How to feel that the waters have departed. How to understand that a pregnant woman will soon drain away? How to understand that the water has moved away, and how to distinguish it from discharge

29.07.2019

Every woman in an "interesting" position is well aware that with the approach of childbirth, the likelihood of sudden discharge of amniotic fluid.

With no experience, expectant mothers listen to the slightest change in their body, fearing to miss this important moment.

They are even more worried about the question of what to do when the water broke during pregnancy.

Is it always the flowing away signal the onset of labor or can you calmly wait until the appointed time?

How to understand that the waters have moved away?

Throughout pregnancy, the baby grows and develops in a special shell filled with liquid. It is this fluid that is called amniotic fluid. In fact, the amniotic fluid is formed from the maternal blood plasma and is constantly renewed and, if necessary, replenished.

This substance is absolutely sterile, which provides reliable protection for the developing body from various infections. The content of a large amount of immunoglobulin in the liquid is an additional barrier against external influences.

A comfortable water environment allows the baby to turn freely and prevents the bladder from compressing the uterus. Regardless of the environmental conditions and the condition of the mother, constant pressure and temperature indicators are maintained in the amniotic fluid. Due to the presence of water, the baby is reliably protected from physical and noise external influences.

If you feel the release of warm fluid from the vagina (this usually happens when a woman is lying and trying to get up), in an amount of more than 100 milliliters or more (it happens that a liter and a half is poured out at once), which do not have a specific smell of urine - these are they, the water has departed.

Why does the water drain?

As the child grows, the volume of the surrounding waters also increases. By the time of delivery, their number can reach 1.5 liters. Excess amniotic fluid or a low content is considered pathological conditions that threaten the normal development of the baby.

With the approach of labor, the hormonal background of the expectant mother begins to change rapidly. Such processes contribute to the natural birth process. Under the influence of the hormone oxytocin, which also contributes to the contraction of the uterus, the fetal membrane becomes looser. And the pressure in the bladder increases significantly under the onslaught of the baby, trying to leave the hostile pulsating uterus.

Fetal membranes do not withstand, and their rupture occurs. This moment is accompanied by the discharge of water during pregnancy. The woman can even hear the bubble burst. Unusual popping or clicking sounds confirm the violation of the integrity of the shell.

Ideally, the discharge of water occurs after the first stage of childbirth, when the cervix is open by more than 4 cm. This development of events is considered optimal for both the baby and the woman in labor.

But in life, processes do not always coincide with descriptions in reference books. This does not mean that other options necessarily confirm the pathology. But the woman must be prepared for the premature discharge of water.

How does the water drain?

Some pregnant women, on the eve of childbirth, are even afraid to take a shower so as not to miss such an important moment.

Anxiety is also present about involuntary urination, which often occurs over long periods. But the discharge of water has its own specific features, and it is difficult to confuse them with other physiological processes.

Water can drain in completely different ways. So, if the baby is prepared for childbirth and took the correct position, his head rests against the bosom and the amniotic fluid is divided by his body into two parts.

The anterior part of the amniotic fluid contains up to 250 ml of fluid. It is this liquid that is poured out when the fetal membrane bursts. Women feel like they are pouring out a lot more fluid. Moreover, this flow cannot be stopped by muscle tension or a change in body position.

In order for a woman to imagine how the process will take place, in antenatal clinics in the classroom, they are advised to experiment with their own perception in advance at home. To do this, it is recommended to pour a glass of warm water on your feet in the shower. Such an experiment will allow you to remember the sensations.

In cases where the child takes the wrong position or did not have time to roll over, the volume of the outgoing fluid can be much larger. Sometimes all the water can pour out at once up to 1.5, or even up to 2 liters. Such a "waterfall" is difficult to confuse with ordinary discharge. But even in this case, the waters can all gush out at the same time, or they can flow out in a small trickle.

Another option for draining water during pregnancy is dripping... Such situations arise if the fetal membrane bursts in the upper part or microcracks appear. Leakage is difficult to distinguish from urinary incontinence or increased vaginal discharge. It can last for hours or even weeks.

There are situations when water does not drain even during childbirth... If the contractions are prolonged, and the fetal membrane remains intact, doctors resort to forced piercing.

This is not a whim of doctors. In this way, the uterus is saved from overvoltage, which can provoke its rupture during childbirth.

What kind of water flows away?

Female must definitely fix the time discharge of waters, as well as their condition. By the appearance of the waters, the doctor will determine the presence of deviations and will be able to decide on further actions.

Normally, the waters are absolutely transparent, may have an admixture of flakes or a slightly yellowish tint.

Such waters do not have a specific odor. so that they can be distinguished from urine. For amniotic fluid, a sweetish smell, reminiscent of fresh milk, is considered natural.

If the waters are green, and even more so black, this indicates the presence of meconium in the waters.

Red waters confirm the presence of blood in them. This is an alarming signal. Blood appears with placental abruption.

Reliable self-diagnosis methods

If a woman doubts the correctness of her conclusions about the fluid that has appeared, you can resort to well-known methods of self-diagnosis or contact a doctor. The need for additional diagnostics arises when the water flows out in an abundant stream, and leaks in small portions.

Dry sheet test

This is a fairly common, informative and accessible way to determine the discharge of amniotic fluid.

To carry it out, a pregnant woman needs to visit the toilet to empty the bladder.

Then the genitals are washed and wiped dry. The woman lies down on a dry white cloth. You can use a diaper or sheet.

If after 15–20 minutes wet marks are found on the fabric, the drainage is confirmed.

