For expectant mother 

How can a doctor determine amniotic fluid leakage? Leakage of amniotic fluid or discharge: how to understand? Signs of amniotic fluid leakage. Danger of premature drainage

Another serious nuisance that can happen during pregnancy is the leakage of amniotic fluid. This can lead to great complications both during pregnancy and already during the birth itself.

Amniotic fluid, or rather the amniotic fluid, plays a significant role in the development of the fetus. Any change in its composition and quantity has great consequences, because the amniotic fluid is not only the habitat of the unborn baby, but also protection from various infections and external influences, its nutrition and a means of facilitating the pregnancy process for the woman herself.

The volume of amniotic fluid increases in direct proportion to the development and growth of the baby. Thus, if in the first trimester of amniotic fluid there is about 6-11 ml, then already in the second trimester it is 260-290 ml. In the last trimester, the rate of amniotic fluid should be 1.2-1.5 liters. But before the birth itself, their volume decreases by 2 times. In this regard, 2 problems may arise: lack of water and polyhydramnios.

In addition, the amniotic fluid performs the following functions, the improper performance of which can lead to serious disorders:

  • saturation of the fetus with special nutrients that are found only in the amniotic fluid;
  • maintaining constant pressure;
  • maintaining a normal temperature no higher than 37 degrees (if the expectant parent is not sick);
  • protection of the fetus and child's place from shocks and squeezes from the outside;
  • protection against infections due to the presence of immunoglobulins in the amniotic fluid;
  • ensuring freedom of movement of the fetus;
  • protection against loud noises from outside.

Normally, such a useful amniotic fluid should flow out only during labor, both naturally and when labor is stimulated by piercing the amniotic sac.

If the amniotic fluid flows out before the onset of childbirth, then the body signals to us that the pregnancy is proceeding with deviations, which must be carefully examined and monitored.

Signs of amniotic fluid leakage

No matter how simple it may sound, often the leakage of amniotic fluid is difficult to notice and determine immediately. Quite often, it is confused with simple urinary incontinence or various secretions, the volume of which increases with the duration of pregnancy. That is why you need to tell your doctor everything in order to prevent water leakage and play it safe against various complications during pregnancy. But you yourself should pay attention to the secretions of this kind and study them carefully, because the amniotic fluid does not have the color and characteristic odor that is present in urine, and also does not have a mucous base, like vaginal discharge.

If you suspect that amniotic fluid is leaking, you can do a quick test at home. To begin with, you have to empty your bladder to the maximum, wash yourself thoroughly and wipe dry. Then you will need to lie down on a completely clean and dry sheet for about 15 minutes. If the sheet becomes even a little wet, then you must immediately call an ambulance.

If the leakage of water is missed during the first trimester, then in 90% of such cases, abortions subsequently have to be performed.

If at the very beginning of pregnancy it is difficult to notice the leakage of water, then at a later date, about 2 weeks before childbirth, it is impossible not to recognize it, because up to 500 ml of amniotic fluid flows out immediately. Usually, after this, contractions begin immediately.

In order not to miss the leakage of amniotic fluid and to recognize them in time, you should give preference to light cotton underwear during pregnancy and regularly use panty liners that will allow you to track the frequency of discharge.

Remember that if during urinary incontinence it is released when laughing, coughing, sneezing, then the amniotic fluid does not depend on it and if it leaks, then just like that, without external factors, which is what the home express test is based on.

How to determine the leakage of amniotic fluid

Leakage of amniotic fluid occurs due to damage to the lining of the walls of the uterus. The stronger the cracks and tears, the more fluid flows out. Also, the height of the fundus of the uterus affects the volume of amniotic fluid flowing out.

Thus, if the cracks are very small, then very little amniotic fluid is lost, and this loss is rather difficult to notice. And in order to notice such a leakage of water, 4 methods were created:

  • Smear microscopy. The dried amniotic fluid crystallizes and forms a fern-leaf pattern. If, when analyzed on glass, such a pattern is obtained, then the water leaks.
  • Nitrazine test. This test determines the pH of the vagina. If, according to the analysis, the vagina is neutral or slightly alkaline, then water is leaking, normally the medium should be acidic. This analysis can be done at home, and the test itself is easily sold in pharmacies.
  • Protein-1 test. This analysis looks for a specific type of protein that is only found in the amniotic fluid.
  • Test for a-microglobulin-1. This element is also found only in amniotic fluid. It is quite easy to detect when water leaks due to its significant content.

The first 2 analyzes do not always give the correct result, because the reaction can be influenced by various components of urine, vaginal discharge, and sperm residues. In addition, the more time has passed since the rupture of the membranes of the uterus, the less informative these tests will be.

The most clear and correct result will be given by tests for protein-1 and a-microglobulin-1. In these tests, the different secretions are easily distinguished from the amniotic fluid. In addition, for these studies, special monoclonal antibodies have been invented that do not react to any other types of secretions other than amniotic fluid.

Cause of water leakage

As noted above, the leakage of amniotic fluid occurs due to cracks and ruptures of the lining of the walls of the uterus. Why are they formed?

