likely amniotic fluid. Most likely, since sperm also creates a similar pattern.
Cytological examination of a smear from the posterior vaginal vault reveals the presence of water more reliably than previous methods.
Aminotest. In this case, a dye is injected intramuscularly into the patient's abdomen. And after half an hour, a sterile tampon is placed in the vagina. If it is stained, it can be reliably confirmed that there is leakage of amniotic fluid. The disadvantages of this diagnosis are its pain, high cost, possibility of infection and provoking bleeding and termination of pregnancy. Such complications occur in one case out of two hundred.
The most modern, error-free and easy way to determine leakage of amniotic fluid is the use of special tests. It is also good because it can be done at home. Its principle is based on the color of the indicator changing upon contact with different media. So, its original color is yellow. It corresponds to the normal pH level in the vagina (4.5). Other liquids color it greenish-blue. Various secretions have a pH of about 5.5. And in amniotic fluid this indicator is the highest - about 7. In this case, the color of the indicator is intense. During the examination, which lasts half a day, the pad with the identifier is glued to the underwear. And then the color of the indicator is used to judge the nature of the discharge.

Treatment of leakage

As such, there is no treatment for premature leakage of pericardial fluid. Depending on the stage of pregnancy, doctors choose different tactics. The so-called anhydrous period(time from the moment the amniotic fluid begins to leak until the birth of the child). If it lasts more than 6 hours, antibiotics must be prescribed to prevent infection. In a full-term pregnancy, spontaneous labor develops within 2-3 hours in most cases. If it is absent within 3 hours, obstetricians-gynecologists begin labor induction (stimulation of labor). However, if the cervix is immature (not ready for the birth of a child), a hormonal background is first created for its maturation. If there are contraindications for natural delivery, perform. If the pregnancy is premature, everything depends on its duration. In the period up to 35 weeks and there are no signs of infection, expectant management is used, because every day is important for the fetus. During this time, the child’s immature airways are prepared using hormonal drugs (glucocorticoids). The woman and child are constantly under the supervision of hospital doctors:

Antibacterial therapy and prevention of fetal hypoxia are carried out;
The woman is on bed rest;
The condition of the child (cardiac activity, blood flow assessment) and mother (laboratory tests, body temperature measurement) is constantly monitored.

After 35 weeks, the baby's airways are considered mature, and expectant management is not used. Depending on the readiness of the birth canal, the doctor chooses a cesarean section or natural birth.

Prevention

What kind prevention of premature leakage of amniotic fluid:

Timely treatment of isthmic-cervical insufficiency (suturing the cervix, insertion of an obstetric pessary) and threatened miscarriage (conserving therapy);
and other possible foci of infection (tonsillitis, caries, pyelonephritis, etc.).

Consequences of premature rupture of amniotic fluid

Premature leakage of amniotic fluid may have no consequences provided that the pregnancy is full-term, there is no infection and normal labor develops. The closer to the due date the waters break, the more favorable the prognosis.

Complications

Frequent consequences of premature leakage of amniotic fluid are:

Intrauterine infection of a child;
Development of infectious complications in the mother (chorioamnionitis - inflammation of the membranes, ethdometritis - inflammation of the inner layer of the uterus, infectious-toxic shock, etc.)
Premature birth;
Weakness of labor.

Early leakage of amniotic fluid

The appearance of amniotic fluid before week 37 is classified as early, and after - premature. The reasons for the manifestation of this pathology of pregnancy at different stages may be different, and the medical recommendations taken in this case also differ:

For periods up to 20 weeks, their etiology is infection and inflammation of the fetus. It is usually not possible to save a baby with such a problem. And if he succeeds, then he is born with a whole bunch of pathologies (blindness, deafness, respiratory failure, paralysis). After a thorough examination of the mother, a medical verdict is made on the possibility of continuing the pregnancy and the expected consequences of such a step.
The etiology of POV at the end of the second – beginning of the third trimester is a wide range of urogenital (sexually transmitted) infections. This is extremely dangerous for the baby, who will most likely be born disabled and may not survive. Conclusions about the outcome of pregnancy in this case are made individually after a long examination.

Why is POV dangerous?

How great the danger of amniotic fluid leakage is and how destructive its consequences can be judged by the functions they perform:

This is a reliable barrier to infection. If it is violated, the “gate of infection” opens from mother to baby.
Preventing compression of the fetus by the umbilical cord and ensuring its normal blood circulation. Otherwise, pathologies of many organs of the baby are possible.
Mechanical protection of the baby from shocks and sudden movements. The liquid medium protects him from possible injuries. Its deficiency is a kind of violation of belly safety precautions.
This liquid, unique in composition, is also the medium through which the exchange of substances takes place between mother and baby and provides its immune protection. Violation of its composition due to infection causes irreparable harm to a baby deprived of a natural shield.

The degree of danger of amniotic fluid leakage is directly related to the duration of pregnancy. At 37 weeks, although it causes anxiety, it is not too scary for the baby. The earlier the pathology is diagnosed, the less harm it can cause.

If a problem is detected late in pregnancy, it is possible to induce labor, or (in the absence of infection) use expectant management to prolong pregnancy by at least a couple of weeks. With appropriate treatment, this gives the fetus time to develop protective mechanisms. Hence, timely contact with specialists allows you to maintain pregnancy in case of untimely discharge of water in the later stages.

