Leakage of water in pregnant women. Reasons for untimely discharge of water. What is the danger of premature leakage of amniotic fluid

12.08.2019

Amniotic fluid (or amniotic fluid) is the environment surrounded by the fetal membrane, where the unborn child grows and develops during 9 months of pregnancy. Amniotic fluid is a flavoring "pillow", their task is to protect the child from environmental factors, in particular from pathogenic microorganisms, and to deliver him nutrients.

By the time of the onset of labor, the volume of amniotic fluid is approaching the 1500 ml mark. In a normal pregnancy, rupture of the amniotic membranes occurs at 38 weeks gestation or later. However, for some women, this process occurs prematurely, which often leads to unpleasant consequences.

Causes of amniotic fluid leakage

Leakage of amniotic fluid is a serious complication that requires urgent treatment. Sometimes the cause of this pathology cannot be established, but the most common factors for rupture of the amniotic membranes include:

mechanical damage (for example, falling or bruising) that injures the membranes;
infections and inflammation of the pelvic organs (endocervicitis), causing destructive changes in the membranes;
isthmic-cervical insufficiency - an opening in the cervix through which the fetal bladder can fall out;
multiple pregnancy - an increase in the load on the amniotic bladder.

Symptoms of amniotic fluid leakage

The rupture of the membranes in the last weeks of pregnancy without pathologies is characterized by the discharge of a large amount of fluid at a time and the onset of contractions some time after. This physiological process can be easily recognized, but it is not always possible to independently determine the leakage of amniotic fluid.

If the integrity of the amniotic bladder is violated, the discharge becomes more watery and plentiful, their number increases with walking, increasing physical activity.

But these symptoms of amniotic fluid leakage are subjective, and a woman may simply not notice them.

Diagnostics of the leakage of amniotic fluid

You can diagnose amniotic fluid leakage at home using the procedure below. A woman should urinate, then rinse the external genitals and dry them well with a towel. After that, put a clean light cotton diaper in the crotch for 1 hour. If the woman's fears are correct, the diaper will gradually become wet.

In addition to the diaper method, there are special pharmacy tests, for example, "AmniSure" and "Frautest". These include a swab or pad, reagent, and test strip. A tampon or pad is placed in the vagina or perineum for a specified time, then transferred to a container with a reagent, where the strip is lowered. Lines appear on the test strip: one indicates the absence of leakage of amniotic fluid, two indicate the presence of a complication.

Treatment of amniotic fluid leakage

When the amniotic membrane ruptures, treatment will differ depending on the length of the pregnancy.

Leakage of amniotic fluid at 20 weeks of gestation or less (sometimes up to 22 weeks).

Antibiotics are prescribed to prevent infection, and the amount of loss is estimated. When it makes sense (with timely treatment), tocolytic therapy is performed. During treatment, bed rest is required. In case of delayed referral to specialists, there is a high chance of severe complications in the fetus, therefore, with massive loss of amniotic fluid, doctors recommend an artificial termination of pregnancy.

Leakage of amniotic fluid in the period from 20 (22) to 35 weeks of pregnancy.

The mother-to-be takes antibiotics to rule out infection. In the case of a timely appeal to a specialist, pregnancy is maintained. For this, tocolytic therapy is used, the woman is assigned to bed rest. After elimination of the pathology, it is recommended to conduct an ultrasound scan twice a month, treatment with glucocorticosteroids is possible. Pregnancy is maintained until at least 35 weeks.

Leakage of amniotic fluid over 35 weeks of gestation.

At this time, the child is ready for birth. In the case of an independent onset of contractions after the leakage of amniotic fluid, doctors carry out childbirth. If this does not happen, expectant tactics are used, in which the doctor's task is to find the safest way of delivery. It is mandatory to take antibiotics to prevent infection.

FAQ

How to determine the leakage of amniotic fluid at home? The best choice for detecting amniotic fluid leakage at home is the AmniSure test system, which consists of a test strip, a polyester swab, and a diluent tube. What color is the amniotic fluid when leaking? Normally, the color of amniotic fluid during leakage should be light yellow. How much does the amniotic fluid leak test cost? The average price for the AmniSure test is 1,000 rubles. The cost of a test strip for determining the leakage of amniotic fluid "Frautest" is 400 rubles.
Leakage of amniotic fluid is a complication that can lead to fetal death. However, timely prevention minimizes the chance of its occurrence, therefore, when planning to conceive a child, a woman should cure all possible diseases of the genital organs, and during pregnancy, carefully monitor her condition and health. But even if the expectant mother has a leakage of amniotic fluid, the main thing is to consult a specialist in a timely manner, then, using modern methods of treatment, it becomes possible to preserve the pregnancy.

Amniotic fluid leakage - is it there or not? This question often arises among expectant mothers, and not only those who are carrying their first child. Indeed, this phenomenon can be confused with others, completely natural and safe for mother and child. How to determine in time that the amniotic fluid is leaking, is it necessary and how to urgently see a doctor?