  • Infections that have affected the amniotic fluid, as well as inflammation of the genital organs of a pregnant woman. This reason often occurs during a premature pregnancy. The cervix matures ahead of time, as a result of which certain substances are released that contribute to the softening of the membrane of the ovum and the detachment of the placenta. This is very dangerous for the expectant mother and her child, not only for their health, but also for their life in general, because can lead to fetal hypoxia and uterine bleeding.
  • Wrong position of the fetus and a narrow pelvis of the woman in labor. Here, water leakage is not so dangerous, because occurs already during the birth itself, but it complicates and slows them down, the uterus opens very slowly. And due to the fact that most of the water ends up in the lower part of the bubble, the shells are severely torn.
  • Cervical insufficiency, otherwise isthmic-cervical insufficiency. The fetal bladder protrudes, due to which the lower part becomes easily exposed to various infections, and any even minor physical activity can lead to its rupture. This deficiency affects 25% of pregnant women in the last trimester.
  • Bad habits: alcoholism, smoking, drug addiction.
  • Various diseases of a woman, such as anemia, connective tissue diseases, weight loss.
  • Multiple pregnancy.
  • Abnormal development of the uterus (short cervix, the presence of a uterine septum) and the fetus.
  • Such serious diseases as colpitis, tumors on the body of the uterus (malignant and benign), endocervicitis.
  • The pregnant woman underwent additional tests, such as amniotic fluid collection or chorionic villus sampling.

What does the leakage of amniotic fluid affect?

The type and degree of complication is influenced by the time at which the leak was detected, as well as how soon it was detected and taken under the control of the attending physician. Leakage of amniotic fluid can lead to the following:

  • Abnormal labor: severe weakness during childbirth, prolonged labor, or, conversely, too rapid labor. Both of these negatively affect both the mother and the child.
  • Premature placental abruption and heavy bleeding, which can lead to pituitary ischemia or uterine amputation.
  • Complications of infectious and inflammatory processes in the unborn baby and his mother, which occur in a quarter of women in labor due to intra-amniotic infection. Also, 12% of complications continue after childbirth, expressed in postpartum endometritis.
  • Serious complications for the fetus: hypoxia and asphyxia. Subsequently, ischemic encephalitis or pancreatitis may develop, the treatment of which is rather difficult and long-term, if it is possible at all.
  • Respiratory distress syndrome. It occurs most often during premature birth, when the baby's lungs are not yet fully formed and cannot subside due to a lack of surfactant.

All the consequences of the leakage of amniotic fluid are very serious and dangerous, which requires an immediate appeal to the attending physician and the appointment of high-quality treatment. First of all, such problems require antibiotic therapy in the early stages, so that the infections that have gotten do not have time to reach the uterine cavity and the fetus. If the terms are later, and the child is almost formed, then with the leakage of amniotic fluid, there is only one purpose: artificial induction of labor.

It is very important to have time to see a doctor and start treatment, in which case the pregnancy can still be saved. If you are inattentive to the problem that has arisen, then the pregnancy will have to be terminated due to too great a threat to the life of not only the unborn baby, but also the mother.

How to deal with water leakage

As well as the consequences of leakage of amniotic fluid, so the choice of treatment for this dangerous ailment depends on the degree of damage to the walls of the uterus and the volume of amniotic fluid flowing out.

  • In the first trimester, if they do not have time to notice the leakage of amniotic fluid in time, then in 90% of cases the case is resolved by abortion.
  • In the second and third trimesters, the attending physician prescribes inpatient treatment for a pregnant woman. The hospital is constantly monitoring the health of the expectant mother and her baby, and the development of the situation. At this time, every day of the baby in the womb without excesses is very valuable and has a great influence on the full development of the fetus. The closer the natural and full-term birth, the healthier and stronger the baby will be. If a large amount of amniotic fluid has leaked out, but 6 hours have not passed after that, then the attending physician prescribes antibiotics for the pregnant woman, which prevent infection of the fetus in the absence of protection of the amniotic fluid.
  • If the leakage of amniotic fluid develops (the volume and frequency increases) and will soon lead to rupture of the bladder, then the doctor urgently prescribes an artificial permission for childbirth. If, after a special puncture and leakage of amniotic fluid within three hours, the contractions did not begin, then special drugs are injected intravenously, stimulating labor activity, as well as accelerating the maturation of the cervix. But, more often than not, if labor does not begin, then an unscheduled caesarean section is performed.

Remember that if the amniotic fluid is leaking, a pregnant woman will not be able to do anything on her own, so do not try to solve the problem on your own without doctors. When the amniotic fluid flows out, it is necessary to strictly follow all the instructions of the attending physician and follow all the recommendations given to them.

Prevention to help protect against leakage of amniotic fluid

If, during the leakage of water, you cannot help yourself with anything, then you can protect yourself from this ailment even before it appears by following the following recommendations:

  • correct and timely preparation for pregnancy: regular visits to the gynecologist and the necessary examinations six months before pregnancy planning, timely detection and treatment of various infections;
  • correct daily regimen and competent nutrition and diet;
  • regular antiseptic treatment of the genital tract and other mucous membranes, basic hygiene both before and during pregnancy.

