Medicine today 

The rupture of amniotic fluid is considered premature. How dangerous is the leakage of amniotic fluid. A useful video clip on how the water breaks before childbirth

A pregnant woman is probably the most beautiful thing that nature has created. However, a pregnant woman is the most restless being. And this, of course, is completely normal - after all, the expectant mother bears the burden of double responsibility - responsibility for the life and health of not only herself, but also her baby.

Women try to get as much information as possible, one way or another related to the characteristics of the course of pregnancy, the development of the child, and possible complications. And the closer the cherished “hour X” approaches, the more anxiety the expectant mother has. Nowadays, it is easy to find a variety of information about pregnancy and childbirth.

However, not always a pregnant woman receives answers to all her questions. In particular, this applies to amniotic fluid. It is very difficult to find anything sensible about amniotic fluid on the Internet, and the knowledge of women is limited only by the fact that the discharge of amniotic fluid indicates the onset of labor, and the symptoms of amniotic fluid leakage are very vague.

In fact, amniotic fluid plays a huge role in the development of the crumbs, it can tell a lot about how the pregnancy proceeded and what can be expected during childbirth. Of course, obstetricians have all this information. However, most often they do not dedicate a pregnant woman to all the details, preferring to silently do their job. But nothing scares more than ignorance.

Volume of amniotic fluid

Heated disputes are constantly being waged, what should be the volume of amniotic fluid. However, the opinions of physicians converge to the following figures. At the tenth week of pregnancy, the average volume of amniotic fluid (amniotic fluid) is about 35 milliliters. By the fourteenth week of pregnancy, this figure triples and is already about 100 milliliters. And by the twentieth week of pregnancy, the volume of amniotic fluid reaches 400 milliliters.

The largest volume of amniotic fluid occurs, as a rule, at the 38th week of pregnancy - about one and a half liters. But then, just before childbirth, its volume can drop significantly, decreasing to 800 - 1000 milliliters. It is this factor that is one of the most unpleasant when prolonging pregnancy - amniotic fluid.

Administration of amniotic fluid

Many women mistakenly believe that amniotic fluid is ordinary water, in which the baby is located. However, this is not quite true. Indeed, approximately 98% of the amniotic fluid consists of ordinary distilled water. However, amniotic fluid is the biologically active environment of the crumbs. The amniotic fluid contains a large amount of active substances, lipids, proteins, fats, carbohydrates, etc.

At a short gestational age, amniotic fluid has no color and is completely transparent. However, as pregnancy progresses, the composition of the amniotic fluid changes greatly. Potto - fatty secretions, the dying upper layer of the epidermis (skin), fluffy hairs of the crumbs enter the amniotic fluid. Because of this, the amniotic fluid is cloudy.

In addition to the shade of the amniotic fluid, as the baby grows, its chemical composition also changes. The only thing that stays the same is the pH level. It always matches the pH levels of the baby's blood. This is what allows the pregnancy to proceed correctly, and the baby to develop normally.

The amniotic fluid itself is also regularly updated throughout pregnancy, since in the body of a pregnant woman the so-called circular metabolism does not stop for a single minute, affecting not only the body of the mother, but also the baby. It is with the help of this circular exchange that the fetus is nourished - nutrients from the mother's body enter the body of the crumbs with the participation of the placenta, waste products are excreted from the fetus's body and oxygen is transported to the cells of the child. And it is this process of circular metabolism that provides regular renewal of the amniotic fluid.

The speed of this process is amazing. In the event that the pregnancy proceeds safely, and the expectant mother does not suffer from any chronic diseases and feels well, the rate of circular metabolic processes reaches about half a liter of amniotic fluid per hour. It is easy to calculate that with the volume of amniotic fluid at the 38th week of pregnancy, when their amount is one and a half liters of water, they are completely replaced in about three hours. There are metabolic processes with the direct participation of both the placenta and the fetal membranes.

In addition, the child is also directly involved in the renewal of amniotic fluid. In the first half of pregnancy, amniotic fluid easily penetrates the fetal body, and only by about the 23rd week of pregnancy, the baby's skin reaches a stage of its formation at which the skin becomes impervious to amniotic and any other fluid. At this stage of skin metabolism in the fetus ends.

However, at the beginning of the 24th week of pregnancy, the baby begins to regularly swallow amniotic fluid. He does this with a very specific purpose - swallowing amniotic fluid allows you to train both the digestive and excretory systems of the fetus. During the day, the baby, thus, processes up to one and a half liters of liquid. In addition, the amniotic fluid enters the baby's body in another way - during the baby's respiratory movements. Thus, about 800 milliliters of amniotic fluid passes through the baby's lungs in one day alone.

Amniotic fluid - what is it for?

Very often, women ask the question of why amniotic fluid is needed? Is it really necessary for the development of the baby? The answer is unequivocal - yes. Amniotic fluid performs many different functions - protective, developing, and obstetric. Below we describe each of them in more detail:

  • Thermoregulating function

From the very first days, amniotic fluid creates in the uterus an ideal temperature for the development of the fetus - 27 degrees Celsius. And any external factors - hypothermia of a pregnant woman or a slight increase in temperature as a result of any disease, will not affect the baby, since it is the amniotic fluid that regulates the temperature inside the fetal bladder. Of course, amniotic fluid is not able to contain radical temperature changes, but basically they successfully cope with their task - they regulate temperature.

  • immune protection

As mentioned earlier, the amniotic fluid contains a huge amount of a wide variety of biologically active substances. Including among these substances are varieties of many immunoglobulins. It is these immunoglobulins that reliably protect the fetus from possible damage by various pathogenic microflora. And there are a lot of pathogenic bacteria that can harm the health of the crumbs and even endanger his life, even in the body of an absolutely healthy woman. Amniotic fluid in pregnant women reduces the risk to almost zero.

  • Mechanical protective function

Amniotic fluid is a wonderful natural shock absorber for the baby. They reliably protect the crumb from mechanical influences. After all, no matter how careful the expectant mother tries to be, everything happens in life - they can push in the bus, and sometimes you can just slip and fall. Amniotic fluid will greatly soften the mechanical effect on the baby and protect it.

  • Cord protection function

Another very important function of amniotic fluid is to protect the umbilical cord. Due to the presence of amniotic fluid, the situation in which the umbilical cord is compressed between the walls of the uterus and the body of the baby is almost completely excluded. Such clamping is extremely dangerous, as it can lead to disruption of the proper development of the fetus due to lack of nutrients, to hypoxia due to lack of oxygen, and even death of the fetus.