If you notice that the vaginal discharge has sharply increased, it appears in a trickle, wet your underwear - try the following experiment. Wash yourself thoroughly, then wipe dry, put a piece of thin white cloth in your underwear. If the naked eye shows symptoms of amniotic fluid leakage in the form of a growing wet spot on a rag pad, you need to go to the doctor.

What can a doctor do? First of all, he will conduct a gynecological examination. If the cervix is not shortened, closed, and no discharge is visible to the eye, it is most likely not water. Any more or less experienced gynecologist knows what kind of leakage of amniotic fluid has signs, mistakes are unlikely. In addition, the doctor may refer the woman for an unscheduled ultrasound scan. But it will be even better and more reliable to conduct a test for leakage of amniotic fluid, but, unfortunately, such diagnostic tools are not available in every antenatal clinic. But there is almost every hospital. Within 10 minutes you will know for sure whether it is water or not. If you don’t want to go to the hospital, you can buy your own test (amniotest) at the pharmacy, its cost is about 400 rubles, and come to the doctor's office immediately with it. Your doctor will take a swab from your vagina for diagnosis.

Remember that amniotic fluid plays a large role in a child's development. Only the integrity of the fetal bladder guarantees those sterile conditions in which the fetus develops. After 12 hours have passed since the rupture of the membranes, the risk of infection of the membranes increases sharply, and this threatens with sepsis for the mother and death for the child. It is clear that it is best to give birth as soon as possible after the bladder has burst, but this is only if the pregnancy is full-term or close to it. But what if amniotic fluid leaks early in pregnancy? Doctors, whenever possible, always try to save the life of the child. A woman with leakage of amniotic fluid is placed in the pregnancy pathology department and antibiotics are constantly administered to prevent various infections. That is, the pregnancy is prolonged as much as possible, and then labor is stimulated. At a minimum, it is desirable to hold the pregnancy up to 32 weeks - at this time, the fetus is already quite viable.

Premature rupture of membranes (PROM) and associated with it is one of the main problems in modern obstetrics.

This complication, which occurs in 10% of women with a normal pregnancy and ranks first among the causes leading to premature birth. About 38% of all preterm births are provoked by PROM, and 20% of all perinatal deaths occur as a result of complications associated with leakage of amniotic fluid and preterm labor.

Why do so many complications arise, how to determine that you are at risk, and most importantly, what to do in this case? We will try to understand everything, starting with the most basic.

The role of amniotic fluid

Amniotic fluid (amniotic fluid) is produced by the inner layer of the amniotic fluid - the amnion, which forms a closed, sealed cavity. The outer shell, the chorion, is denser and protects the amnion from damage.

The amniotic fluid plays the role of a kind of shock absorber, protecting the child from shock when the mother turns or falls, does not allow strong uterine muscles to squeeze the fetus and the umbilical cord. The amniotic fluid is involved in the nutrition and development of the baby. But most importantly, the amniotic fluid is sterile. The fetal bladder is an obstacle to microorganisms that can harm a developing baby. That is why violation of the integrity of the bubble is so dangerous.

Causes of premature rupture of membranes

Infectious diseases of the genital organs and inflammatory diseases of other organs and systems in the mother.

This is one of the main reasons for the development of the PRPO. The toxins released by bacteria during their vital activity lead to thinning of the walls and, as a result, to microcracks or ruptures of the fetal membrane. Often women do not even suspect that they have an infection, but even an ordinary one can already cause PRPO.

Clinically narrow pelvis and abnormal position of the child

Bladder rupture occurs already during childbirth. In the normal position of the child, when the head is inserted, a belt of contact is formed and the waters are divided into front and back. With a transverse or breech presentation of the child, the contact zone is not formed, and all the waters rush into the lower part of the fetal bladder. This leads to the fact that the shells do not withstand the pressure and burst.

Insufficiency of the cervix

In this case, the cervix is not completely closed, this leads to the fact that the fetal bladder protrudes into the cervical canal, becomes easily infected and can rupture even with little physical exertion.

Amniocentesis and Chorionic Biopsy

These diagnostic methods can sometimes lead to rupture of the membranes.

Bad habits of the mother

Women who smoke and abuse alcohol are more at risk of PROM.

Multiple pregnancies and uterine malformations

Any developmental abnormality or multiple pregnancy dramatically increases the likelihood of PROM.

How to recognize that PRPO has occurred and there is a leakage of amniotic fluid?

If there has been a massive outpouring of amniotic fluid, it is difficult to confuse it with anything else. But the problem is that when examining a woman with suspected PRPO, 47% of doctors doubt the correct diagnosis. With microcracks or lateral ruptures, water can drip dropwise almost imperceptibly, and it is rather difficult to determine that this is a PRPO.