Remember, during pregnancy, you must carefully monitor your health and the slightest suspicion, the malaise must be reported to your doctor. If you have any suspicions about your state of health, do not hesitate to ask your doctor to prescribe additional tests if there are special indications for them. After all, even a minor ailment can become a serious obstacle to the full bearing and birth of a healthy child.

A pregnant woman faces various difficulties throughout the entire period of bearing her baby. It is remarkable that many carry a child without serious problems and postpartum complications. However, there is a percentage of women who are unlucky enough to have some type of pregnancy pathology. An example of such a pathological condition is the leakage of amniotic fluid, which is dangerous to life and health baby by circumstance.

Amniotic fluid, also called amniotic fluid, are a special biological environment for the embryo. Their synthesis takes place in the baby's amniotic membrane. By filling the cavity of the pregnant uterus, they surround the fetus and play a huge role in ensuring the normal development and growth of the baby in the mother's tummy.

By its composition, amniotic fluid is a complex liquid that contains many nutrients and other substances:

  • proteins;
  • carbohydrates;
  • lipids;
  • vitamins;
  • enzymatic, hormonal systems;
  • mineral components;
  • immunoglobulins;
  • gases (oxygen, carbon dioxide);
  • fetal skin lubrication;
  • vellus hair.

The main functions of amniotic fluid

The main functions of amniotic fluid are:

  1. Providing your child with all the necessary nutrients additionally to the main source of food through the placenta and umbilical cord. All the necessary substances are absorbed by the skin of the child, and in the later periods of pregnancy, the baby himself swallows a small amount of amniotic fluid and receives some of the nutrients orally.
  2. Maintaining a constant temperature regime(within 37 degrees), as well as constant pressure.
  3. Providing protective function in relation to the baby - a decrease in the strength of shocks from the outside, a softening of fluctuations inside the ovum.
  4. Protective antibacterial function, mediated by the presence of antibodies in the composition of waters.
  5. Ensuring free movement and the movement of the baby in the womb.
  6. Reducing the intensity of sound exposure from the outside.

Thus, amniotic fluid is vital for the baby at any of the terms of intrauterine development.

How does normal rupture of amniotic fluid occur?

Normally, in any pregnancy, there comes a moment when the amniotic fluid begins to pour out. This happens in the form two main options.

  1. In the first version, the fetal membranes, tearing in the center, provide one-time outpouring about 250 ml of amniotic fluid. The tear occurs right near the exit from the uterus. A pregnant woman feels at such a moment a sudden wetting of her underwear and clothes.
  2. In the second version, the rupture of the baby's membranes occurs on their lateral part, that is, above the place of exit from the uterus. This ensures that there is no one-time expiration, and gradual leakage of amniotic fluid in small quantities for a certain amount of time.

As mentioned above, the amniotic fluid can be poured out only if the integrity of the amniotic membrane of the fetus is violated. Amniotic fluid leakage is a rather dangerous phenomenon, first of all, for the child.

  • First, if medical care is not provided in a timely manner, it threatens with miscarriage or even spontaneous abortion. Secondly, there is a risk from the walls of the uterus, asphyxiation of the child.
  • Thirdly, the leakage of water can provoke disturbances in the normal birth process, that is, its reduced or increased intensity. A particularly important consequence is the formation of respiratory distress syndrome in a newborn premature baby.

Causes of amniotic fluid leakage

In the normal course of pregnancy, amniotic fluid will be poured out only at the end of the first labor period, that is, after sufficient opening of the cervical canal. But in some cases, the wife observes the leakage of water in an earlier period of bearing the baby. Thus, the leakage of amniotic fluid is considered to be its advance expiration at periods before the course of pregnancy.

The list of etiological factors that can cause amniotic fluid leakage include:

  • The presence of an insufficiency of the cervix, leading to "protrusion" of the bladder in which the fetus is located, which only increases the risk of infection of the child with an infectious agent.
  • Infected genitals of the mother, which leads to increased maturation of the cervix and a high rate of production of specialized enzymes that can provoke exfoliation of the placenta and softening of the membranes of the fetus.
  • Small transverse dimensions of the pelvic ring of the expectant mother.
  • Wrong position of the baby in the womb.
  • The presence of the development of several embryos in the uterine cavity (multiple pregnancy).
  • Abnormal structure of the uterus (uterine septum, congenital shortening of the organ).
  • Chronic general somatic diseases (anemic syndrome, dystrophic changes in organs and tissues in various manifestations).
  • Alcohol abuse, smoking experience.
  • Incorrectly planned and illiterately performed invasive diagnostic techniques in the prenatal period.

Symptoms of amniotic fluid leakage

How amniotic fluid leaks? In almost all cases, the symptoms of amniotic fluid leakage appear in the late stages of gestation. In the early stages, the appearance of such signs is also possible, however, their determination is quite difficult due to the small amount of fluid released. There is so little of it that, mixed with ordinary vaginal discharge, it will completely remain unnoticed by a woman.