Test strip

At home, you can use a more modern way to determine the discharge of water. Test strips are available at a pharmacy. They allow you to confirm the type of discharge with high accuracy. Such a pad is impregnated with a special substance that reacts to the acidity of the discharge.

Normally, the vaginal flora has a balance within the pH range of 4.5. In amniotic fluid, acidity reaches pH 7.0. The gasket begins to react to liquids in which this figure exceeds 5.5.

For the test, the pad is placed on the underwear and is not removed until fluid leaks are felt. If there is no such sensation, the gasket can be left on until 12 hours.

An indicator of the presence of fetal waters is a change in the color of the pad to a blue or green tint.

If you do not trust home diagnostics, you can contact the doctors... In gynecology, it is customary to determine the questionable discharge of water using:

Gynecological examination;

Smear microscopy;

Aminotest with the use of a dye introduced into the amniotic fluid;

Cytoscopic examination

Send the waters: when will labor start?

In most cases, water is drained on the eve of childbirth. Contractions can begin literally immediately after the discharge of water, if the fetus is ready for birth and the neck has time to prepare for labor. It may take some time and labor will begin in 2-3 hours.

In pregnant debutantes, the cervix opens more slowly. In an hour, the neck can open only half a centimeter. Therefore, labor in such pregnant women begins no earlier than after 9-12 hours.

For women with birth experience, the process is developing much faster. Their neck is able to open in 5-6 hours. In these cases, if there is no desire to give birth at home or on the road, you will have to hurry up.

It is more difficult if the cervix is not ready for labor, and the waters have already departed. In such cases, it may take 12 or 72 hours before the onset of contractions. What to do if labor does not begin, doctors decide on a case-by-case basis.

There is a widespread belief among pregnant women that a baby cannot live more than 6 hours without water, since he can die from a lack of oxygen. Such rumors absolutely baseless.

Despite the lost water, the baby's nutrition and respiration continues to be provided by the mother's body through the placenta. The lack of water will not in any way affect its oxygen requirements.

In addition, the waters do not drain out in full and they are constantly renewed. Therefore, literally in 4 hours, if the fetal membrane has retained its integrity and only leakage is observed, their volume will be replenished with new fluid.

What is the real danger to the baby? In the public domain for infections. If earlier the child was practically in sterile conditions, then the crack that appears in the fetal membrane opens up direct access for the penetration of various pathogens.

The baby, still in the uterus, did not have time to develop protective mechanisms. Any infection is now fatal for him.

If the anhydrous period lasts more than 12 hours, doctors begin antimicrobial therapy with drugs that are safe for the child.

What if the water broke?

What should a woman do when her water has broken? The answer is unequivocal: urgently go to the hospital. Do not wait for the next visit to the gynecologist, namely, collect the necessary things, documents and call an ambulance.

The further development of events will depend on the timing of the withdrawal of the waters, their characteristics in terms of color and volume.

38-40 week

Most likely, the baby is already ready for birth. If the water has receded in a normal volume or is constantly leaking, besides, their color is absolutely transparent, there is no reason for concern. A natural process has begun, and prenatal contractions will begin soon.

Mothers who give birth for the first time still have a couple of hours left to calmly gather, gain strength and even have a little rest.

In no case, after the water has departed:

To take a bath;

Be exposed to physical stress;

Having sex;

Use tampons or sanitary napkins.

If there is a need to carry out hygiene procedures, for example, to treat or shave the genitals, you need to use the shower. Wash only from front to back to prevent germs from entering the vagina.

If the water is constantly leaking, instead of pads, which are saturated with fragrances and are not always sterile, you need to use a cotton cloth.

Herbal teas made from chamomile, echinacea, mint will help to calm down. In addition, such drinks also have antimicrobial properties.

For moms who give birth not for the first time, there is no time for tea drinking. Contractions and childbirth can begin at any time. For such women, the discharge of water is not alarming, but an important signal. Therefore, they should immediately go to the hospital.

The reason for immediate seeking help is the abundant drainage of water. If the water departed at the same time and in a large volume, it means that the entire fetal bladder has emptied. This confirms that the baby did not have time to take the correct position.

In such situations, it is extremely rare, but it is possible for one of the baby's limbs or even part of the umbilical cord to fall into the neck or vagina. If you do not provide assistance to such a woman in labor in time, childbirth will be complicated. In addition, the prolapsed umbilical cord can be pinched by the muscles of the cervix or the fetus, and the baby will have problems supplying oxygen.

If the waters have an unnatural color or smell, you cannot postpone the visit to the hospital. The presence of blood in the waters is a wake-up call. The natural process should not be accompanied by bleeding.

35-38 week

By 35 weeks, the baby has already formed lungs and is able to breathe independently at birth. Therefore, if the waters drain during this period, the doctors decide to stimulate the birth process according to vital signs.

If nothing threatens the baby and the expectant mother, it is advisable to prolong the pregnancy. Expectant tactics allows you to deliver the baby and give birth on time.

The woman is admitted to the hospital for the waiting period. Doctors monitor changes in condition and test indicators. I use antibiotics to prevent infection of the fetus.

If there is a suspicion of the presence of infections, they resort to forced labor or caesarean section.

20-34 week

In order to prevent the birth of a premature baby and ensure a safe continuation of pregnancy after an early discharge of water, doctors in most cases adhere to expectant tactics. They try to prolong such a pregnancy as long as possible.

The woman will have to spend the remaining period before labor in a hospital under close supervision. The expectant mother is placed in a sterile ward, where she must be in a supine position.