Signs that should alert

The usual discharge became more abundant and watery.
The discharge becomes more when the position of the body changes.
The abdomen visually decreases in size or the height of the fundus of the uterus becomes lower.

In the event of the above symptoms, it is necessary to exclude the leakage of amniotic fluid as soon as possible.

Complications

Premature rupture of membranes increases infant mortality by 4 times. The most common complications of PROM are infection and respiratory distress syndrome.

Respiratory distress syndrome. The most severe complication in premature babies. The child's lungs have not yet developed and cannot independently participate in the act of breathing. They stick together from the inside, preventing air from circulating. These children need expensive surfactant injections and mechanical ventilation.
Infectious complications in mother and child. The most common complication. It develops regardless of the gestational age 6-32 hours after the rupture, causing dire consequences. Sometimes they are so serious that they cannot save the child.

In addition, children suffer from hypoxia, premature or abnormal labor may begin.

Standard diagnosis of amniotic fluid leakage

Today there are several methods for detecting leakage.

The most common and familiar to many women is the nitrazine test, or litmus strip. This indirect diagnostic method determines the acidity of the vagina. A healthy vagina has an acidic environment, and when amniotic fluid enters, it shifts to the neutral side, as indicated by the test. But the acidity of the vagina also changes with infection, the presence or leakage of urine. Therefore, in 30-40% of cases, the tests give a false-positive result, and the woman is subjected to unjustified hospitalization.
Arbrisation symptom. The vaginal contents are collected. In the presence of impurities of amniotic fluid, it crystallizes with the formation of a pattern similar to fern leaves. Infection, semen, or urinary leakage can also affect the test result.
Amniocentesis. If other diagnostic methods give a negative result, but the condition of the pregnant woman causes concern, amniocentesis with a dye is performed. A harmless dye is injected into the cavity of the amniotic bladder, and a clean tampon is placed in the vagina. If the tampon gets stained, it means 100% that there is a leak. This method is used very rarely and in extreme cases, since in itself it can provoke a rupture.

amnishua-amnisure ">

Modern immunological diagnostic method using the Amnishua test (AmniSure).

Unlike previous methods, the test does not require the assistance of medical personnel and can be performed by a woman herself at home.

The principle of the test is based on the determination of placental alpha-1-microglobulin (PAGM-1), which is present in large quantities from early pregnancy in the amniotic fluid and is not found in other physiological body fluids. The Amnishua test even reacts to traces of PAMG-1 in the vagina. Its sensitivity is 98.9% and is on par with dye amniocentesis in terms of accuracy.

How to use the test?

Diagnostics takes about 5 minutes and does not require the use of mirrors. The Amnishua kit includes a test strip (similar in appearance to a pregnancy test), a reagent bottle and a sterile swab. With the help of a tampon, a small amount of vaginal discharge is taken, after which the tampon must be placed in the vial, shaken slightly, then the test strip is lowered into the vial, and the results can be read. Two red lines - there is a gap, one line - there is no gap. Even if one of the lines has a faint pink tint, it also suggests that there is leakage.

Do I need a test if there is no suspicion of leakage?

It is advisable to have such a test for every pregnant woman in her purse, especially if she goes out of town or on vacation. A rupture can occur spontaneously, and the nearest medical center is too far away. If the test gives a positive result, it means that there is a gap of 100%, and an urgent need to go to the hospital. And if the test is negative, then you can safely enjoy your rest further. The fact is that during pregnancy, under the influence of progesterone, vaginal secretion increases, and sometimes it can be so abundant that some women confuse it with amniotic fluid. In this case, adequate diagnosis is also needed in order to avoid unnecessary hospitalization and preventive measures aimed at eliminating leakage.

It should be noted that the test only determines the fact of rupture, and does not indicate the degree and presence of complications. The Amnishua test is not curative or prophylactic - it is only a diagnosis, and if the result is positive, you should immediately seek medical help.

Management of pregnant women with PRPO

There are two tactics for managing pregnant women with PROM.

Premature pregnancy before

Pregnancy is maintained as long as possible. In some cases, up to two months or more. But only in a hospital setting! The woman is in a sterile delivery unit, where the fetus is constantly monitored. Antibiotics, drugs that accelerate the maturation of the lungs and tocolytic drugs that prevent the uterus from contracting are administered. If the condition of the fetus worsens, infection occurs or detachment begins, the woman is given an emergency delivery.

Full-term pregnancy and more

In this case, the woman is also placed in a hospital and monitored. They carry out a thorough sanitation of the vagina and monitor the condition of the child. Stimulation is performed only if the child's condition worsens.

Remember that amniotic fluid leakage is not the norm! Water cannot seep or accumulate. If the test showed a positive result, be sure to seek help from doctors - they will help maintain the pregnancy and give birth to a healthy baby.