In certain cases, a pregnant woman can mistake the occurrence of a minimal discharge for the manifestation of urinary incontinence. In the later stages of pregnancy, the leaks will differ in their abundance, and the woman will not confuse them with anything else. Often the amount of discharge increases with tension of the pelvic muscles or active change of position.

What does amniotic fluid look like? Amniotic fluid can be of a different nature. In some cases, it is a colorless transparent liquid, while in others it is reddish, with a brown or green tint, with a pronounced odor, which clearly indicates the presence of pathology on the part of pregnancy.

How to diagnose amniotic fluid leakage

Currently, there are many methods that allow you to accurately determine the presence of excess amniotic fluid at the first suspicion of the mother. Specialized amniotic fluid tests using indicator test strips.

One of these tests for amniotic fluid leakage is "Frautest amnio"... Its essence lies in the fact that a pregnant woman wears a special pad on her underwear, which contains a test strip. When the gasket feels wet, it is removed, the strip is taken out and placed in the case included in the set for half an hour. Next, the color of the strip is assessed: if it turns yellow-green, the test can be considered positive.

The formation of such a color reaction is associated with the determination of the acidity of a woman's discharge, or to be more precise, the amniotic fluid is alkaline, and ordinary vaginal discharge is acidic. This allows you to distinguish them from each other. The main advantage of the test for the determination of amniotic fluid "Frautestamnio" is its simplicity and highly sensitive response to even the smallest traces of amniotic fluid in the secretions.

Another kind of tests AmniSure ROM based on the method of determining the protein alpha-microglobulin, which is highly specific for the composition of amniotic fluid. The kit includes a swab, diluent tube and test strip.

After collecting secretions using a swab, it is placed in a test tube for one minute. Next, the test strip is immersed in the same test tube, and the results are read on a clean, light surface from this strip. The presence of two stripes indicates the presence of amniotic fluid in the discharge of a pregnant woman.

In addition to quick tests, such research methods, how:

  • Collecting a woman's gynecological anamnesis, information about pregnancy, examination and instrumental research.
  • Taking a smear from the vagina.
  • (Ultrasound).
  • Amniocentesis with dye injection.

All therapeutic measures are aimed at preserving the life and health of the baby. But patient management tactics with a full-term and premature pregnancy differs significantly.

Prevention of amniotic fluid leakage

  • Timely detection and treatment of cervical insufficiency.
  • Timely preserving therapy in relation to the fetus (prevention of spontaneous miscarriage).
  • Remediation of chronic foci of infection in a woman's body, including in the genital tract.

A lively discussion, consisting of your questions and advice to each other, is only welcome. Share your own experience and clarify any unclear points on this topic. Your active discussion of the problem of premature leakage of amniotic fluid during pregnancy is beneficial not only to you, but also to all readers.

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Amniotic fluid is a source of nutrition and protection for the fetus, therefore, if it is prematurely separated, it is required to conduct a special test for leakage of amniotic fluid, for example, the most affordable and positive Frautest according to reviews. If you do not pay attention to such a problem in a timely manner, the future baby will not receive the required amount of vitamins and minerals, and the risk of dangerous complications increases. You can buy special pads to determine the leakage of amniotic fluid at the pharmacy or order through the online store.

How to determine the leakage of amniotic fluid

With vaginal discharge, you need to pay special attention to their color, smell, consistency. It is important to clearly understand which liquid is within the normal range, and when you should immediately contact your doctor - a gynecologist. Normally, there is moderate discharge of a slimy consistency, beige and transparent without a specific odor. They periodically appear and disappear at different stages of pregnancy.

In case of problems with the fetal bladder, the main sign of amniotic fluid leakage is a palpable trickle, which may suddenly appear when changing the position of the body or while walking. The nature of such abundant discharge is spontaneous, reminiscent of a symptom of urinary incontinence. The presence of stains on underwear complements the concern for one's own health. To avoid the discharge of amniotic fluid, it is necessary to conduct an amniotic fluid test at home.

What is an amniotic fluid leak test

Normally, such a physiological process can appear at 37-39 obstetric weeks, becoming an immediate harbinger of childbirth. As part of the pathology, it is diagnosed in the second trimester, therefore, an examination for the integrity of the bladder is urgently carried out. To do this, use amniotic fluid leak test, which the looks like a regular gasket... Determination of a reliable result for some pregnant women takes several minutes, for others - several hours. However, with an abundance of physiological secretions, the reliability of the test falls.

Varieties of tests

You can buy such a test in a specialized online store or look at your local pharmacy. The assortment of offers is frightening with its diversity, therefore, in order to find out what is better to take, it is advisable to first consult with a gynecologist, further study the instructions for use, read the positive and negative reviews on the forums of expectant mothers.

Test strip for leakage of amniotic fluid

To determine the volume of amniotic fluid, pregnant women often use this technique, trusting the result. Basically, it is a sanitary napkin that needs to be attached to the underwear and not removed for a certain period of time. This procedure does not cause discomfort. Among the advantages, it is worth highlighting the ease of use in practice, an affordable price, with moderate physiological secretions, a reliable result. Among the disadvantages is a false response with thrush, significant fluid separation.