To control the condition of the baby and mother:

Once every four hours, measure the temperature and heart rate;

Every day, a blood test is performed for the level of leukocytes;

The volume and quality signs of the amniotic fluid are constantly being monitored, for which the diaper is regularly changed under the woman;

Vaginal culture is performed every 5 days;

The baby's condition is monitored using ultrasound and cardiotocography.

The decision on the timing and method of delivery is made in each case individually.

Up to 20 weeks

Water in the early stages can leave due to:

Fetal infection;

Inflammatory processes;

Careless sex;

Hormonal disruptions;

Excessive physical activity.

There is no single tactic for the early drainage of water. The decision is made after a detailed examination. But in most cases, such a pregnancy cannot be maintained.

The waters are gone, and there are no contractions

Only during ideal labor will the water drain during labor. Various "variations" are characterized by the discharge of water in the absence of contractions. Doctors recommend in any case to go to the hospital.

You should not wait for a long time in the hope that labor will begin. Contractions may not start in the next 48 hours. Women, fearing the stimulation of labor, postpone the visit to the hospital, which creates favorable conditions for the development of infectious processes.

In some maternity hospitals, the practice is still preserved to stimulate labor in 4-6 hours after the discharge of amniotic fluid. This tactic is absolutely inconsistent with modern medical views.

Doctors have proven that nothing threatens the baby for the next 12 hours. And even the absence of contractions for 48 or even 72 hours is not considered a pathology.

The decision to deliver urgently is justified:

With complete discharge of amniotic fluid;

With the threat of displacement or detachment of the placenta;

If the contractions were present, and with the passage of the waters, they began to fade;

In case of unnatural smell or color of amniotic fluid;

When the state of either the mother or the baby changes.

When a baby is infected;

If concomitant pathologies are present.

The doctor chooses the method of delivery in the absence of contractions in accordance with the condition of the woman:

1. If there is an abnormal position of the fetus, the woman in labor has health problems or a too narrow pelvis, a cesarean section is performed.

2. If the cervix is ripe, but labor is inhibited, labor is stimulated. For this, the hormone oxytocin is injected, which makes it possible to accelerate uterine contractions and cervical dilatation.

3. With an immature cervix, labor is stimulated by the introduction of a gel or suppositories into the cervix containing prostaglandins hormones.

In any situation, when the water is draining, regardless of the timing and presence of contractions, it is necessary not to postpone the visit to the hospital. Trust the doctors. In a hospital setting, all conditions have been created for a successful delivery or prolongation of pregnancy.

During pregnancy, the baby is reliably protected in the womb from negative influences. The leading role in the protection of the fetus is assigned to the amniotic fluid. The liquid fills the child's place in which the child is protected from harmful influences from the outside. The feeling of an uncontrolled outflow of urine allows you to understand that the water has departed. Normally, when the uterus is ready to open, the bladder bursts, the contents begin to flow out smoothly. During pregnancy over 32 weeks, the discharge of amniotic fluid is possible at any moment.

There are many unfamiliar phenomena during gestation, and women are faced with the problem of urinary incontinence. You may not understand that the water has departed, confusing it with urination. Therefore, in order to correctly assess what it means to have water withdrawn during pregnancy, there are distinctive characteristics of the phenomenon.

Term. The effusion begins over a long period of 32 to 42 weeks. The process is considered natural, however, there are deviations from the norm in these terms. If the amniotic bladder bursts, and the contractions have not begun (this occurs from 32 to 37 weeks of pregnancy), delivery is artificially stimulated. The fetus is weak by this time and to save life, special medical care is required.

The volume of the liquid. When the water leaves, their volume is felt, since by the time of delivery, about 1.5 liters of liquid are formed inside the fetal bladder. Most are located in the front, above the head of the fetus. It pours out first when the bubble bursts.

How many liters of water leaves before giving birth? The volume ranges from 600 milliliters to 1 liter. Therefore, women argue that the discharge of water looks like a powerful outpouring of a bucket of water. The remaining part is blocked in the passage of the uterus by the head of the fetus, the remnants of amniotic fluid are excreted with the fetus at birth. The fluid acts as a lubricant when moving through the birth canal.

Colour. The normal color of waters is yellow or colorless. A brighter shade means that when the bladder ruptures, pressure has occurred on the urinary canal, and urine came out along with the fetal fluid. This is fine.

Red blotches in the composition should not scare a woman. These are natural particles of the tissues of the uterine canal.
Green and brown are a harbinger of danger. The waters are called dirty and are dangerous for the life of the child. In 90% of cases, a cesarean section is prescribed. Scarlet color means profuse bleeding inside. Movement is prohibited, you need to lie down on a flat surface and urgently call an ambulance.

Can water flow away in parts? Yes, if a hole has formed in the wall of the fetal bladder. The situation threatens with complications of the birth process. The precursors of bubble bursting are characteristic sensations. If a woman is at home at a later date, you need to closely monitor them.

Signs

If, during urination, a clot of mucus falls out with a slap or remains on the laundry, it means that the water will soon disappear. The cork for some mothers comes off in parts in a couple of days. In the absence of pathologies during pregnancy, there will be no other clear signs. But there are a number of possible changes in the body.

What sensations does a pregnant woman feel when the water leaves:

pain with attacks if contractions have begun;
pulls the lower abdomen - a harbinger of the onset of contractions;
abundant moisture in the genitals;
the sound of a pop inside.

A woman should feel that the water has departed at the moment of a strong flow from the vagina. From this moment, generic activity begins to actively develop. If there are no contractions within 10-12 hours, surgery is required. Without amniotic fluid, the child will begin to suffer from asphyxia.