Irina Topal doctor of the highest category, medical
AmniSure International consultant

Discussion

Yeah, very good test. They tortured me so much. Now they poked some pieces of paper, then all sorts of strokes. It is not clear what they did there. Amnishur advised - they bought it. The result is positive. They were immediately placed in a sterile ward, where I stayed until the very birth, for which I bow to the doctors. My daughter was born healthy and without complications.

A very interesting, albeit long article. My colleagues from the Center for Obstetrics and Gynecology are very pleased with the use of the described test. It is better to stock up on them just in case, especially now, before the summer period.

05/31/2011 18:28:09, Frame

Comment on the article "What is amniotic fluid leakage and what is the threat?"

It is common practice to issue a hospitalization referral to a 40-week-old pregnant woman. A woman often does not even know that she can refuse him. Obediently following the instructions of the doctor, she goes to the maternity hospital and even without labor activity ends up in the prenatal ward (since the time is the same!), Where they try to stimulate labor activity with the help of instruments and medications. What happens then? The baby did not give a signal to the mother's body about readiness for childbirth, the cervix is also often ...

What is oligohydramnios? This is a special condition during a woman's pregnancy, of a pathological nature, in which the amniotic fluid surrounding and protecting the child in the amniotic cavity is significantly less than its recommended indicators. As a rule, the diagnosis of oligohydramnios is made in pregnant patients much less frequently than polyhydramnios. The low content of amniotic fluid, in the overwhelming majority of cases, indicates various abnormalities occurring in the development of the fetus, and can cause ...

Pregnancy at 37-40 weeks is full-term and labor can begin at any time. And there are three main signs that indicate their imminent approach. Discharge of the mucous plug. It can occur 2 weeks before delivery, but most often within a day. The cork looks like a small lump of pinkish, brown or yellowish mucus. Often, the cork does not come off entirely, but in parts. During pregnancy, she closes the entrance to the cervical canal, protecting the fetal bladder from ...

Video [link-1] In the video, the professor describes in detail all the existing methods for diagnosing amniotic fluid leakage, dwelling on each in detail and considering the advantages and disadvantages. In short, the most accurate diagnostic method in world practice is the Amnishur test. Everything else is a waste of time and money. The professor is not ours, but the head of the European College of Obstetricians and Gynecologists. The video is small, I recommend watching it - it is very informative and removes many questions.

Amnishur [link-1] According to various authors, the frequency of preterm birth is from 5 to 12% per year and over the past 20 years has tended to increase, and this is despite the rapid development of medicine. About 40% of all premature births are the result of early rupture of amniotic fluid, which leads to functional underdevelopment of organs and systems, perinatanal mortality and, in more than half of cases, to intrauterine infection of the fetus. However, all unwanted ...

Source [link-1] This site also has a large number of other useful articles and there is a free doctor's consultation in the chat or in the advisory section. Pregnancy is not a disease, and if there are no contraindications in each individual case, a woman can lead a contented active lifestyle until a certain date. Go in for sports, take long walks and go on vacation to the country house or even abroad, and the optimal period for this is the period from 14 to 30 weeks ...

If the pregnancy is normal, the parents-to-be can have sex, it will not hurt the child, and as the due date approaches, it is even desirable to do this. The prohibition on having sex during pregnancy, if imposed, is most often, for a while, and it is better to check with the attending physician how long abstinence should be maintained. Doctors of antenatal clinics usually warn expectant mothers if sex is contraindicated for them, and when everything is going well, they do not always explain that intimate relationships are not dangerous ...

Source [link-1] Traditional methods Examination in the speculum Technique: Visual determination of the leakage of amniotic fluid in the posterior fornix of the vagina. During the study, the woman is asked to cough. Accuracy: Subjective Disadvantages: Examination in mirrors is required for research. Urine, semen, and other fluids can easily be confused with amniotic fluid. Nitrazine (pH) (all existing tests from various manufacturers, seals and litmus tests that react to leakage ...

What is amniotic fluid leakage and what is the threat? Amniotic fluid during pregnancy and childbirth: how much and why? This is called amniotic fluid leakage.

Discussion

It’s not good if the water really does not work, there may be an infection of the water. Go to a paid diagnostic center and do a water test. But I personally had strong discharge in the later stages, I bought and did an amnio test.

By the way girls, infa for Muscovites. Yesterday I tried to call the gynecological ambulance ... So I continuously dialed for half an hour, it was busy !! In the end, I never got through ... So keep in mind ..

In addition to the joyful expectation of the birth of a baby, 9 months of pregnancy also bring a lot of worries and worries about his condition. Is he comfortable in the stomach, will he be born on time, and what do all the changes that occur throughout this time with the woman's body mean? Which of them can be classified as normal, and which signal danger and require immediate medical attention? All these and many other questions concern pregnant women, forcing some ...

All 9 months, a baby is growing under your heart, which is surrounded not only by your love and affection, but also by reliable protection from the amniotic membranes and amniotic fluid. The fetal bladder forms an airtight reservoir with a sterile environment that protects the baby from infection. Normally, rupture of membranes and rupture of amniotic fluid occurs before childbirth (when the cervix is fully open) or directly during childbirth. If the integrity of the bubble has been broken before, this is ...