Test systems

These are more sophisticated systems for examining the vaginal environment and suspicious secretion of clear fluid. The amniotic fluid contains special proteins of high concentration. Just for their search, there is an immunochromatography method, on the basis of which these test systems have been developed. They are not cheap, and among the advantages is a reliable result.

How tests work

In case of problems with premature leakage of amniotic fluid, it is necessary to conduct a test at home. The principle of operation is simple: a sanitary napkin from the manufacturer is impregnated with a special substance, and when liquid enters it, the nitrazine test changes color to blue or green. In this way, it is possible to distinguish the leakage of amniotic fluid from natural secretions, to promptly prevent the rupture of the bladder and other equally dangerous pathologies.

Terms of use

The test for water leakage can be used at home, and then independently investigate the result obtained. To check for the presence of pathology, it is required to carefully attach the pad to the underwear and not change the usual rhythm of life. After a while, remove the hygiene product, study the shade, use the instructions to draw logical conclusions.

Frautest

The most popular test among pregnant women from the Hungarian manufacturer, which is not so expensive, while there is no doubt about the result. Externally, this is a regular gasket with a special strip in the central part. This polymer matrix is ​​patented and contains a colorimetric indicator that changes color and shade when in contact with a medium of high pH.

Among the advantages - no direct contact with dyes, hypoallergenic effect, color retention for 48 hours after home examination. Disadvantages - a false result with infection of the genital tract, after infection of the fetus. The rules of use are as follows:

  1. Attach the test to the underwear so that the yellow insert is centered against the vagina.
  2. You can wear the pad for up to 10-12 hours, then remove it and check if the color of the test strip has changed.
  3. With a positive result, it will turn blue-green, with a negative result, it will not change its hue.

Amniotest

The use of this rapid test for amniotic fluid leakage is similar in principle to its predecessor. When signs of outpouring of amniotic fluid appear, the strip changes shade, which indicates pathology. To clarify the reliability of the result, it is recommended to repeat the test, and if the answer is positive, immediately contact a gynecologist. Advantages - low cost, availability for sale, truthfulness of the result. Disadvantages - reduced efficiency in infectious processes and fungal infections.

AmniSure ROM Test

If you suspect a leakage of amniotic fluid, it is recommended to buy Amnishur tests, which cost an order of magnitude more than Frautest, but do not disappoint in the veracity of the result. The main goal of such a home study is to identify a protein - placental α1-microglobulin. The main advantage is the ability to get an answer in 15 minutes, the disadvantage is the high price, the possibility of one-time use. The device will be used in the following sequence:

  1. Previously, it is required to carry out the usual hygiene procedures of the external genital organs.
  2. Shake the bottle with solvent, open, unseal the tampon and insert into the vagina about 5-7 cm on the way to the uterus.
  3. After 1-2 minutes, take it out, immerse it in the prepared solution from the bottle, wait another 1 minute.
  4. Then remove the test strip from the package, after which the background indicated by the arrows, immerse it in a bottle with a solvent and observe.
  5. With a profuse outpouring, the result will appear instantly, and in the case of a slight leakage of amniotic fluid, you will have to wait up to 5 minutes.
  6. When clear red lines appear, one means no rupture of shells, two means presence.

Reasons for faulty tests

You should not 100% trust such pharmacological products, since patient reviews report that the response of the strips is often false positive. It is better to consult a gynecologist immediately after a home examination, in addition to undergo an ultrasound of the pelvic organs. The main causes of amniotic fluid leakage errors can be as follows:

  • improperly performed home research;
  • the presence of bacterial vaginal infections;
  • prolonged response after rupture of the membranes of the membranes;
  • taking certain medications;
  • non-observance of basic rules of personal hygiene.

Choosing a type of test

Before making a purchase, it is important to decide whether pathogenic fungi and bacteria inhabit the cervix. If so, then be sure to be treated. Only after that, you can conduct a home test and significantly increase its chances of a truthful and reliable answer. You should not start from the price of pharmaceutical products, it is better to trust high quality. The main criteria for choosing a test presented below:

  1. Design. At home, it is better to use test pads, since you can get confused in the device of complex systems.
  2. Manufacturer. Modern women prefer the time-tested Frautest.

Rupture of amniotic fluid (amniotic fluid) is one of the stages of normal labor. The rupture of the membranes of the membranes occurs during contractions with the opening of the cervix. Leakage of amniotic fluid for up to 37 weeks can cause premature birth and other serious complications of pregnancy.

Possible options for the outpouring of water

Leakage and outflow of amniotic fluid are distinguished by the time of occurrence. Normally, the fetal bladder opens at full-term pregnancy (after 37 weeks) with partial or complete dilatation of the cervix. At this moment, the woman has an active labor activity. The uterus contracts regularly, the body prepares for the birth of the baby. Such an outpouring of waters is called timely and does not pose a danger to the woman and the fetus.

The belated outpouring of amniotic fluid is spoken of if the membranes of the fetal bladder rupture in attempts, in the second stage of labor. Often, a baby is born in the whole fetal bladder ("in a shirt"). This phenomenon occurs with very dense membranes and is also considered the norm.