Most pregnant women are very sensitive to their condition at the time of bearing a child. And such a decision is not without meaning, because no matter how wonderful the doctor is, he only sees you once every 7-10 days at an appointment. And if the expectant mother does not talk about her ailments or the sensations that bother her, then you may miss the moment when prompt intervention from a specialist and the provision of qualified assistance are required. Water leakage during pregnancy refers precisely to such conditions when the woman is the first to sound the alarm and, at times, forces the gynecologist to prescribe additional tests. What signs should alert an expectant mother? Should we insist on additional tests? We will try to understand this issue in order to help all expectant mothers recognize this condition in time.

Doctors call amniotic fluid the fluid in which the baby is located during development in the mother's womb. They protect the fragile body from pressure from the abdominal wall and internal organs, and also protect the baby from various infections. Amniotic fluid is found in the amniotic sac. Its rupture occurs after the onset of labor and is one of the signs of the onset of labor. But in some cases, a woman notices leakage of water, but there are no other symptoms of impending labor. Why does this happen and what reasons can lead to this?

Reasons

Experts identify several reasons that can lead to amniotic fluid leakage at different stages of pregnancy:

Infectious diseases characteristic of the genital area. Colpitis, endocervicitis.
Inflammatory processes occurring in the genital tract.
Neoplasms of the uterus. These can be either benign (various types of fibroids) or malignant tumors, regardless of their location.
Prenatal diagnostic methods such as chorionic villus biopsy or amniocentesis.
Impact of external factors. The most common include falling or the use of physical force. Trying to climb onto a stepladder or stool to change curtains, traveling on crowded public transport during rush hour, when passengers can inadvertently hit you in the stomach...
Etc.

Premature leakage of amniotic fluid can be caused by one or more of the above factors. Try to keep their impact to a minimum.

What should an expectant mother be wary of?

Symptoms of amniotic fluid leakage can often be confused with heavy vaginal discharge, which occurs in the last stages of pregnancy. Also, slight urinary incontinence, which is also quite common in late pregnancy, can be misleading.

Many women notice stains appearing on their underwear. They will be colorless and do not have the characteristic urine odor. It is also quite difficult to confuse them with vaginal discharge, since the waters do not have a mucous base.

In order not to miss this pathology, experts advise abandoning dark underwear and switching to lighter cotton models. Be sure to use panty liners. This way, you will not only protect your laundry from getting dirty, but you will also be able to notice the regularity of discharge. Leakage of water does not only occur when laughing or coughing, like urinary incontinence. If you are at rest or lying in bed, you will not be immune from this process. It is on this feature that the test is based, which can be done at home.

Test to determine the problem

To avoid unnecessary worries and start treatment on time, doctors advise performing a simple test at home at the slightest suspicion. It will help diagnose the condition of the expectant mother and consists of several stages:

Going to the toilet. You should empty your bladder as much as possible. This is necessary in order to exclude urinary incontinence during the test period.
Going to the bathroom. Wash your genitals thoroughly and dry with a soft, clean towel. Not even a drop of moisture should remain. All procedures should be done gently, but quickly enough.
Place a clean, light sheet on the bed. And then you undress and lie down. It is necessary to lie in a calm state for at least 15-20 minutes. If during this period transparent or slightly greenish spots appear on the sheet again, you should immediately call an ambulance.

Carrying out such a test will allow you to determine with a high degree of probability that amniotic fluid is leaking. Even if, upon examination by a specialist, it turns out that you were mistaken, it is better to play it safe, because the consequences of such a condition can be very dire. After the woman is taken to a medical facility, doctors will perform several diagnostic procedures aimed at establishing the pathology.

At home, you can also perform a nitrazine test, which is based on changes in the pH of the vaginal environment. As a rule, the environment is acidic, while the amniotic fluid is slightly alkaline.

Medical examination

Doctors will definitely conduct an examination using special diagnostic methods that help to accurately determine the presence of pathology.

The most popular and fastest diagnostic method has become a smear. During the examination, the gynecologist takes a smear, which reveals crystals and particles of amniotic fluid. But it does not allow you to determine the time of leakage of water, and the picture may also be blurred if there are traces of sperm in the vagina. Ultrasound can also help determine the level of amniotic fluid.

Treatment of this pathology

Depending on at what stage of pregnancy you notice water leakage, your doctor may take appropriate measures.

In the early stages, water leakage, as a rule, goes completely unnoticed. The amount of liquid is still too small and the woman simply does not notice that water is beginning to be released. In the first trimester, this leads to abortion in 90% of cases.
For a longer period, the specialist takes a wait-and-see approach, placing the woman in a hospital for constant monitoring of her condition and the condition of the baby. Every day that doctors manage to win back the baby in the womb plays a huge role in his development. The longer a woman carries a baby and the closer the natural birth date is, the greater the chance that the baby will be born healthier and more viable. If another 6 hours have not passed since the water leaked, then the specialist prescribes antibiotics, which are aimed at preventing infection of the child in the womb, since it is no longer protected by fetal fluid.
If the PDR is close enough, then the doctor may decide to stimulate the labor process if the leakage of water accelerates and ultimately leads to rupture of the membranes. If labor does not begin within 3 hours after the start of amniotic fluid leakage, then a course of medications is used to stimulate labor. Changing hormonal levels with the help of drugs accelerates cervical ripening.

The most important thing that the expectant mother should remember is that if amniotic fluid leaks, she will not be able to do anything. All that remains is to listen to the doctor’s orders and follow all his recommendations.