Discussion

11. When examining, is the doctor always able to confidently diagnose premature effusion of water?
With a massive rupture, it is not difficult to diagnose. But, unfortunately, in almost half of the cases, doctors of even leading clinics doubt the diagnosis if they rely only on examination data and old research methods.

12. Is it possible to diagnose premature effusion of water using ultrasound?
Ultrasound examination makes it possible to tell whether a woman has oligohydramnios or not. But the cause of low water can be not only rupture of the membranes, but also impaired renal function of the fetus and other conditions. On the other hand, there are cases when a small rupture of the membranes occurs against the background of polyhydramnios, for example, with kidney pathology of a pregnant woman. Ultrasound examination is an important method of monitoring the condition of a woman who has a premature rupture of the membranes, but does not answer the question of whether the membranes are intact.

13. Is it possible to determine the leakage of water using a litmus test?
Indeed, there is such a method for determining amniotic fluid, based on determining the acidity of the vaginal environment. This is called the nitrazine test or amniotest. Normally, the vaginal environment is acidic, and the amniotic fluid is neutral. Therefore, the ingress of amniotic fluid into the vagina leads to the fact that the acidity of the vaginal environment decreases. But, unfortunately, the acidity of the vaginal environment also decreases in other conditions, for example, with infection, urine, semen. Therefore, unfortunately, a test based on determining the acidity of the vagina gives a lot of both false positive and false negative results.

14. In many antenatal clinics they take a swab on water, how accurate is this method for diagnosing premature outpouring of water?
Vaginal discharge containing fetal water, when applied to a glass slide and dried, forms a pattern resembling fern leaves (fern phenomenon). Unfortunately, the test also gives a lot of inaccurate results. In addition, in many hospitals, laboratories are open only during the day and on weekdays.
15. What are the modern methods for diagnosing premature rupture of the membranes?
Modern methods for diagnosing premature rupture of the membranes are based on the determination of specific proteins, which are abundant in the amniotic fluid and are not normally contained in the vaginal discharge and other body fluids. To detect these substances, an antibody system is developed that is applied to the test strip. The way these tests work is similar to a pregnancy test. The most accurate test is a protein-detecting test called placental alpha microglobulin. The trade name is AmniSure®.

16. What is the accuracy of the Amnishur test?
The accuracy of the Amnishur test is 98.7%.

17. Can a woman put the Amnishur test on her own?
Yes, unlike all other research methods, the Amnishur test does not require examination in mirrors and a woman can put it at home. Everything you need for the test is included in the kit. This is a tampon, which is inserted into the vagina to a depth of 5-7 cm and held there for 1 minute, a tube with a solvent, in which the tampon is washed for 1 minute and then discarded, and a test strip, which is inserted into the test tube. The result is read after 10 minutes. In case of a positive result, as with a pregnancy test, 2 strips appear. If the result is negative - one strip.

18. What if the test result is positive?
If the test is positive, you need to call an ambulance or go to the hospital if the pregnancy is more than 28 weeks and to the gynecological department of the hospital if the pregnancy is less than 28 weeks. The sooner treatment is started, the greater the chances of avoiding complications.

19. What if the test is negative?
If the test is negative, you can stay at home, but at the next visit to the doctor, you need to talk about the troubling symptoms.

20. If more than 12 hours have passed from the moment of the alleged rupture of the membranes, can a test be performed?
No, if more than 12 hours have passed since the alleged rupture and the signs of water leakage have stopped, then the test may show an incorrect result.

Questions and answers about premature amniotic fluid leakage

1. How common is premature rupture of membranes?
True premature rupture of the membranes occurs in about every tenth pregnant woman. However, almost every fourth woman experiences certain symptoms that can be confused with premature rupture of the membranes. This is a physiological increase in vaginal secretion, and a slight urinary incontinence in the later stages of pregnancy and profuse discharge during infection of the genital tract.

2. How is the premature rupture of the membranes manifested?
If a massive rupture of the membranes has occurred, then it cannot be confused with anything: a large amount of clear liquid, odorless and colorless, is immediately released. However, if the gap is small, doctors also call it subclinical or high lateral tear, then it can be very difficult to make a diagnosis.

3. What is the danger of premature rupture of the membranes?
There are 3 types of complications that can lead to premature rupture of the membranes. The most frequent and severe complication is the development of an ascending infection, up to the sepsis of the newborn. In a premature pregnancy, premature rupture of the membranes can lead to premature birth with all the consequences of the birth of a premature baby. With massive outpouring of water, mechanical injury to the fetus, prolapse of the umbilical cord, placental abruption is possible.