  • Hermetic isolation from infectious agents

In addition to immunoglobulins, the fetal bladder reliably protects the baby from the penetration of infectious agents. All the necessary substances and oxygen are easily delivered to the baby through the placenta, but infectious agents have no way to go there.

  • Prevention of splicing of body parts of the crumbs

Due to the fact that there is amniotic fluid in the fetal bladder, a situation is excluded in which the fetal membranes themselves directly adhere to the baby's body.

  • Ensuring harmonious development

The presence of amniotic fluid in sufficient quantities ensures the proper development of the internal organs and entire systems of the baby. So, for example, with the help of amniotic fluid, the correct formation and subsequent development of the entire respiratory system occurs. Immediately after the formation of the baby's chest and the possibility of its movement, the amniotic fluid allows the fetus to imitate respiratory movements, thereby helping the development and training of the lungs. If the child does not perform such training daily, he will not be able to breathe on his own when he is born.

Almost the same applies to the digestive and excretory systems. By swallowing amniotic fluid, the baby trains its stomach and intestines to digest food, and the excretory system to get rid of waste products. This is extremely important for the successful intrauterine development of the crumbs and life after birth. The baby begins to swallow amniotic fluid from about the 14th week of pregnancy. And from about the same age, the crumbs' kidneys begin to produce urine, which is still sterile.

  • Metabolic Support

Amniotic fluid is most directly involved in metabolism. The amniotic fluid also contains a huge amount of oxygen and nutrients, so necessary for the normal development of the baby. It is the amniotic fluid that fully supplies the baby with proteins, fats and carbohydrates, enzymes, hormones, glucose and other substances.

  • Providing conditions for the physical development of the child

Amniotic fluid is a kind of pool for the crumbs. The child has the opportunity to move without any difficulty inside the uterine cavity as he wants. The exception is long gestation, when the baby becomes too big and there is not enough space in the uterus. However, in this case, amniotic fluid gives the crumbs the opportunity to change the position of the body without much effort.

  • Ensuring the correct formation of the circulatory system of the fetus

Another very important function of the amniotic fluid is the correct formation of the circulatory system of the fetus and its subsequent functioning, including such an indicator. Like normal blood clotting. This is due to those substances that are contained in the amniotic fluid - in particular fibrinolysin and thromboplastin.

  • Prevention of bleeding during pregnancy and childbirth

Thanks to its enzymes, amniotic fluid has the ability to clot blood, thereby effectively preventing bleeding, both during pregnancy and during childbirth. This feature of amniotic fluid has saved more than one thousand lives, both babies and their mothers.

  • Facilitation of the birth process

In addition to all of the above, amniotic fluid is of no small importance during childbirth. Thanks to them, the fetus occupies the correct position in the lower part of the uterus. And the cervix itself, under the pressure of the fetal bladder filled with amniotic fluid, opens much faster and more painlessly than in cases where the water has already departed.

What can amniotic fluid tell?

As it is already clear from all that has been said, the amniotic fluid is a biologically active environment for the crumbs, so it is very sensitive to the slightest changes in the physical condition of the child. Doctors use this feature of amniotic fluid for diagnostic purposes. Assessing the condition and composition of the amniotic fluid, doctors can monitor the condition of both the mother and the baby, detecting deviations from the norm in time.

Even the volume of amniotic fluid, which is easily determined by ultrasound, can say a lot. There are such deviations from the norm as oligohydramnios and polyhydramnios. These deviations must be detected as soon as possible and corrective therapy prescribed, because the amount of amniotic fluid is also very important.

Another method for examining amniotic fluid is amnioscopy. Amnioscopy refers to visual inspection and examination of the lower part of the amniotic sac. If the data obtained by doctors is not enough, they can resort to another diagnostic method - amniocentesis.

Amniocentosis is a diagnostic puncture of the membranes in order to take a sample of the amniotic fluid to assess its color and composition. To do this, a woman makes a puncture (puncture) with a special needle either in the lower part of the abdominal wall or in the posterior fornix of the vagina. This procedure is performed under local anesthesia and does not bring any harm to the baby and his mother.

Another important amniotic fluid test that can save a baby's life is a test that determines the presence and level of phospholipids in the amniotic fluid. In order for the lungs to fully open during inspiration, the correct optimal ratio of the level of sphingomyelin and lecithin in the blood of the crumbs is necessary. Only under this condition will the child be able to breathe on their own.

In addition to the maturity of the respiratory system, the degree of maturity of the urinary system, in particular the kidneys, is equally important for the survival of a newborn baby. Based on the analysis of the amniotic fluid, it is also possible to establish the degree of maturity of the baby's kidneys - it is reliably indicated by the level of concentration in the amniotic fluid of a hormone such as creatinine. Its low content indicates that the child's kidneys are not yet mature enough and will not be able to fully cope with the functions assigned to them.

This information that amniotic fluid can provide is very important if there are deviations in the normal course of pregnancy and the condition of the pregnant woman is severe and can even threaten not only her health, but also life - for example, a severe form of preeclampsia, in which delivery needed as soon as possible. Doctors, by the state of amniotic fluid, assess the maturity of the fetus and its readiness for existence outside the uterine cavity - and that is why the analysis of amniotic fluid sometimes saves lives.

Doctors - gynecologists, in the event that the fetus is not yet mature enough, and the woman's condition is such that the continuation of the pregnancy becomes impossible, they begin to administer to the pregnant woman drugs that accelerate the maturation of both the lungs and the kidneys of the fetus. By the way, doctors also calculate the dose of these drugs and the duration of the course of treatment precisely on the basis of a laboratory study of the amniotic fluid.

Many women sometimes refuse the proposed studies, believing that doctors are simply playing it safe, or fearing for the health of their baby, because they believe that these studies can harm the baby. Often these fears are artificially fueled by various tales about the allegedly terrible danger of these procedures, in most cases leading to the loss of a child. These stories are passed from mouth to mouth in the circle of expectant mothers. And they completely distort reality.

In fact, in no case should they be abandoned, since they are carried out strictly according to certain indications in cases where the doctor believes that there is a real threat to the health and life of the mother or her baby. Believe me - no doctor will prescribe such studies just like that, without good reason.

Leakage of amniotic fluid

Nature is very wise - she provided for the fetal membranes to be airtight until the very beginning of the birth process. Normally, during pregnancy, amniotic fluid does not leak, under no circumstances. However, sometimes, under the influence of any external factors, such as a fall or other rough physical impact, they can lead to tearing of the fetal bladder and, as a result, leakage of amniotic fluid of varying intensity, depending on the degree of damage to the fetal bladder. The leakage of amniotic fluid begins, the signs of which are noticed by pregnant women.