Premature rupture of amniotic fluid is called a condition in which the fetal bladder opens before the onset of labor. After 37 weeks, this phenomenon is not too dangerous. In this case, a spontaneous start of labor will occur within the next few hours. If necessary, the doctor can stimulate the onset of labor with medications.

A certain danger for a woman and her baby is the outpouring of water for up to 37 weeks. In this case, there is a high probability of starting labor ahead of time and the birth of a premature baby. Long-term presence of the baby in a waterless space can lead to his infection and the development of serious complications.

What is amniotic fluid leakage?

With the complete outpouring of the amniotic fluid, a significant rupture of the fetal bladder occurs. In this case, it is practically impossible to save the pregnancy until the due date. Water seepage looks a little different. In this situation, the fetal bladder does not rupture completely, but only in one small area. Amniotic fluid leaves the fetal bladder in small portions, drop by drop. The expectant mother may not even notice for the time being the leakage of water, writing off all the symptoms to an increase in natural secretions.

The most dangerous is the gradual leakage of water for a period of up to 37 weeks. In this case, even a small defect in the fetal bladder can provoke infection of the fetus. In some cases, intrauterine infection can lead to the death of the child. At term, the risk of infection is significantly reduced.

The value of amniotic fluid

Before talking about the problem and its possible consequences, you should figure out why amniotic fluid is needed.

The main functions of amniotic fluid:

  • protecting the baby from infections;
  • mechanical protection of the fetus and umbilical cord from any external influences;
  • metabolism between mother and child;
  • maintaining a constant pressure of the internal environment of the uterus;
  • maintaining a constant temperature;
  • creating favorable conditions for the existence of the fetus.

The composition of the amniotic fluid changes throughout pregnancy. In the study, you can find various fractions of proteins, fats and carbohydrates, minerals and vitamins, oxygen and carbon dioxide. The amniotic fluid contains immunoglobulins that protect the baby from various infectious agents. And finally, particles of desquamated epithelium, vellus hair, and elements of primordial lubrication float freely in the amniotic fluid.

What happens if the amniotic fluid moves away or starts to leak? The baby will lose its most important protective shell - a complete fetal bladder with amniotic fluid inside. In such conditions, the child will not be able to exist for a long time. Further intrauterine development of the fetus will be a big question.

Causes

Leakage of water before full-term pregnancy can be triggered by the following conditions:

  • isthmic-cervical insufficiency;
  • genital tract infections;
  • injuries during pregnancy;
  • polyhydramnios;
  • multiple pregnancy;
  • invasive interventions during pregnancy (amniocentesis, cordocentesis, chorionic biopsy).

Symptoms

It is not difficult to recognize a full-fledged outpouring of amniotic fluid. In the third trimester of pregnancy, the volume of amniotic fluid is 1000-1500 ml. When most of the waters recede, it is simply impossible not to notice. In such a situation, you must immediately call an ambulance. Further tactics will depend on the duration of pregnancy and the condition of the fetus.

Leakage of amniotic fluid can go unnoticed for a long time. Outwardly, the waters are a clear, cloudy or slightly yellowish liquid. Amniotic fluid has its own specific smell, but it can be quite difficult to recognize it. The smell is not too harsh and is simply not felt by many women.

Allocation of amniotic fluid, even with a slight rupture of the fetal bladder, occurs constantly. Drops of amniotic fluid remain on underwear and bedding in the form of small, rounded spots. With a change in body position and physical activity, the amount of discharge increases. In the event of an increase in the rupture of the bladder, amniotic fluid begins to flow down the legs.

Water leakage or other problem?

Leakage of amniotic fluid is often confused with symptoms of a genital tract infection or urinary incontinence. Each of these states has its own distinctive features.

Vaginal discharge during infection:

  • copious, thick, stringy;
  • milky, yellow, green;
  • have a characteristic unpleasant odor;
  • accompanied by itching, burning and discomfort in the vagina.

Two simple methods are used to diagnose the cause of vaginal discharge:

  • overview smear on flora;
  • bacteriological inoculation.

If pathogenic bacteria are found in the vagina or on the cervix, specific therapy is performed. During pregnancy, priority is given to topical antibacterial drugs in suppositories and gels. The course of therapy is 5-10 days. After treatment, vaginal discharge should decrease or disappear completely.

Discharge during urinary incontinence:

  • liquid;
  • yellowish;
  • have a characteristic pungent odor;
  • may be accompanied by a burning sensation and pain when urinating.

Urinary incontinence is a common problem in pregnant women. The sphincters of the bladder do not always cope with increased stress, which leads to periodic urinary incontinence. The discharge increases with coughing, sneezing, laughing, any physical activity. The longer the pregnancy, the more noticeable the problem becomes. If you suspect urinary incontinence, you should see a urologist.

Discharge during leakage of water:

  • liquid;
  • transparent, cloudy or slightly yellowish;
  • have a weak specific odor;
  • aggravated by a change in body position;
  • are not accompanied by any discomfort in the vagina.