4. Who is more likely to have ruptured membranes?
Risk factors for premature rupture of the membranes are infection of the genital organs, overstretching of the membranes as a result of polyhydramnios or with multiple pregnancies, abdominal trauma, incomplete closure of the uterine pharynx. Premature rupture of membranes during a previous pregnancy is an important risk factor. However, in almost every third woman, rupture of the membranes occurs in the absence of any significant risk factors.

5. How quickly does labor occur with a premature rupture of the membranes?
This is largely determined by the gestational age. In full-term pregnancies, half of women experience spontaneous labor within 12 hours and more than 90% within 48 hours. With premature pregnancy, it is possible to maintain the pregnancy for a week or longer if the infection does not join.

6. Can a small amount of amniotic fluid be released normally?
Normally, the membranes are hermetically sealed and no, even the smallest, penetration of amniotic fluid into the vagina occurs. For leakage of amniotic fluid, women often mistake increased vaginal secretion or mild urinary incontinence.

7. Is it true that in case of premature outpouring of water, pregnancy is terminated regardless of the term?
Premature rupture of the membranes is indeed a very dangerous complication of pregnancy, but with timely diagnosis, hospitalization and early treatment, premature pregnancy can often be prolonged if no infection occurs. With a full-term pregnancy and close to full-term, as a rule, the onset of labor is stimulated. Modern methods of diagnosis and treatment, in this case, allow you to smoothly prepare a woman for childbirth.
8. If there is a premature rupture of the membranes, but the mucous plug has not come off, does it protect against infection?
The mucous plug really protects against infection, but when the membranes are ruptured, one protection by the mucous plug is not enough. If treatment is not started within 24 hours of the rupture, serious infectious complications can occur.

9. Is it true that the waters are divided into front and back waters and the outpouring of the front waters is not dangerous, often occurs in the norm?
Fruit waters are indeed divided into anterior and posterior, but no matter where the rupture occurs, it is the gateway for infection.

10. What precedes the breakup?
By itself, the rupture of the membranes is painless and without any precursors.

I read on the internet about the leakage of amniotic fluid and is now terrified. Didn't find what you were looking for? Check out other discussions: What is amniotic fluid leakage and what is the risk?

Discussion

In pharmacies, they sell a test to determine the amniotic fluid, called an amniotest. If you are very worried, IMHO will go to the RD, they will give you a test (such a test is done at 17 RD, in RD at 7 GB - for sure). Leakage of water is not good - infection of the fetus is possible

I forgot to add that the watery discharge is about a little more than a teaspoon.

All the same, how can this be determined and what is the threat. Leakage of amniotic fluid during pregnancy. Print version. 4,2 5 (169 ratings) Rate the article.

Discussion

You can order an AmniSure test on an Internet, it is done at home, the issue price is 900-1000r, I had a similar paranoia, starting from your term to 32-33 weeks. I did this test three times - the water is ok)))

a week ago I was discharged from the hospital ... got there on the same suspicion ..
it was like this: starting at 2 am and up to 12 noon four times after using the toilet, I did not manage to get to bed, as something poured down my legs. called my doctor. She recommended not to sit at home, go to the hospital and do a water test. I arrived, the test showed a negative result, but they didn’t let me go, they gave me a gastric hospital. For 11 days they watched me, did an ultrasound, everything was ok there too, the bubble was intact. TTT.
It seems to me that it is better not to risk it, but to see a doctor as soon as possible! since if it really is leaking water, then this is very bad. I was told that perhaps it threatens premature birth! therefore, for your own peace of mind, it is better to lie in the taxiway.
Also, are your kidneys healthy? it may not be water, but the reaction of diseased kidneys. My kidneys on the ultrasound were in order, that it was not clear! did not repeat itself any more.

Good day, my dear future mothers! Do you know what complication of pregnancy any of you should be warned about? It provokes every fifth premature birth. It is the cause of every fifth intrauterine death of a child. Even a doctor may not recognize it in time. And at the same time, it is easy to identify it at home - you just need to know what to do. Leakage of amniotic fluid how to define this formidable condition, what is it in general, and what are its signs? Calm down, now we will arm ourselves with the necessary knowledge!

I think any expectant mother has a rough idea of what amniotic fluid is. But I will repeat a little to systematize the information. A baby lives in the uterine cavity until birth for 9 months. There he is surrounded by his own protective shell - the fetal bladder. This is something like the shell of an egg, only soft. The fetal bladder is completely sealed and reliably protects the baby from premature contact with the outside world.

Especially from an encounter with pathogenic bacteria, for which the child is not yet completely ready. Normally, this barrier is not violated until the very birth.

The fetal bladder will rupture with the onset of attempts. And some children manage to be born in it - this is where the expression "was born in a shirt" came from.

The cavity of the fetal bladder is filled with liquid, in which the baby swims like an astronaut in zero gravity. It is secreted by the amnion - the inner layer of the membranes. Therefore, another name for amniotic fluid is amniotic fluid.