However, very often, expectant mothers begin to panic terribly when they find wet spots on their underwear. Women believe that they have started leaking amniotic fluid. However, in most cases, these spots are in no way related to the leakage of amniotic fluid, but are explained by completely different factors. Firstly, the longer the gestational age, the more abundant the woman's vaginal discharge becomes. And secondly, during long periods of pregnancy, the muscles of the pelvic organs, including the bladder, relax, which is why mild urinary incontinence is possible.

In order to clarify the situation on her own, a woman needs to do a test for amniotic fluid leakage at home: go to the toilet and completely empty your bladder, wash yourself and dry yourself. Lie down on your bed with a clean, dry sheet. Monitor your condition - if a wet spot appears on it in the next 15 minutes, immediately call an ambulance team - the doctors know exactly how to determine the leakage of amniotic fluid.

Leakage of amniotic fluid is a very alarming signal if the pregnancy has not reached its logical conclusion. And in the event that the time has come for the appearance of the crumbs into the world, the leakage of amniotic fluid is a signal for the mother that the time for childbirth has come. That is why it is unacceptable to ignore this phenomenon in any case.

Indeed, in the event that the gestational age is not long enough for the baby to be born, damage to the fetal bladder can lead to the penetration of pathogenic microflora into the fetal membranes, infection and death of the fetus. Doctors in this case will take amniotic fluid to assess the degree of maturity of the lungs and kidneys of the crumbs.

In the event that they are mature enough for the baby to exist outside the uterus, doctors will stimulate the onset of labor to avoid infection of the fetus. In the same case, if the lungs have not reached the minimum possible degree of maturity, doctors will try to prolong the pregnancy for as long as possible. For a baby, even one single extra day spent in the mother’s tummy can be decisive if the discharge of amniotic fluid cannot be stopped.

All this time, both mother and baby will be under the strictest supervision of medical personnel. To prevent infection of the crumbs, which has lost its natural habitat - amniotic fluid, doctors will conduct special antibacterial therapy aimed at destroying alien pathogenic microflora. A woman at this time must strictly observe strict bed rest - the successful outcome of pregnancy depends on this.

As a rule, in this way, doctors manage to win one to two weeks, during which the light crumbs have time to ripen. However, doctors take not only a wait-and-see attitude - throughout this time, a pregnant woman receives special injections of a hormonal drug, which greatly accelerates the process of maturation of the baby's respiratory and urinary systems. As a rule, such a tactic of preserving pregnancy brings very, very good results if the pregnant woman has leaking amniotic fluid.

amniotic fluid color

However, pregnant women should not focus on the premature discharge of amniotic fluid - although this phenomenon takes place, it is not so often - no more than one case per 30 thousand pregnancies. Most often, the amniotic fluid departs at the most appropriate and provided by nature moment - from 38 to 40 weeks of pregnancy, when the development of the crumbs is completely completed, and he is ready to be born - it is at this time that amniotic fluid begins to leak before childbirth.

However, the amniotic fluid that has departed in time can tell the doctor and the expectant mother a lot of information regarding the condition of the baby. Very often, an assessment of the color and transparency of amniotic fluid helps doctors make the right decision and decide on the tactics of childbirth. So, what can this water traffic light tell us - the color of amniotic fluid? However, when evaluating the condition of a pregnant woman by color, remember that amniotic fluid with suspension is a physiological norm.

  • amniotic fluid yellow

In the event that a pregnant woman has lost water that is yellow and slightly cloudy, there is no cause for concern. Approximately such they should be during the normal course of pregnancy. Mommy can calmly pack up and get to the hospital, from which she will return with her long-awaited little happiness.

  • Amniotic fluid yellow with red patches

Sometimes the amniotic fluid has a natural yellow tint, but looking closely, a pregnant woman may notice red streaks in them. If you feel good, nothing bothers you, and you begin to feel contractions - you should not be scared. In 99% of cases, these streaks are only a consequence of the fact that the cervix began to open and only indicates that the birth process is going according to plan.

  • Green amniotic fluid

But in the event that the departed amniotic fluid is green, the woman and the doctors should sound the alarm, as this is a signal of serious problems in the crumbs. The green color of the amniotic fluid occurs in two cases - if intrauterine defecation occurred, or if there was too little amniotic fluid. Meconium in the amniotic fluid can lead to the development of congenital pneumonia in the crumbs.

In addition, in both cases, the baby suffers from hypoxia - intrauterine starvation. A woman who notices that the amniotic fluid has a green tint should get to the hospital as soon as possible and be sure to inform the doctors that the amniotic fluid is green, as timely measures taken will help preserve the health and even the life of the baby.

  • Dark brown amniotic fluid

The amniotic fluid is dark brown, alas, the color of great misfortune. This color in almost all cases indicates intrauterine death of the crumbs. And in this case, we are talking about saving a woman's life. However, in our time, such cases are so rare that it makes no sense to talk about it. With regular monitoring by a gynecologist, all problems are detected in a timely manner and amniotic fluid during pregnancy reflects the condition of the woman.

  • Amniotic fluid red

The red color of amniotic fluid is the color of a serious danger, both for mother and baby. Most often, a red or pink tint of amniotic fluid occurs as a result of blood entering during bleeding, either in the mother or in the baby. You understand how dangerous it is for mother and child. If a similar situation overtook you, your actions should be as follows - immediately take a horizontal position and in no case move. Relatives should call an ambulance without delay.

Premature rupture of amniotic fluid is a common problem that can be dangerous for mother and baby. Why is it so important for a baby to be in a liquid environment and in a whole amniotic sac? Let's talk about this topic.

Throughout pregnancy, the fetus floats in the amniotic fluid that fills the amniotic sac. It performs a wide range of functions. Amniotic fluid is involved in the metabolism of the baby, protects it from external influences (mechanical, sound, light) and various infectious diseases. In addition, with its help, the child’s digestive and respiratory systems are trained. Amniotic fluid is constantly updated. Its amount can also tell about the condition of the fetus inside the womb.

The outflow of amniotic fluid normally occurs during the birth process. When the cervix matures, the membranes soften and enzymes are released that help the placenta to separate. The fetal bladder loses elasticity and strength and bursts. Amniotic fluid leaks out. After the amniotic fluid breaks, contractions usually intensify.

If the fetal bladder loses its integrity until the fetus ripens and is ready for natural childbirth, then they speak of premature rupture of the membranes. The degree of threat to the mother and child is assessed depending on the duration of pregnancy. The main risks are due to preterm birth and infection of both the fetus and the pregnant woman.