How to determine if the water is described or departed:

if the flow of fluid is controlled, then it is urination;
if not, then the water began to flow away.

Does the water hurt? No, pain is associated only with the onset of contractions. Since the fetal bladder has no nerve endings, the woman does not feel the rupture.

If a pregnant woman claims that while she was washing, the water left or that it happened in the toilet, then 90% of it is. The phenomenon is typical for timely contractions, when the uterus expands and presses on the bladder. Along with this, the amniotic sac also breaks.

Difference from discharge

Leakage of water is dangerous at any time, you need to be able to distinguish it from discharge. Worry about leaking water or fluid is justified.

period: the leakage is systematic for a long time, and the discharge disappears for a long time;
consistency: discharge is thicker and denser, in case of leakage, water pours;
the color of the discharge is white, and the amniotic fluid is transparent;
the smell is not typical of natural secretions.

During physical activity, the intensity of humidity increases, there is a feeling as if the labor is about to go away. If this feeling persists, it is more likely to be leaking.

How to determine that the amniotic fluid has departed during pregnancy:

when the fetal membrane ruptures, a soft cotton is heard, the sound will be reflected in the ears;
the liquid is transparent, the laundry gets wet through;
positive indications of leak tests.

How to determine the discharge of amniotic fluid at home using a test:

pee, wash, dry thoroughly and lie on a white cotton diaper. If after 30 minutes a wet spot forms, then the amniotic fluid in the pregnant woman has departed or is leaking;
attach a special pad to the panties. The tests are sold at the pharmacy and contain a specific reagent that reacts color to the liquid in the bladder. The instructions describe the detailed meanings and rules for the procedure.

In a maternity hospital or a gynecological clinic, such a procedure must be done free of charge, upon contact. The service is provided in a private clinic, without queuing, but for a decent fee. Examination by a gynecologist gives a 100% guarantee - whether the water has departed before childbirth or not.

The timing

Regardless of whether the pregnancy is pathological or not, it is important to notice the process of rupture of the amniotic bladder. This can be expected at different times.

At what point do the waters leave? When the uterus is ready for labor, the amniotic sac bursts. At the period from 32 to 37, as well as after the end of 42 weeks, there are serious risks of complications in childbirth and a threat to the health of the baby. It is forbidden to do without doctors in this situation.

Differences in time of onset:

prenatal;
timely;
lingering.

Prenatal effusion. Before week 37, rupture of the amniotic bladder is called premature and carries the risk of serious complications. The degree of danger depends on the duration of pregnancy and timely hospitalization.

Effects:

entanglement of the umbilical cord;
malposition;
death due to physiological prematurity.

Labor activity in the early stages does not occur, so urgent surgical intervention will hang the chances of a successful outcome. To avoid a bad development of events, you need to exclude risk factors.

ignoring leaks;
hit;
trauma;
exacerbation of chronic infections;
excessive physical activity;
severe stress.

Timely outpouring. In the absence of pathologies, by 37 weeks the uterus is ready to miss the fetus, the organ becomes softer and open by 3.5-5 centimeters. The gradual discharge of water should begin before the end of 42 weeks, due to the natural rupture of the amniotic fluid. Contractions should start at the same time or within the next 10-12 hours.

Prolonged outpouring. Approximately 10% of women in labor do not leave water on time. In this case, an amniotomy procedure is prescribed - a puncture or rupture of the amniotic bladder. With the right medical approach, the procedure goes well, without consequences.

Pregnant women have a method to speed up the process of childbirth and drainage of water. Slow constant walking increases the rate of onset of labor by 30%.

How to speed up the passage of amniotic fluid:

special drugs sold without a prescription in pharmacies;
eating fresh pineapple;
light physical work;
sexual contact;
stimulation of the nipples.

Doctors insist not to stimulate the process on their own. If necessary, the obstetrician will perform the puncture operation in the hospital on time.

Outpouring actions

After the waters leave, the excitement begins. Mom is confused, there is a feeling that the woman does not control the actions. As soon as the volume of liquid is released, this feeling disappears. It is believed that if water leaves, the weight decreases, but this is not the case.

If a woman is in a maternity hospital, obstetricians will do everything necessary for the safe birth of a baby, stimulate childbirth. When the woman in labor is still at home, you need to mentally plan the course of action in advance, clearly follow the accepted order.

Outpouring actions:

calm down and exhale;
call emergency help;
if necessary, take a shower, change panties;
collect documents (it is better to do this in advance);
collect things for the hospital;
wait for the arrival of doctors;
if contractions have begun, breathe deeply;
if the waters are red or green, lie down and not move.

Can I take a shower if the water has receded? Yes, but the uterus may already be open, so you shouldn't wash deeply, just rinse outside. The sensations after the discharge of the waters do not bring negative influence to the woman in labor. First, it is completely painless. Secondly, thoughts and feelings are filled with excitement in anticipation of meeting your own baby.

Does the abdomen change after the passage of water? Obstetricians say that only the position of the fetus changes, the child sinks to the bottom. This is logical, since after the effusion, the head cuts into the cervix. The belly shows that the baby is moving down.

About 10% of women claim that the abdomen decreases after the passage of water. These are unfounded facts, the abdomen looks voluminous and elastic until delivery.

Any pregnant woman awaits the onset of labor with a kind of trepidation and fear. Some think that this moment would come sooner, others want to wait a little longer. But in any case, no matter how you prepare for childbirth, they always come unexpectedly.