It has several important functions:

She straightens the uterus so that the baby can move freely.
Absorbs shocks and shocks.
Stabilizes the temperature around the baby.
Participates in the nutrition of the fetus.
Prevents the umbilical cord from pinching during labor.

And in the first stage of labor, the fetal bladder filled with amniotic fluid, like a wedge, opens the cervix from the inside ...

What amniotic fluid looks like

The type and amount of amniotic fluid changes over the course of pregnancy. At first they are yellowish, then brighten, and in the third trimester, at 38, 39, 40 weeks they become whitish and opalescent.

It is clear that only obstetricians and gynecologists will be able to appreciate these beauties. They are sometimes judged by the nature of the amniotic fluid during childbirth, for example, the approximate duration of pregnancy. A woman is unlikely to be able to collect and examine the amniotic fluid.

It is just worth remembering that amniotic fluid:

Light
Liquid
Warm
Without smell
They can pour out in any quantity.

Amniotic fluid

The amount of amniotic fluid during pregnancy increases with the growth of the fetus. Maximum of them can be typed 1.5-2 liters. Anything more is already considered a pathology.

But it is not at all necessary that all this amount will pour out at once. Imagine a balloon filled with water. If you poke a tiny hole in it, the water will drip out. A similar situation is possible during pregnancy. A woman may misunderstand this condition. And this is fraught with disaster.

How long can water leak? Anyone. Why this happens is not known exactly. They provoke early rupture of amniotic fluid:

infections,
a narrow pelvis in a woman,
polyhydramnios,
multiple pregnancy
abnormal presentation of the fetus,
bad habits and serious diseases in the mother,
injury.

As a result, large or small tears appear in the membranes, which should reliably protect the child. This situation requires immediate medical attention. But the problem is that diagnosing these conditions can sometimes be difficult.

How to determine the leakage of amniotic fluid

We got to the main question: how to determine the leakage of amniotic fluid. This problem worries not only pregnant women, but also obstetricians and gynecologists. After all, if there was a "depressurization" of the membranes, then an infection can penetrate to the child. And the gap may also increase, and then there will be a premature rupture of amniotic fluid - and premature birth ...

Signs of a leak

It may seem that the symptoms of such a "leak" are obvious. When some kind of extraneous liquid flows out, it is hard not to notice it. But a woman, when she feels the water leaking, can confuse this with two states:

Urinary incontinence.
Inflammatory discharge.

Wet laundry, stains on the pads, liquid profuse discharge - how do you know if this is amniotic fluid?

It is best if you trust your doctor. But if it is far away or waiting for a long time, there is an easy way to test yourself. To do this, take three simple steps:

Go to the bathroom and get rid of excess fluid.
Wash and dry yourself.
Lie naked on a light dry sheet and lie down for 15-20 minutes.

Are there damp spots on the sheet? In this case, a "leak" can be suspected. Urgently to the gynecologist!

If you managed to find a problem using this method, this is good (in terms of the fact that now you will not waste precious time and ask for help in time)! But how often does it happen that the liquid oozes out in drops. How to distinguish drip from discharge?

Previously, only gynecologists could answer this question. Now you can find out everything at home. How can a doctor determine that it is amniotic fluid that is leaking, and not urine or vaginal secretions? He has several ways:

Examination: The doctor may simply see the transparent moisture when viewed in the mirrors.
Smear: when dry, the amniotic fluid forms a pattern on the slide that resembles frosty patterns - a "fern leaf".
Ultrasound : ultrasound can be used to judge the level of amniotic fluid, the condition of the fetus and membranes.
The nitrazine test is the determination of the pH of the secretions. With the leakage of water, the pH becomes neutral from acidic.
Amniocentesis: A safe dye is injected into the uterine cavity through a puncture in the abdomen. If after that staining of the tampon in the vagina appears, then there is a water leak. This method is only used in particularly difficult cases.
Immunological tests.

Outpouring tests

Immunological tests respond to specific substances found only in the amniotic fluid. There are two types of tests:

To determine the PSIFR-1
To determine PAMG-1.

Both of these tests detect specific proteins. I will not decipher their names - you will forget them right away anyway. Here's what is important for you and me: the accuracy of tests for PAMG - 1 - 98.8%. On PSIFR-1 - four times lower.

The PAMG-1 Amnishur test was recognized as the gold standard. Its accuracy is almost 99%, it allows you to determine even traces of amniotic fluid.

In addition, there are tests for home use that are pH based. For example, the famous Frautest amnio pads. They are much cheaper than immunoassay. But they give 17% false negative results and 13% false positives. Whether it is worth using them is up to you. In any case, when purchasing diagnostic test strips or pads, ask about their mechanism of action and the accuracy of the results.

Premature rupture of amniotic fluid

Strictly speaking, everything that we discussed with you, including dripping water, is considered a premature outpouring. However, in everyday life, this is more often called a massive outpouring of water before the onset of attempts.