The causes of premature rupture of amniotic fluid are numerous. The most common is infection of the genital organs of a pregnant woman. In this case, the cervix softens ahead of schedule, and the released enzymes thin the fetal bladder, leading to the separation of the placenta. In this case, the infection of the baby is most likely.

To PRPO (premature rupture of the membranes) can also lead to structural features of the pelvis, the condition of the cervix, and the position of the fetus. A weak neck creates conditions for protrusion of the bladder and violation of its integrity. The narrow pelvis and the unusual position of the fetus create a threatening condition, when most of the water accumulates at the bottom of the bubble and breaks it. Normally, the fetus is tightly adjacent to the pelvic floor and creates a belt of contact that does not allow the bulk of the water to pass to the bottom of the bladder.

Medical intervention associated with a puncture of the bladder for fluid analysis can provoke further violation of the integrity. Uterine anomalies such as the presence of a septum, placental abruption, polyhydramnios, and multiple pregnancies are risk factors. Provoke premature rupture of amniotic fluid during full-term pregnancy can be physical activity, with premature blunt abdominal trauma and bad habits of the mother associated with the use of alcohol and nicotine, narcotic substances. Taking certain potent drugs can also have a negative effect.

Finding the symptoms of amniotic fluid rupture is quite easy. During this process, a fairly large amount of liquid is released so that it can be confused with something else. The waters are normally colorless and have a slightly sweet smell. It is more difficult to determine the presence of shell cracks. After all, then the amniotic fluid flows out drop by drop and is easily mistaken for vaginal discharge. Another premature rupture of amniotic fluid has signs in the form of an increase in the amount of discharge in the supine position.

If there is a suspicion of leakage of amniotic fluid, tests are prescribed - a smear for pH, ultrasound. They may suggest amniocentesis with staining or some other technique. The Amnishur test has proven itself well. After establishing the fact of violation of the integrity of the membrane, a decision is made on further actions depending on the duration of pregnancy and the presence of complications.

Doctors, depending on the timing at which premature rupture of amniotic fluid occurred, offer various ways to reduce the risk of complications. If the pregnancy is full-term, then usually childbirth occurs on its own within the next two days. In this case, the woman is placed in a hospital and is under observation. Rehabilitation of the genital tract is carried out to avoid infection, the birth canal is prepared. The decision to wait for natural childbirth reduces the risk of birth injuries and other negative consequences.

For periods up to 22 weeks, PROM is usually an indication for termination of pregnancy due to too high risks of complications of infection of the fetus and mother. If the pregnancy has exceeded the specified period, then many factors are taken into account. The more the baby has developed, the better the prognosis. The main indicator of the possibility of having a viable child is the maturation of his lungs. For this, the woman is placed in almost sterile conditions. Provide bed rest and antibiotic prophylaxis. Everything is done to save the life and health of mother and baby.

22.01.2020 17:59:00
7 Easy Ways to Boost Your Metabolism
If you stimulate your metabolism, your body will certainly transform: calorie consumption will increase, weight will begin to drop faster, and health will improve. We will tell you how to speed up your metabolism to maximum performance.
22.01.2020 09:08:00
4 effective ways to reduce belly fat
It is unlikely that anyone likes belly fat, but getting rid of it is not easy. To finally overcome fat in the middle part of the body, you should apply the following 4 methods.
21.01.2020 18:18:00
Diet "2 kilograms": lose weight quickly and without hunger
If you haven't reached your dream weight yet, don't despair! We present you a diet that helps you lose those extra pounds without hunger.

The period of bearing a baby is not only the most wonderful time, but also the most responsible. Now you are responsible not only for your life, but also for the life of your baby. We all know that with the slightest change in sensations, discharge, it is worth consulting a doctor. But there are situations that we can overlook or ignore.

One of these situations is the leakage of amniotic fluid. It is quite difficult to diagnose such a complication in yourself. However, let's still try to figure out what symptoms of amniotic fluid leakage should alert you. If you find them in your home, you should not flip through the entire Internet in search of a confirming photo.

Contact your OB/GYN doctor immediately to clarify the situation. With this complication, every minute counts, and the sooner you get to the doctor, the more likely it is to give birth to a healthy and strong baby.

Amniotic fluid, or amniotic fluid, is a substance that is produced by the amniotic membranes. Amnio is one of the shells that formed during the development of pregnancy to protect the baby from drying out. What does amniotic fluid look like? Usually they are transparent, slightly cloudy. It may contain scales of the baby's skin, particles of original lubricant and the first fluff. Therefore, when the expectant mother does an ultrasound on high-resolution devices, such elements will be visible. In addition, amniotic fluid contains proteins, fats, carbohydrates, salts, vitamins and other necessary elements to support the life of the fetus.

Such a liquid performs several functions, such as:

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

Feature of the pathology

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

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

The consequences that cause this kind of complications include:

  • Premature termination of pregnancy.
  • Chronic hypoxia may develop and, as a result, fetal death.
  • There may be disturbances in the work of the central nervous system and the gastrointestinal tract.
  • If this is the result of an infectious process, then infection of the fetus is possible.
  • The appearance of late - preeclampsia - in a pregnant woman.
  • -Premature labor - provoked by the early outflow of water.
  • Due to the large enough space that surrounds the baby, he often takes a transverse or breech presentation., And this is an indication for a "caesarean section"

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

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

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

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

Amnioscopy- visual examination of amniotic fluid. On a gynecological chair, a woman is introduced into the cervical canal with an amnioscope tube. With the help of illumination, the doctor can assess the structure of amniotic fluid, the presence of blood, meconium, flakes of primordial lubricant. This procedure is carried out only with a mature smoothed cervix and a whole bladder.

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

Symptoms of amniotic fluid leakage in the second and third trimester

There are several tell-tale signs that help you recognize how amniotic fluid is leaking. These include:

  • Unusually large amount of discharge at a time, about 1 tablespoon.
  • Allocations occur with movement or even a slight change in posture.
  • Most often, such secretions are transparent in color and odorless. But in case you observe cloudy, green, pink or brown discharge, this is an occasion for urgent medical attention.
  • The number of fetal movements is reduced.
  • The belly is reduced in volume.

There are now tests to detect amniotic fluid leakage, they help to give an accurate assessment of your condition. These include:

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

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

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

Causes

Doctors identify several reasons that entail premature rupture of the amniotic membranes:

  • Infectious or inflammatory processes that violate the integrity of the bladder.
  • Hormonal changes.
  • The beginning of labor activity.
  • Strong blow or push.
  • Benign or malignant neoplasms in the uterus.
  • Such research methods as amniocentesis, chorionbiopsy can violate the integrity of the bladder. Both studies are aimed at identifying chromosomal pathologies of development in the fetus.