How to understand that the cork has come off? How and for how much does the mucous plug go away before childbirth? Should I go to the hospital right away or wait any longer?

So many questions give rise to panic, which only aggravates the situation, increasing tension, almost leading to hysteria, which is extremely harmful for both mother and baby.

That is why, in order to prepare and know exactly how to be and what to do, it is necessary to arm yourself with knowledge in advance.

Many women preparing for childbirth for the first time have heard that some kind of cork should go away before giving birth, but at the same time they have no idea what it is, what it looks like, and do not even imagine how the cork comes off before childbirth and what the cork means. ...

So what is it - a traffic jam during pregnancy?

At the very beginning of pregnancy mucus accumulates in the cervix, or rather, the uterus itself produces it when.

This mucus accumulates and thickens, tightly clogging the cervix, as if sealing it, blocking the path of any infection from the vagina, thereby protecting the unborn child.

This cork looks like a piece of mucus, jelly, or jellyfish. In principle, there is very little of it, about two tablespoons. It usually has a white-yellowish color., may have an admixture of blood or streaks of pink or pure white (each woman is purely individual).

How long does the plug take off? It is impossible to say exactly how long the traffic jam takes. It departs for everyone in different ways and at different times. Many women may not even notice that the cork has ALREADY come off. After all, this can happen when going to the toilet (then you feel like something has dropped out).

Often, the mucous plug comes off while taking a morning shower, at this moment, too, you may not feel or see anything. Only if the cork has come off at night or during the day, when you are in your underwear, you can see a piece of mucus on your panties.

Not all corks come off entirely, this can happen in stages, the cork comes off in parts, that is, in such small quantities that only increased mucus secretion can be noticed on the panties.

But for many pregnant women, the cork may not come off at all, and then the obstetrician or doctor who takes delivery will remove it with his own hand. And it happens that the cork comes off along with the waters, and then it can also be overlooked.

If you nevertheless notice that the cork has come off, - do not panic, this does not mean at all that childbirth will come immediately, you may have as many as 2 weeks in stock, especially if the deadline has not yet come.

If the loose cork is normal white or yellowish in color(sometimes streaked with blood), and after that the water did not leave and the contractions did not come, then it's okay, you can relax.

However, for personal peace of mind, you should still go to the doctor and find out how soon you will have childbirth and if everything is in order. Depending on the general course of pregnancy, the doctor will give specific recommendations or send you to the hospital.

Do not forget that the detached mucous plug yet the fact that childbirth will come soon and the moment is near when you will take your treasure in your hands.

So, it is better not to go far from home, go on a trip and generally travel by transport. Review the packages that you have prepared for the hospital, whether everything is in place, whether everything is prepared at home, and wait.

But if, after the mucous plug, water has departed or contractions have begun, then you will have to go to the hospital immediately.

And one more thing: if the discharge of the mucous plug is accompanied by bloody discharge of a scarlet color (the plug with blood comes off), while quite abundant, then you should consult a doctor immediately.

Although streaks of blood in the mucous plug are normal (when the cervix is preparing for childbirth, it expands, as a result of which capillaries may burst), it should not be. So, in the event of such a problem, call an ambulance immediately.

Remember - attentive attitude to yourself and your health, close observation of your own body- the guarantee of a successful childbirth and the health of your baby. Therefore, if mucous discharge appears, do not panic in vain, calm down, remember the information received and act in accordance with the assessment of the situation.

Very soon you will become a mother, and this is an incomparable sensation, because you will take responsibility for one more life.

Expert commentary

The separation of the mucous plug from the vagina indicates the harbingers of childbirth. Moreover, no matter in what time frame. begin by the same mechanism as physiological or belated.

The mucous plug is formed from the secretion of the cervical glands... It is a thick, jelly-like mass that fills the entire cervical canal. The secretion of the cervical glands is constantly maintained by high levels of estrogens and gestagens, hormones responsible for the growth and maturation of the fetus.

Thus, the mucous plug is not an accumulation of thick liquid formed from the very beginning of pregnancy. The secretion of cervical cells occurs in a continuous mode, and the mucous plug always remains "fresh".

It fills the inside of the cervix with a length of 4-5 centimeters: completely, leaving no gaps between the walls of the canal. There are antibodies in the mucus- immune cells that neutralize pathogens.

Before labor begins, the balance of female hormones changes. There are significantly more estrogens than progestogens. That is, the process of fruit ripening is considered complete and canceled. Under the action of estrogens, the mucous plug is liquefied. with its subsequent separation.

In primiparous and multiparous women the separation of the mucous plug proceeds in different ways.

The fact is that the cervix that has not gone through the process of childbirth in nulliparous pregnant women has a smaller canal diameter, and its walls are quite dense, which hold the mucus so firmly that the mucous plug leaves either with blood or in parts.

At the same time, prenatal structural changes in the cervical canal occur, which are accompanied by the separation of epithelial cells. This is accompanied by minor bleeding. That's why nulliparous note streaks of blood in insignificant thick secretions.

In women who have given birth the inner surface of the cervical canal is elastic. The integumentary epithelium is loosened, and the intercellular spaces are able to stretch. Therefore, the mucous plug in women giving birth departs instantly and bloodlessly.

Regardless of parity (number of births) the separation of the mucous plug from the cervical canal in pregnant women is painless.

Exception from general cases are women with lesions of the cervical canal... Scars on the inner lining of the cervix are formed as a result of its forcible expansion during abortion or inflammatory lesions of cervical cells with Trichomonas infection.

Much less often spotting in women who have given birth again when the mucous plug leaves associated with the presence of the cervix.