In this case, the symptoms are obvious. You suddenly find yourself wet, a warm transparent liquid flows down your legs, which you cannot hold. Her pressure increases with coughing, straining, contractions.

I understand that the situation is exciting. But for doctors, remember two things:

color of discharge
their number (what size spot or puddle did you see?)

And without delay - to the hospital! It is highly desirable that your baby is born within the next 6 hours.

For those who still do not believe that you need to go to the hospital right away, or are delaying it from fear of childbirth, I will list the complications that threaten you and your baby:

Infections, sepsis.
Lack of oxygen in the child.
Placental abruption and heavy bleeding.
Abnormalities of labor.
Intracranial hemorrhage in a child
Deformation of the arms and legs of the fetus.

Hope everything is clear. In each case, if water leakage is detected, obstetricians-gynecologists have to solve a difficult question: "to give birth or not to give birth?" Or rather, to give birth now or to let the baby grow up, despite the depressurization of the fetal bladder.

If the baby is full-term, then the issue, as a rule, is resolved in the direction of childbirth. The main thing is to seek medical help in time, and not to wind yourself up with doubts at home!

Let this problem not touch you, my dears! But still. If you are going on a long trip in the third trimester, bring the Amnishur test with you. To be fully armed in case of anything. After all, now you know how to determine the leakage of amniotic fluid! And if there are pregnant friends in your environment, share the article with them, maybe it will be useful for them too.

Until next time, Anastasia Smolinets

Amniotic fluid is a valuable aid for the successful carrying of a baby during pregnancy: it is the environment where the baby grows and develops before it is born. Amniotic fluid creates ideal conditions for the intrauterine life of the fetus and protects it from possible harmful effects. In addition, due to their biochemical composition, they become part of metabolic processes and prevent the growth of bacteria. The baby and the surrounding amniotic fluid are protected by the fetal bladder. Its integrity is extremely important for the preservation of all the properties of amniotic fluid. The leakage of these waters is dangerous, has its own symptoms and should be monitored by a gynecologist.

Most often, the fetal bladder ruptures during labor shortly before the onset of the persistent period. If the integrity of the amniotic membrane is violated earlier, it does not matter, at the 22nd week or immediately before childbirth, then this phenomenon is considered premature.

Symptoms of amniotic fluid leakage

Emptying the fetal bladder can occur in different ways. In some cases, it is accompanied by a violent outpouring of amniotic fluid, then the rupture of the fetal membrane is obvious and does not require confirmation. But it is not uncommon for water to leak from time to time in small quantities, and this resembles an overly abundant discharge that can be caused by urinary incontinence or thrush. In this case, it is important to determine in time whether the fetal bladder is intact or not.

How to tell if water is leaking?

First you need to remember: the amniotic fluid is absolutely transparent, colorless and odorless. There are several ways to find out if an unusually fluid discharge during pregnancy is amniotic fluid:

A pad for detecting amniotic fluid at home.
Examination by a doctor on a gynecological chair.
Taking a special smear.
An ultrasound scan to determine the amount of water in the uterus.

The first is a home leakage test. It is sold in any pharmacy and is a special pad that reacts only to amniotic fluid. The test does not recognize normal water, urine or vaginal discharge.

However, only a doctor can reliably determine the true discharge of water. To do this, it is necessary to examine the pregnant woman on the gynecological chair. Coughing will help to understand whether it is water: if the integrity of the fetal bladder is really broken, then as a result of an increase in intra-abdominal pressure when coughing, the doctor will see another portion of amniotic fluid.

To confirm the diagnosis, the gynecologist will also take a smear to detect the substances present in the amniotic fluid in the secretions. If the test is positive, the test strip changes color, as does the home pad.

An ultrasound examination will help in determining the amount of water in the uterus.

Why is the leakage of amniotic fluid dangerous?

Given the fact that the main task of the amniotic membrane is to protect the baby from infections, chorionamniotitis should be called among the most severe consequences of premature rupture of the membranes. This inflammatory disease primarily captures the membranes, and then, as it develops, it causes infection of the fetus in the womb. In the early stages, this can lead to malformations in the child and miscarriage. Starting from the fourth month of pregnancy, the infection affects various organs of the fetus, placental insufficiency, developmental delay and even intrauterine death of the baby are possible.

Leakage of amniotic fluid can develop into premature labor. In this case, the child is born prematurely, requires special care for survival, is susceptible to neurological diseases and delayed psychomotor development in the future.

In addition, as a result of a decrease in the amount of water surrounding the fetus, the walls of the uterus press on it more strongly, which can lead to curvature of the limbs. In the scientific literature, this is called "fetal crash syndrome".

So, it is obvious that the leakage of amniotic fluid before the due date of birth is a very dangerous phenomenon. Therefore, the detection of watery discharge during pregnancy requires immediate medical attention and, if necessary, taking measures to prevent complications.