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

Diagnosis and treatment

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

  • Ultrasound, which will help determine the condition of the fetus, a possible placental abruption.
  • Looking in mirrors. So the doctor will see a small amount of accumulated fluid, and when coughing, its amount will increase.
  • Analysis of a vaginal smear under a microscope.
  • Amniotest.
  • Amniocentesis with dye. A small amount of dye is injected through the abdominal cavity, and the vagina is closed with a swab. If after a certain time the swab changed color, this indicates that the diagnosis was confirmed.

After confirming the diagnosis, the doctor must decide whether you are left in the hospital for preservation, or labor is stimulated. What decision your doctor will make depends on how long the pregnancy is, how mature he is and how ready to be born, what condition the baby is in now, what condition your body is in. Most often, before the 22nd week of pregnancy, the doctor recommends terminating the pregnancy in order to avoid other dangerous complications.

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

Consequences and complications

Unfortunately, the consequences of such a complication are rather sad. It poses a risk to the health and life of not only the mother, but also the baby, since premature bladder failure is the cause of an increase in infant mortality by 4 times. The most common complications are:

  • Respiratory distress syndrome. A very serious complication in premature babies. It is caused by the fact that the baby's lungs have not yet fully developed and cannot independently perform their function. They stick together and do not allow air to circulate. Such children need mechanical ventilation and expensive injections.
  • Infectious complications in the mother and / or fetus. It is the most common complication, and can strike within 6-32 hours after the breach of the integrity of the bladder. Sometimes there are cases so serious that it is not possible to save the baby.
  • Fetal hypoxia may occur due to impaired blood circulation in the uterus and placenta.
  • In pregnant women with such a complication, there is a weak labor activity and bleeding after.

Prevention

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

Also, around c you may feel less confident as it becomes harder for you to strike a balance. This is due to the fact that due to the enlarged uterus, the center of gravity shifts. The main condition during this period is comfortable shoes. It should not be big or small, you should feel comfortable in it. Thus, you can protect yourself from accidental falls and stomach bumps.

Video

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

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

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

Premature rupture of the membranes is their spontaneous rupture before the onset of labor during pregnancy from 22 to 42 weeks. The frequency of premature rupture of amniotic fluid is from 10 to 15%, depending on the duration of pregnancy.

Amniotic fluid is a biologically active environment that surrounds the fetus, intermediate between it and the mother's body, which is throughout the entire pregnancy! and performs a variety of functions during childbirth. Normally, their amount is about 600 ml; fluctuations depend on the duration of pregnancy - from 300 ml (at 20 weeks) to 1500 ml (at 40 weeks). In full-term pregnancy, amniotic fluid is a product of the secretion of the amniotic epithelium, extravasation from the vessels of the decidua and fetal kidney function, and is excreted by the placental and paraplacental routes. For 1 hour, 200-300 ml of amniotic fluid is replaced, and complete - within 3-5 hours. In addition, amniotic fluid is the most important part of the defense system that prevents mechanical, chemical and infectious effects. During physiological pregnancy, the amniotic fluid remains sterile. The amniotic fluid has antimicrobial activity due to the production of interferon by the membranes, contains lysozyme, antibodies to certain types of bacteria and viruses, immunoglobulins.

, , , , , ,

Causes of premature rupture of amniotic fluid

In the etiology of premature rupture of amniotic fluid, there are several reasons:

  • infection (amnionitis, iervicitis, vaginitis of streptococcal or other etiology);
  • overstretching of the uterus (polyhydramnios and / or crowded pregnancy);
  • narrow pelvis;
  • extensor insertion of the head;
  • breech presentation;
  • malposition;
  • fetal malformations;
  • structural changes in tissues (due to insufficient consumption of ascorbic acid and trace elements, in particular copper);
  • injury.

The most common factor is infectious. Ascending cervical and vaginal infection leads to colonization with bacteria that secrete collagenase, which reduces the strength and elasticity of the membranes.

A direct relationship has been established between the intake of vitamin C and the degree of collagen degradation, leading to premature rupture of amniotic fluid. A relationship was found with the level of insulin-like factor in the vaginal secretion, with an increase in which the risk of premature rupture of the membranes increases sharply. Based on this, the role of ascorbic acid, a-tocopherol, retinol and beta-carotene in the prevention of premature rupture of amniotic fluid was confirmed. In addition, it has been proven that the mechanical strength of the fetal bladder depends on the content of surface-active phospholipid (amniotic surfactant).

With the onset of labor activity, the bactericidal activity of amniotic fluid decreases, they can delay the development of microorganisms only for 3-12 hours, and later become a nutrient medium for their reproduction.

With the rupture of the membranes, the possibility of penetration of microorganisms into the amniotic fluid increases significantly until the moment of delivery. With a duration of an anhydrous period of more than 6 hours, 50% of children are born infected, more than 18 hours - the seeding of amniotic fluid increases dramatically. The development of chorioamnionitis and postpartum infectious complications is observed in 10-15% of cases, despite the ongoing prophylaxis.

The most common complication of childbirth with premature rupture of amniotic fluid is the weakness of labor. Primary weakness of labor activity is observed 5.7 times, and secondary - 4 times more often compared with physiological childbirth. This is due to the lack of an increase in the concentration of prostaglandin after premature rupture of amniotic fluid, inhibition of lipid peroxidation processes, insufficient amounts of oxytocin, low production of prostaglandin by chorionic cells due to high production of progesterone.

, , , , , ,

Diagnosis of premature rupture of amniotic fluid

When examining the cervix in the mirrors, the outflow of amniotic fluid from the cervical canal is visually established. In case of difficulty in making a diagnosis, differentiate amniotic fluid and urine, increased secretion of amniotic fluid and cervical glands before delivery using one or more of the following tests:

  • nitrazine. A few drops of fluid taken from the vagina are applied to a strip of nitrazine paper. In the presence of amniotic fluid, the paper turns dark blue;
  • fern test - the phenomenon of the formation of a fern leaf pattern (arborization). With a cotton swab, the material is taken from the site of the external pharynx of the cervical canal, a thin layer is applied to a clean glass slide, after which the drug is dried in air for 5-7 minutes. The preparation is viewed under a microscope at low magnification. The definition of crystallization in the form of a fern leaf or a tree structure is a confirmation of the presence of amniotic fluid. The "fern leaf" that forms from arborization of amniotic fluid has more branches than from arborization of cervical mucus. The fern test is considered more accurate than the nitrazine test;
  • cytological. Determination of amniotic fluid cells in a vaginal swab produces fewer false positives than a nitrazine test and may be the most accurate in confirming a diagnosis;
  • pH determination with a test strip. The amniotic fluid is alkaline (pH 7.0-7.5), while the normal vaginal contents are acidic (pH 4.0-4.4). With a sterile cotton swab, the material is taken from the site of the external pharynx of the cervix of the uterine canal, applied to the test strip. The coloration of the strip in blue-green (pH 6.5) or blue (pH 7.0) indicates the presence of amniotic fluid in the test material. False positive results are possible if blood, urine or antiseptics enter the test material;
  • study of smears of moisture content according to the method of L. S. Zeyvang. 1-2 drops of the contents of the vagina are applied to a glass slide and 1-2 drops of a 1% aqueous solution of eosin are added, followed by viewing in a light-optical microscope at low magnification. In the case of outflow of amniotic fluid in the test fluid, among the bright pink epithelial cells of the contents of the vagina and erythrocytes, accumulations of unstained nuclear-free cells of the fetal epidermis are determined, which do not perceive paint due to coating with original lubricant;
  • ultrasopography. If a sufficient amount of amniotic fluid is determined, the diagnosis of premature rupture of the membranes is doubtful. In the case of determining oligohydramnios and subject to the presence of at least one positive test for amniotic fluid, a diagnosis of premature rupture of amniotic fluid is established.

Spontaneous labor activity (without attempts to induce it) during full-term pregnancy develops in 70% of pregnant women during the first 24 hours from the moment of ascertaining the rupture of the membranes, and in 90% - in the first 48 hours. Expectant management in these cases in the absence of clinical manifestations of infection and timely antibiotic prophylaxis does not increase the frequency of purulent-inflammatory complications in the puerperal woman and the newborn.

Management of pregnant women with premature rupture of amniotic fluid

Hospitalization is required in an obstetric hospital of the III level of medical care from 22 to 34 weeks of pregnancy. Before the transfer of a pregnant woman from obstetric hospitals of I-II levels to institutions of the III level of medical care, an external obstetric examination, examination of the cervix in the mirrors and auscultation of the fetal heartbeat are performed. With confirmed premature rupture of amniotic fluid, it is necessary to begin the prevention of respiratory distress syndrome: intramuscular injection of dexamethasone 6 mg every 12 hours, per course - 24 mg (A) or betamethasone 12 mg every 24 hours, per course - 24 mg (A).

From the 35th week of pregnancy, delivery can be carried out in institutions of the II level of medical care, if necessary, with the call of a consultant from a healthcare institution of the highest level of medical care.

The main stages of examination in a hospital during hospitalization:

  • establishment of gestational age;
  • determination of the approximate time of rupture of the membranes according to the anamnesis;
  • diagnosis of the presence of labor activity by external examination methods;
  • examination of the cervix in the mirrors (vaginal examination in the absence of labor and contraindications to expectant management of a pregnant woman is not performed);
  • confirmation of the diagnosis by laboratory methods in doubtful cases;
  • Ultrasound with determination of the volume of amniotic fluid;
  • bacterioscopic examination of vaginal discharge with Gram-stained smears.

Management of pregnant women with premature rupture of membranes

Depending on the gestational age, concomitant pathology, obstetric situation and obstetric and gynecological history, individual management tactics are selected.

In all cases, the patient and her family should receive detailed information about the condition of the pregnant woman and the fetus, the benefits of the possible danger of one or another method of further management of the pregnancy, with the written consent of the patient.

Expectant management (without induction of labor) can be chosen:

  • in pregnant women with a low degree of predicted perinatal and obstetric risk;
  • with a satisfactory condition of the fetus;
  • in the absence of clinical and laboratory signs of chorioamnionitis (an increase in body temperature over 38 ° C, a specific smell of amniotic fluid, a fetal heart rate of more than 170 per 1 min; the presence of two or more symptoms gives rise to a diagnosis of chorioamnionitis);
  • in the absence of complications after the outflow of amniotic fluid (prolapse of umbilical cord loops, placental abruption and the presence of other indications for urgent delivery).

In the case of choosing expectant tactics "in the obstetric hospital, it is necessary to carry out:

  • measuring the body temperature of a pregnant woman twice a day;
  • determination of the number of leukocytes in peripheral blood, depending on the clinical course, but at least once a day;
  • bacterioscopic examination of vaginal discharge once every three days (with counting the number of leukocytes in a smear);
  • monitoring the condition of the fetus by auscultation twice a day and, if necessary, recording CTG at least once a day from the 32nd week of pregnancy;
  • warn the pregnant woman about the need to independently conduct a test of fetal movements and contact the doctor on duty in case of a change in the motor activity of the fetus (too slow or stormy);
  • prophylactic administration of semisynthetic penicillins or cephalosporics of the second generation in average therapeutic doses from the moment of hospitalization for 5-7 days in the absence of signs of infection in a pregnant woman.

At 22-25 weeks gestation:

  • antibiotic therapy since admission to the obstetric hospital.

At 26-34 weeks gestation:

  • monitoring the condition of the pregnant woman and the fetus without an internal obstetric examination is carried out in an obstetric hospital of the III level of medical care;
  • antibiotic therapy from the moment of hospitalization in an obstetric hospital;
  • prevention of fetal respiratory distress syndrome by intramuscular injection of dexamethasone 6 mg every 12 hours (for a course of 24 mg) or betamethasone 12 mg every 24 hours (for a course of 24 mg). Repeated preventive courses are not carried out.

At 35-36 weeks gestation:

  • expectant or active tactics are possible;
  • if the condition of the pregnant woman and the fetus is satisfactory and there are no indications for operative delivery, observation is carried out without an internal obstetric examination in health care institutions of the II-III level of medical care;
  • antibiotic therapy is started after 18 hours of the anhydrous period;
  • with a mature cervix, induction of labor activity begins in the morning (not earlier than 6:00) with oxytocin or irostaglandins;
  • with an immature cervix, preparation for childbirth is carried out by intravaginal administration of prostaglandin E2;
  • in the presence of indications, delivery is carried out by caesarean section.

At 37-42 weeks gestation:

  • in the absence of the development of spontaneous labor activity, an internal obstetric examination is performed after 24 hours;
  • with a mature cervix, labor is induced in the morning (not earlier than 6:00) with oxytopin or prostaglandin E2;
  • with an immature cervix, preparation for childbirth is carried out by intravaginal administration of prostaglandin E2;
  • if indicated, delivery is prescribed by caesarean section.

Tactics of managing pregnant women in the presence of infectious complications

In case of development of chorioamnionitis, termination of pregnancy is indicated.

In the treatment regimen, cephalosporins of II-III generation and metronidazole (or ornidazole) are prescribed 30 minutes before the administration of cephalosporins.