Fine discharge of the mucous plug occurs 3-5 days before the onset of labor... The amount of thick liquid is negligible. No more than ovulation. Because ovulatory mucus fills the cervical canal, the size of which remains unchanged during pregnancy.

The separation of the mucous plug indicates hormonal changes in the body of a pregnant woman, which ensure labor, canceling the process of carrying a child. This process is physiological and does not require medical intervention.

At the same time, with discharge from the genital tract, not examined under a microscope, it is impossible to distinguish where they came from: from the cervical canal or from the uterus?

The amniotic fluid sometimes drains before the onset of labor.

The separation of the mucous plug does not mean that the protection of the fetus from the vaginal microflora is impaired, since the second and more important barrier is the dense membrane of the fetal bladder.

And here when the amniotic membrane is torn(which also happens absolutely painlessly), the risk of infection of the fetus becomes irreversible and increases steadily. The time of the anhydrous period is counted in hours and minutes.

It is impossible to determine what kind of vaginal discharge appeared at home. Therefore, when they appear, you should record the exact time and call an ambulance. A mucous membrane is a plug or amniotic fluid - only a doctor can determine.

Outpouring of amniotic fluid is one of the signs of childbirth, their active period, or the imminent onset of contractions. It is important to understand in time that this happened and seek medical help, especially in case of premature pregnancy.

Amniotic fluid begins to form already on the sixth to eighth day of the embryo's life. In the first two trimesters, their number increases rapidly. They protect the baby from external influences: microbes, loud noises, dampen the movements of the mother. Their outpouring is a signal of the onset of labor or a serious complication of pregnancy.

Amniotic fluid and its functionality

Amniotic fluid is the amniotic fluid around the fetus that is made up mostly of water. The composition is completely renewed every three to six hours: the amniotic fluid is absorbed by the placenta, swallowed by the fetus, in parallel with this it is secreted by the lungs, the digestive and urinary systems of the fetus, and part of the fluid comes from the bloodstream of the placenta.

Amniotic fluid includes:

proteins;
fats;
carbohydrates;
vitamins and minerals;
biologically active substances;
hormones;
fetal epithelial cells;
vellus hairs of the baby and other products of his life.

Amniotic fluid performs a number of important functions in the gestation process. They serve as a kind of "safety cushion", while making it possible to actively move. In addition, they serve as a food element for the baby - he swallows liquid, taking useful elements from it. By creating a layer between the fetus and the environment, the amniotic fluid protects the baby from fluctuations in the temperature of the external environment. Amniotic fluid plays a huge role in the process of labor.

Create a wedge. After the onset of contractions, the fetal bladder "falls" into the cervical canal and creates additional pressure on the cervix, stimulating its further opening. At the same time, the action is relaxed, soft, as a result of this, the contractions are less painful and the woman tolerates them more easily. This effect is especially important up to 4-5 cm of cervical opening. After that, usually the fetal bladder opens on its own.
Stimulates contractions... After the waters are poured out, the volume in the uterine cavity is sharply reduced. This leads to its involuntary contraction. If there were no contractions, they gradually begin, and if they already were, they intensify several times.
Protect against complications... A whole fetal bladder protects against loss of umbilical cord loops and small parts of the fetus's body (arms, legs). Therefore, immediately after the outpouring of water, it is important to conduct a vaginal examination and make sure that there are no such complications. If a baby's umbilical cord, arm or leg is found, an emergency caesarean section is performed. Also, the whole fetal bladder mechanically protects the baby from pathogenic bacteria. Therefore, the longer the anhydrous period, the higher the risk of infectious postpartum complications in mother and child.

Possible outpouring scenarios

The waters are gone, but there are no fights... This is one of the unfavorable options for the onset of labor. Depending on the time of the anhydrous interval, an early rupture is distinguished (labor begins soon or there are already small contractions) and a premature rupture (before the start of any contractions). In the latter case, the anhydrous period is determined in hours, sometimes it can reach up to a month or more. Depending on the duration of pregnancy, in which the water began to leak, the tactics of managing the woman are being built. This can be both immediate delivery and prolongation of pregnancy for a day or two or more.
There are contractions, but there is no water yet... This is a more favorable combination, especially if labor begins during full-term pregnancy. This option is considered a classic, the fetal bladder performs all its functions - "wedge", protection, stimulator of contractions and pain relief. A belated rupture is a case when they say that a child was “born in a shirt,” in the whole fetal bladder. It is important to immediately break the walls of the bubble, otherwise the baby will not be able to take the first breath.
Fight and water - at the same time... This option is also possible. Most likely, there were contractions of the uterus even before the water departed, it is just that the woman practically did not feel them. In this case, rapid childbirth is often encountered - a woman usually says that “she didn’t have time to come to the hospital and immediately gave birth”.

It should be

Normally, water is discharged in accordance with the following criteria.