If you suspect water leakage, you should immediately consult a doctor.

Diagnostics

There are several ways to determine the leakage of amniotic fluid:

Diaper test

The easiest way to recognize a dangerous pathology at home. You must empty your bladder and shower before testing. After showering, take a horizontal position with a clean and dry cotton diaper under your buttocks. The leakage of water is indicated by the gradual wetting of the diaper over the next two hours.

Pharmacy test

A special test strip for determining amniotic fluid can be purchased at any pharmacy. This test can distinguish amniotic fluid from normal vaginal secretions and urine. Before using the test, you must read the instructions.

The study is based on the identification of certain ingredients in the composition of the amniotic fluid. These substances change the pH of the vaginal discharge. Normally, vaginal secretions have a pH of 3.8-4.5. The test strip begins to react when it comes into contact with a medium with a higher pH (above 5.5).

The test is for single use only. Make sure the packaging is intact before use. The test strip is attached directly to the laundry and remains there for up to 12 hours. If the pad gets wet quickly, it must be removed from the underwear immediately.

It is necessary to evaluate the result in a well-lit place. When amniotic fluid leaks, green or blue spots appear on the gasket. Spots can be of various shapes, sizes and intensities. With normal vaginal discharge, the pad does not change color.

An important point: the appearance of blue or green spots is possible with some bacterial infections of the genital tract. See your doctor whenever you change the test strip indicator.

Restrictions:

  • it is not recommended to test less than 12 hours after intercourse and the use of any vaginal suppositories;
  • do not use the pad immediately after taking a shower;
  • if itching, burning or other signs of an allergic reaction appear, remove the pad, change underwear and consult a doctor.

Cytological examination

Testing is done by a physician. For research, vaginal discharge is taken. The resulting material is applied to a glass slide and examined under a microscope. The detection of rejected fetal skin cells and other specific elements in the smear indicates leakage of amniotic fluid.

Arborization smear

The test is carried out in a medical facility. For research, cervical mucus is taken and applied to a glass slide. After drying, the material is examined under a microscope. When amniotic fluid leaks on the glass, a pattern resembling fern leaves is clearly visible.

Amniotest

Testing consists in identifying a special substance - placental alpha-1-microglobulin in vaginal secretions. The presence of this element clearly indicates the leakage of amniotic fluid. For examination, a tampon soaked in a special indicator is inserted into the woman's vagina. Next, the swab is lowered into a test tube with a solution. A test with an indicator is added to the same test tube. When amniotic fluid leaks, a colored strip appears on the test.

Complications

Leakage of amniotic fluid can lead to the start of labor at any time. The shorter the gestation period, the harder it will be for a premature baby to adapt to new conditions of existence. It is not always possible to suspend childbirth when the water is outpouring.

The rupture of the membranes of the membranes and prolonged leakage of water can provoke infection of the fetus. In this case, the child is born with various developmental pathologies and damage to internal organs. Sudden fetal death from infection is possible at any stage of pregnancy.

What to do?

If there is a suspicion of leakage of amniotic fluid, the expectant mother must be hospitalized in a hospital. Further tactics will depend on the duration of pregnancy, the general condition of the woman and the fetus.

After 37 weeks, obstetricians stimulate labor when water leaks. Prolonged stay of a baby in a waterless space can lead to infection. It makes no sense to wait in this case. A baby born after 37 weeks is considered full-term and can exist outside the womb.

At gestational age up to 37 weeks and there are no signs of infection of the fetus, expectant tactics are used. Therapy is prescribed, aimed at maintaining pregnancy and reducing the tone of the uterus. The lungs of the fetus are prepared for spontaneous breathing with the help of hormonal drugs.

There is no specific treatment that can stop the leakage of water. To assess the condition of the baby, ultrasound, Doppler and CTG are regularly performed. With severe fetal suffering, early delivery is performed.

Amniotic fluid becomes the natural habitat of the fetus for the entire period of its intrauterine development. Under normal conditions, this biologically active fluid leaves shortly before delivery.

In the presence of all sorts of pathologies and diseases, amniotic fluid can leave earlier than normal. It is important to be able to timely establish the fact of amniotic fluid discharge and know how to behave in such situations.

Functions of amniotic fluid

Amniotic fluid ensures the vital activity of the fetus as a whole. Among their main functions are the following provisions:

1. Nutrition of the developing child. The amniotic fluid contains a number of nutrients necessary for the normal development of the fetus.

2. Maintaining the required pressure and temperature indicators at a stable level.

3. Protection of the child from adverse influences. Thanks to the amniotic fluid, the intensity of various external pressures, shocks, etc. decreases.

4. Protection against infectious processes.

5. Creation of conditions for free movement of the baby.

6. Protection against excessive noise.

Normally, intrauterine water flows out when regular labor is established and some cervical dilatation is established.

Leakage of amniotic fluid during different periods of pregnancy

The earlier the waters leave, the more dangerous it is for a developing child.

Up to 20 weeks

The main reasons for the discharge of water in the early stages of pregnancy are:

  • infection of the fetus;
  • development of the inflammatory process - chorionamnionitis.