The method of delivery is determined by the gestational age, the condition of the pregnant woman and the fetus, and the obstetric situation.

In the case of operative delivery, intensive antibiotic therapy is carried out in a therapeutic regimen for at least 7 days.

Thus, premature rupture of amniotic fluid is accompanied by a number of serious complications, which requires the improvement of tactics of labor management and antenatal protection of the fetus in this pathology, the prevention of purulent-inflammatory diseases in the puerperal woman and the newborn, as well as special attention in the management of the early neonatal period.

ICD-10 code

According to the International Classification of Diseases of the 10th revision (ICD-10), the code for premature rupture of the membranes is 042:

  • 042.0 Premature rupture of membranes within 24 hours before onset of labor;
  • 042 1 Premature rupture of membranes, onset of labor after 24 hours of waterless period;
  • 042.2 Premature rupture of membranes, delayed labor associated with therapy;
  • 042.9 Premature rupture of membranes, unspecified

18.08.2017 / Heading: / Mari no comments

Water is essential for all life on Earth. Amniotic fluid is also vital for a baby in the womb. The more complex and perfect the process, the more severe the consequences of deviations from the norm. It turns out that the number of pregnancies that were accompanied by such complications is growing every year. For mothers, questions remain open:

  • how to see or how to determine the leakage of amniotic fluid?
  • how to behave?
  • Is it possible to prevent complications and save the baby?

How not to miss symptoms

POPV refers to the leakage of amniotic fluid as a result of damage to the fetal membrane. In a standard situation, the outpouring of amniotic fluid occurs before childbirth. Up to this point, the liquid provides:

  • metabolism between the fetus and the mother's body;
  • sterility of the environment for the growth and development of the fetus;
  • protection from shock, noise, squeezing by the uterine muscles;
  • cushioning of sudden movements when mom moves.

For a normal pregnancy, the volume of amniotic water should be 1.5-2 liters. Fluid levels are monitored by ultrasound. Pregnant women are often faced with the concept of low water - lack of amniotic water. Its cause can be both the physiological characteristics of the mother's body, and microcracks in the shell around the child. In a neglected form, leakage provokes premature birth, and in the early stages - miscarriages. For a child, complications of this kind are fraught with oxygen starvation. Without liquid, the baby can do from 12 hours to a day.

Important! Amniotic fluid leakage can occur at any stage of pregnancy.

There is a classification of ruptures according to the time and location of the damage.

By location:

  • cervical rupture - the membrane is damaged in the cervical region, as a result of which a significant amount of fluid is lost;
  • high lateral or upper tear of the bubble - the liquid comes out in small portions, drop by drop.

Abundant discharge and urinary incontinence are common in the later stages. This greatly complicates the diagnosis of pathology.

Exceptional attentiveness makes it possible to recognize the leakage of amniotic fluid. First calls:

  • the nature of the discharge has changed: frequent, abundant, watery with less mucus;
  • sudden movements, coughing, even hiccups and laughter, are accompanied by secretions;
  • due to the loss of some volume of water, the tummy decreases in size and may drop slightly;
  • after emptying the bladder, fluid from the vagina still continues to stand out.

Do not ignore even minor signs. The sooner action is taken, the easier the mother and child will bear the effects of POPV.

Common Causes

The outflow of amniotic fluid in the early stages goes unnoticed by the pregnant woman, since the doses are very small. A few drops are easy to confuse with the usual discharge during pregnancy. The causes of leakage lie both in deviations in the bearing of a baby, and in the structural features of the mother's body, the state of health at the planning stage.

The main provoking factors include:

  • bacterial infections and inflammatory processes;
  • "Female" inflammation;
  • incorrect position of the child;
  • narrow pelvis of the expectant mother;
  • abnormal structure of the uterus;
  • insufficiency of the cervix;
  • detachment of the placenta;
  • amnicentesis, chorion biopsy;
  • pregnancy with two or more children;
  • lacerations as a result of a fall.

Important! Alcohol and drug abuse, smoking automatically classify a pregnant woman as a risk group.

How infections damage the amniotic sac

Infections are the most insidious phenomena, because they can harm the body of the mother and child imperceptibly. Hormonal restructuring, a large load on the body, general weakness create a favorable climate for harmful bacteria that are present in a woman's body in small quantities and previously did not pose a danger. Even vaginal dysbacteriosis can lead to serious consequences.

Chronic diseases and forgotten "women's" problems remind of themselves with renewed vigor.

According to statistics, 10% of women in whom childbirth ended with a premature outpouring of amniotic fluid are diagnosed with various inflammations of the respiratory or gastrointestinal tract. Inflammation of the genital organs leads to similar complications in 25% of cases. The danger of such a situation is that bacteria penetrate through the holes in the shell, bypassing all defense mechanisms.

Important! Even a slight suspicion should serve as a guide to action. There are several ways to determine the leakage of amniotic fluid at home, as well as a laboratory method.

When to Be Careful

Erosion or other diseases of the cervix, abortions and operations in this area lead to damage to the amniotic sac in 50% of cases. Anomalies in the structure of the cervix are also dangerous. Insufficiency of the neck, when the walls do not close, leading to a protrusion of the bladder. Small physical exertion is enough to damage the bladder.

The incorrect location of the fetus creates an additional load on the membranes. In late pregnancy, when the belly drops and the baby is inserted into the birth canal, a belt of contact forms around the baby's head. Thus, the amniotic fluid is divided into anterior and posterior waters. This mechanism allows you to distribute the load on the walls of the shell. When the fetus is located across or head up, then all the liquid rushes down, presses on the lower wall with double force and the risk of damage to the shell increases.

The functionally narrow pelvis of the expectant mother for the same reasons can lead to rupture of the bladder. The head cannot be inserted into the birth canal, since it is larger in diameter and the entire volume of fluid is in the lower part of the bladder.

Perinatal diagnosis is aimed at identifying malformations, chromosomal disorders, hereditary diseases and, in rare cases, can cause fluid to leak from the amniotic sac. A biopsy of the chorionic villi is performed at a period of 11-13 weeks by cutting a fragment of the placenta. Amniocentesis is the study of amniotic fluid.

The sampling of material for analysis is carried out using a puncture. A long needle is inserted into the uterus by piercing the abdomen in a place that is safe for the fetus. The optimal period is the second trimester. If necessary, amniocentesis is carried out in the third trimester. After such analyzes, a course of anti-inflammatory therapy is prescribed and the condition of the expectant mother is carefully monitored.

Important! The presence of the above features during pregnancy should not plunge expectant mothers into panic. The information above only emphasizes the importance of being attentive to your condition.