After 37 weeks. In principle, any options for the discharge of amniotic fluid during a full-term pregnancy are considered a normal option. After all, each woman has an individual body, so variations are possible. If the integrity of the fetal bladder is violated before this period, this is clear evidence of some pathological process. Most often, such complications occur with infection, uterine fibroids.
With or without contractions... If the waters are poured out after 37 weeks, even in the absence of labor, this is considered a normal option. As a rule, expectant tactics are conducted - for six to eight hours, the woman and the fetus are observed, CTG is performed (helps to assess the condition of the fetus). During this period, contractions begin in 90% of cases.
Light in color. Normally, the amniotic fluid should be transparent, with a slight white tint. They may contain scales of the epithelium, which looks like a small suspension. Any deviations are a sign of some pathological processes. The presence of a mucous plug in the waters is allowed.
Without smell . The amniotic fluid is normally odorless, let's say a slight sour tint.
Moderate amount... At the end of pregnancy, the volume of amniotic fluid is approximately 500 ml. They are divided into two portions - front and back. The first are poured out immediately, and the second - only after the birth of the baby.
Leaking all the time... As soon as they appear even a little bit in the discharge, they will leak all the time - this is the norm. Usually, at first there are few of them, then there is a sharp increase (the main amount comes out), and then again a little. An exception is a high rupture (tear) of the bubble, when, after the initial appearance, there may no longer be water for several days.

Characteristic signs

There are casuistic cases when expectant mothers do not pay attention to vaginal discharge and miss the moment of pouring out. But usually these changes are hard to miss. The recommendations are as follows.

Put a lining on. If there is any doubt about the nature of the discharge, a white cloth should be used instead of the liner. So both the amount and color of the highlight will be seen more clearly.
Estimate the volume. When amniotic fluid is leaking, it is not a teaspoon, but a glass or more.
Make a test. There are special test strips for the presence of amniotic fluid in the secretions, they can be freely purchased at pharmacies.

As you can see from the table, when the amniotic fluid is poured out, it is easy to distinguish it from standard vaginal discharge.

Table - Differences between amniotic fluid and leucorrhoea and mucous plug

Sign	Water	Beli	Mucous plug
When did	There was no earlier	Occur periodically	There was no earlier
Colour	- Transparent with a slight white tint; - with pathology - green, yellow, cloudy	- White or mucous transparent; - stringy like chicken protein	- Transparent or grayish mucous membranes; - sticky; - non-sticky
Quantity	Usually "flows down the legs"	Minor	Minor
Smell	No or sour	Sourish	No
Impurities	Epithelium, vellus hair of the fetus	No	Single streaks of blood are possible

There are special laboratory methods to determine if the water has moved away. But in most cases, a routine examination is enough for a doctor to understand this. And in addition, an ultrasound scan shows if there is still fluid around the fetus.

Something is going wrong

By when and how the waters leave, what color they have, the smell can be judged by the state of the child in utero. This is very important, pathological waters are a sign of fetal suffering, often to save the baby it is necessary to urgently perform a cesarean section, otherwise negative consequences cannot be avoided.

Up to 37 weeks. The appearance of amniotic fluid before full-term pregnancy threatens premature birth. If amniotic fluid is drained before 22 weeks, late miscarriage occurs.
Yellow or green... This color is direct evidence of fetal hypoxia, most often due to intrauterine infection. The most dangerous conditions are when impurities of meconium (feces of a child) are found in the waters or they represent a fetid green dregs. Delay in minutes can cost a child's life.
With an unpleasant odor... The feeling of a putrid odor is a sign of infection of the membranes, waters and the fetus itself.
Very much or a little... It is observed with polyhydramnios or low water, respectively. Conditions can be caused by various reasons - from intrauterine infection to child malformations and Rh-conflict.

Reasons for an early "start"

Often you have to deal with early and premature rupture of amniotic fluid. There are always hidden conditions and diseases behind this. A particular danger is the leakage of amniotic fluid during premature pregnancy. The most common reasons are as follows:

genital infections;
acute infections (for example, SARS, flu, pyelonephritis);
uterine fibroids;
polyhydramnios;
thrombophilia in a woman;
fetal pathology;
multiple pregnancy.

Consequences for the baby

The influence of untimely discharge of amniotic fluid on the baby is ambiguous, much depends on the duration of pregnancy, concomitant pathologies and diseases in the mother and fetus. The risks of negative consequences in a full-term pregnancy are significantly lower than in similar situations up to 37 weeks. An increase in the hours of anhydrous stay of the baby in the womb increases the likelihood of the following complications for him:

infection - hence the development of pneumonia, conjunctivitis;
hypoxia - this entails changes in the structures of the brain and hemorrhage in them.

Correct woman behavior

Women often panic if they find leakage of amniotic fluid, especially during premature pregnancies. This only exacerbates the situation and increases the period of time before seeking medical help. If there is a suspicion or obvious leakage, the following should be done:

if there is little discharge- observe for an hour or two (perhaps it is leucorrhoea, which often happens after laying candles or against the background of a pessary);
if there is a lot of discharge- contact the hospital as soon as possible.

When transporting, it is better to lie on your left side, while at the same time the beginning of contractions - to breathe correctly.

At that moment, when the period of pregnancy is already approaching the final stage, the expectant mother can only wait for the waters to recede, contractions and the birth itself begin. This is the most exciting period, therefore, in order to calm down women, it is very important to have theoretical knowledge of when the water leaves and what needs to be done at this moment?

What does “water drainage” mean and how to recognize it?

Amniotic fluid - fetal or amniotic fluid that is located inside the amnion and chorion during pregnancy. They surround the fetus on all sides, creating a safe and natural environment for it, which plays a critical role in the formation of intrauterine life.

Water can drain not only right in front of the birth itself, but also a few hours before that moment. They can resemble incontinence or flow as a stream of water, the amount of which can reach up to 1.5 liters. This is considered quite normal.

Very often, the discharge of water is confused with strong mucous secretions. It is best to have an amniotest for such cases, thanks to which it will be possible to find out for sure whether it was discharge or it was water.

There are several signs that can help you tell if the water has moved away:

contractions may begin;
fluid oozes almost constantly;
the smell may be slightly sweet;
there may be blotches of "white flakes".

Attention! It is very important to be prepared for this state of affairs so that, if necessary, do not panic and take a number of necessary measures.

How does water drain from pregnant women?

During or before childbirth, the bubble, where the fetus is in the liquid, bursts. After this, there is a discharge of water, which may indicate the imminent onset of labor. If at this moment the expectant mother is still outside the hospital, then it is necessary to get ready there as soon as possible.

As for the specific timing of childbirth after the waters have departed - everything is determined on an individual basis and they can vary significantly. Experts identify several options for the development of the situation:

Premature (prenatal) effusion.
Timely outpouring.
Prolonged outpouring.

Important! For each of these options, not only the doctor who leads the pregnancy should be ready, but also the woman in labor herself.

What should be the amount and color of the waste water:

Fluid outflow is the main symptom of water withdrawal. The expectant mother will feel like a stream of fluid poured out of her, which is not similar to urination, since the outpouring begins and ends quickly enough. It may seem to a woman during this period that there is a lot of liquid, but often not everything comes out right away:

most of the water is poured out immediately, which is located directly in front of the fetus. Thanks to this, the baby manages to get closer to the exit from the uterus. It will not be possible to indicate a specific amount of liquid, because it all depends on individual characteristics, including the weight of the child and the expectant mother, as well as the characteristics of the body. On average, 800-1000 ml comes out;

secondary effusion of fluid occurs already during childbirth. At this moment, relatively little liquid comes out, about 200 ml, but the woman does not feel this, as she experiences stress during childbirth.

At this moment, the girl will feel a strong phlegm in the perineum. In some particularly rare cases, the water drains slowly, which can present a lot of problems for further labor.

- leaks

Some time before the approximate date of birth or during the period of the onset of labor, every expectant mother may feel a strange kind of leakage. In rare cases, a situation of such a plan can also occur when the waters do not leave immediately in large quantities, but gradually. This often happens when a hole has formed in the amniotic fluid in which the fluid is located.

The main problem is that it can often be easily confused with incontinence or light discharge. Only a specialist in laboratory conditions is able to accurately determine the true cause.

- Colour

The amniotic fluid in a normal state should be transparent, without any inclusions or other shades. If green colors were found, this may signal that the child is postponed and there is a risk of a lack of oxygen in the fetus's body (hypoxia), which is why, in most cases, a decision is made about a cesarean section.

The pink color of the water may indicate that blood got into the water during the separation of the placenta. In this case, the woman must be taken to the intensive care unit as quickly as possible.

Important! If the water is discharged at home, and not in the hospital under the supervision of specialists, it is necessary to remember as accurately as possible their color, quantity and possible inclusions of white flakes or blood.

It is very useful to monitor the color of the liquid, as it can inform that pregnancy and imminent childbirth will proceed without complications or force you to take emergency measures to avoid possible negative consequences. If there are any deviations from the norm, you must immediately inform the doctor about it.

Can water flow back without contractions?

It cannot be said unequivocally that after the waters recede, contractions begin immediately. Often, the cervix should first open, after which the expectant mother will feel paroxysmal pain in the lower abdomen, after which the bubble should burst.

There are also cases when a pregnant woman does not experience any pain until the moment when the fluid is poured out. Even less often, there are cases when contractions occur only after 10-12 hours. Everything entirely depends on the individual characteristics of the organism and the course of pregnancy.

There is a certain period of time after the water has departed, it is called safe and lasts for 6-12 hours. During this period, if the woman in labor is not in the hospital, it is necessary to immediately call an ambulance and go there without waiting for contractions. At this time, bacteria will not be able to enter the woman's body.

If the contractions did not start in the hospital, then they resort to the following measures:

Stimulation.
Dropper or injection with oxytocin.
Caesarean section (if the contractions never started).

How can we help the waters recede?

For most women, the bladder remains intact, right up to the contractions. This is completely normal and should not be scared. In the case when the attempts have already begun, and the bubble has not yet burst, it is pierced. Do not be afraid, this is a completely safe and painless procedure, which is carried out with a special probe through the cervix.

The probe looks like a hook, which pierces the shell. After that, contractions may become more frequent and the process of childbirth will become more active.

The piercing method is used already at the stage when the woman in labor is about to give birth, and a little in advance before this period, you can apply other methods of stimulation:

daily walks in the fresh air;
stimulation of the nipples;
small physical activity;
sex;
eating a small amount of fresh pineapple;
the use of evening primrose oil (after consultation with a specialist);
the use of special cookies that are designed to stimulate childbirth (sold in pharmacies).

What to do if water runs out?

If such a situation found a woman in the hospital, then the specialists will do everything necessary and the woman in labor will not have anything to worry about and will only have to mentally and physically prepare for childbirth.

In the case when the water began to drain at home, then the woman and her close circle will need to complete a small but necessary list of measures so that further childbirth will pass without complications:

Call an ambulance.
Change your underwear. In this case, it is not recommended to wash away, because there is a high risk of infection.
Change to the hospital.
Collect all the necessary documents and things.
During contractions, breathing exercises should be done to relieve pain attacks.
If the color of the liquid is brown or red, it is necessary to take a horizontal position and try not to move until the ambulance arrives.
Try to worry as little as possible and not panic.

Experts categorically do not recommend a woman to worry, for the reason that the waters do not leave until the last moment. They will puncture if necessary. After the water has departed, it is important not to panic, but to hurry up and call an ambulance as soon as possible to go to the hospital, where qualified medical care will be provided.

Specially for- Elena Kichak