Diagnostics

The determination of leakage can be carried out both in the laboratory and independently.

If there are indications, swabs are taken from the pregnant woman and examined for the presence of amniotic fluid proteins.

There is another method that is not very accurate, but is used quite often. The so-called fern symptom. The smear is applied to a glass slide, after drying, the result is evaluated visually. Mucus crystallizes on drying. If the smear contains amniotic water, then a pattern resembling fern leaves is formed. A similar effect may have an admixture of urine or semen in a smear.

Amniotest is distinguished by absolute accuracy, high price, painful procedure and the risk of provoking additional problems: infection, bleeding. With the help of a long needle, a special dye is introduced into the amniotic fluid. The dye is not dangerous for the baby, since the amniotic fluid is completely renewed every 2-3 hours, which means that the dye is removed from the mother's body. 30 minutes after the procedure, a tampon is placed in the patient's vagina. The coloration of the tampon indicates the presence of holes in the shell. For every 300 such manipulations, there is 1 case of severe complications.

If the indicators according to ultrasound are below normal, doctors must confirm or refute the leakage of amniotic fluid with additional studies, since the damage to the membrane itself is not visible on the monitor.

A very dubious diagnostic method, which is also practiced, is an examination by a gynecologist. The expectant mother is asked to cough. At this time, the doctor carefully observes whether fluid has appeared.

time-tested diagnostics

Laboratory tests and examinations are an inconvenient, often lengthy and exhausting way to detect amniotic fluid leakage. How to determine damage to the shell yourself, they knew long before the advent of modern tests.

For a homemade test, a clean cotton cloth is enough, you can use a white sheet. A woman should thoroughly wash herself and dry herself. You need to lie on a sheet without underwear. You should relax as much as possible. After 20 minutes, you need to evaluate the result. If the tissue is wet, then there is a reason for more accurate analyzes.

According to another method, the white fabric is folded several times and "worn" for 1.5-2 hours like a pad. You need to lie down several times to change the position of the body: lie for 10 minutes on the right side, then on the left and on the back. Gently stand up and sit down, lean slightly to both sides. Movements are performed carefully without much enthusiasm. After the lining fabric is inspected. Amniotic fluid leakage looks like a wet spot when the fluid is completely absorbed into the tissue. When dry, the edges of the stain will be uneven with a brownish tint. If there are few secretions and they are not absorbed, but remain on the surface in the form of mucus, everything is fine.

Modern Tests: Test Pad

The pad test is a simple and popular way to test for the presence of amniotic fluid in the discharge. Relatively affordable.

It works due to the fact that the acid-base balance in the human body is different. And the pH of the vagina has an acidic environment and is 3.8-4.5. Acidity inhibits the development of "unfriendly" bacteria and helps maintain women's health.

Amniotic waters are the habitat of a new organism, rich in nutrients and biologically active components. The color of amniotic fluid at the initial stages of pregnancy is yellowish, then it becomes more transparent, similar to ordinary water. By the end of pregnancy becomes cloudy. Greenish or brown color indicates infections. pH of amniotic waters 6.98-7.23.

Thus, if leakage occurs, the acidity of the vagina will decrease and the pH will increase accordingly. The gasket is equipped with an indicator that turns turquoise upon contact with a neutral environment - pH 5.5 and above.

Important! During the test, it is important that moisture does not get on the gasket. Hands and perineum must be absolutely dry.

The test pad can be worn for 12 hours or until the woman feels wet. Then the pad is removed from the laundry, the test strip is removed and placed in a special case (included in the kit). If after 30 minutes the strip has not changed color, everything is fine.

The disadvantage is that the acidity of the vagina can decrease for other reasons. The most common is thrush or other infections. Which also during pregnancy requires prompt and adequate treatment. In any case, thanks to the test, a woman can identify a particular problem in a timely manner.

Amniotic water protein test

Science does not stand still. More accurate tests have also been developed. The marker in this case is placental α1 microglobulin. The protein is found in large quantities in the amniotic fluid and is absent from the vagina, urine, and blood. Thus, the test accurately determines the leakage of water.

In addition to high accuracy, there are a number of other advantages:

  • does not require special skills or tools;
  • carried out at home;
  • quick result;
  • the package contains everything you need.

The procedure is simple. Before starting the test, you must remove the container with a special solution from the package and shake it so that the contents sink to the bottom.

The set includes a sterile swab. With it, you need to take a sample of vaginal discharge. The tampon is inserted inside for 5-7 cm no more. It is recommended to hold the tampon in the vagina for about 1 minute.

Important! The tampon should not come into contact with other liquids or substances other than vaginal discharge. Hands must be dry.

The resulting sample is lowered into a test tube with a solution for one minute. During the whole time it is necessary to stir the solution with a swab.

The swab is removed from the tube. The box also contains a sealed test strip that resembles a rapid pregnancy test. Further actions are the same: lower the strip into the test tube with the reagent with the end indicated by the arrows to the level indicated by the line.

The result will not be long in coming. After 30 seconds, if the amniotic sac is damaged, two strips will appear. One line is good. To be sure of this, you should finally wait 10 minutes. A small amount of amniotic fluid will appear later, and one line may be paler. The accuracy of the test with two strips is 100%. The error of a negative result is 1%. In other words, in exceptional cases, the test may not detect a protein:

  1. if the outpouring of water occurred 12 hours before the test;
  2. amniotic fluid enters the vagina in very small doses.

The price of the amniotic fluid leak test is the only drawback. But when it comes to the well-being of mother and baby, the financial part fades into the background.

What to do next?

POPV is not treatable. Violation of the integrity of the membranes around the child before the 22nd week of pregnancy often leads to fetal fading or miscarriage. In such cases, doctors recommend termination of pregnancy.

With leaks for a period of 36 weeks or more, pregnancy is not preserved. Often within 12 hours, the process of childbirth starts. Depending on the case, labor induction is prescribed or a caesarean section is performed.

For a period of 22 to 36 weeks, doctors take a "wait and see" position. The woman is immediately placed in a hospital under round-the-clock supervision. With the help of ultrasound, the amount of remaining water, the heartbeat and the general condition of the baby are evaluated.

Pregnancy is kept as long as possible to give the baby more time. Special drug therapy is prescribed. Drugs are introduced that accelerate the development and maturation of the lungs and other systems. In such situations, childbirth can begin at any time. If the condition of the child or mother worsens, the pregnancy is no longer maintained. After the crumbs are placed in a special box - an incubator. Next is the treatment. The child will stay in the incubator until he gains the necessary weight and gets stronger.

5 / 5 ( 1 vote)