There is no single algorithm of actions for the discharge of water at this stage of pregnancy. In most cases, doctors recommend termination of pregnancy. If the child can be saved, it is highly likely that he will be born with many pathologies, including:

  • blindness;
  • cerebral paralysis;
  • lack of hearing;
  • severe respiratory failure.

In such situations, doctors prescribe a detailed examination, based on the results of which they conclude about the possibility of prolonging pregnancy and the existing risks to the fetus.

At 25-27 weeks

This is also an unfavorable and very dangerous situation. The most common cause of water leakage during this period of pregnancy is urogenital infections.

There is no single algorithm of actions. In most situations, there is no need to think about a favorable outcome for the child. Even if such children survive, they grow up to be deeply disabled. The doctor informs parents about possible scenarios individually based on the results of the examination.

At 38-40 weeks

The situation is not as dangerous as in earlier periods, but it is also very unpleasant. Most often, expectant tactics are used to maintain pregnancy. The task of the doctor is to establish the maximum allowable duration of waiting and find the safest way of delivery.

Thus, the earlier the water begins to drain, the higher the likelihood of complications.

Causes of water leakage

Early discharge of intrauterine waters is associated with a variety of damaging factors affecting the body of the fetus and the woman.

The most common cause is urogenital infection. Under its influence, many pathological changes occur.

Also, fluid leakage can be associated with:

  • inflammatory processes and infections in the uterus, vagina, cervix, and fetal bladder;
  • isthmic-cervical insufficiency;
  • disruptions in hormonal levels, including hyperandrogenism. Because of it, many other pathologies can develop.

Risk factors for fetal fluid leakage

The leakage of amniotic fluid can be provoked by various factors. Among the most common are the following:

  • Infectious diseases.
  • Injuries.
  • Lots and low water.
  • Hormonal disruptions.
  • Careless intercourse.
  • Falls and other external abdominal injuries.

Why is the leakage of amniotic fluid dangerous?

The main thing is to detect the problem in a timely manner and take measures to eliminate it.

The danger of fluid leakage directly depends on the period at which it happened. After 36 weeks, this phenomenon, although not considered normal, does not pose an excessive danger to the child.

The main thing here is to detect the problem in a timely manner and take the necessary measures. Usually, doctors simply artificially stimulate labor or use other methods of delivery.

If the patient goes to the hospital on time, and the cavity of her uterus, at the same time, is not infected, doctors try to prolong the pregnancy as much as possible, using the previously mentioned expectant tactics.

Much more dangerous is fluid leakage in the early stages, in the region of 20-25 weeks. But even under such circumstances, this deviation is not a mandatory indicator for immediate termination of pregnancy.

With timely treatment for medical help, the use of tocolytic therapy methods, antibiotics and bed rest can significantly improve the situation.

The problem is that many patients do not consult a doctor in a timely manner when fluid leaks in the early stages. Usually they are admitted to the hospital with already developed infections and other complications, and sometimes even with a dead fetus.

In such situations, the pregnancy is terminated, and the woman is prescribed a course of treatment.

Thus, even if the water does not begin to drain within the prescribed period, the opportunity to maintain the pregnancy is present.

The main thing is to detect the problem in a timely manner and take measures to eliminate it.

Symptoms and signs of leakage

It is quite difficult to independently determine the leakage of fluid. The main signs are as follows:

  • an increase in the volume of fluid released from the vagina when changing the position of the body or making movements;
  • in the presence of a significant rupture of the amniotic fluid, the liquid begins to literally flow. A pregnant woman cannot hold back the flow even with a strong tension of the pelvic muscles;
  • with a small rupture of the bubble, it is possible to confirm the leakage of water only by passing the appropriate tests. There are also home tests.

Check out the available methods of medical and self-determination of the presence of amniotic fluid leakage, described below.

Methods for detecting leakage of amniotic fluid

The expediency of using a particular medical method is determined by a specialist in accordance with the conditions of a particular situation.

Gynecological examination

An extremely uninformative, but still widely used method. During the examination, the doctor discovers a clear liquid in the posterior fornix of the vagina. The patient is asked to cough. If the detected fluid is amniotic fluid, it will begin to leak from the cervical canal.

The main disadvantage is that with this examination, amniotic fluid can be confused with semen, urine, natural secretions and other fluids.

Smear microscopy

Also not the most reliable method. A smear of liquid is taken and placed on a glass slide. When dry, the liquid crystallizes and a pattern resembling fern leaves is created on the glass.

The main drawback is that a similar pattern appears in the presence of sperm impurities in the smear.

Aminotest

Most often used. It is considered one of the most effective methods for determining rupture of the amniotic membranes.

A puncture is made on the surface of the patient's abdomen to inject an indigo-carmine solution. After half an hour, a cotton swab is inserted into the vagina. If it stains, there is leakage.

The method is accurate, but expensive and painful. The main disadvantage is the possibility of infection, bleeding and other problems that can affect the normal course of pregnancy and even lead to its termination. Severe complications occur in about 1 in 250-300 cases.

Cytological examination

One of the simplest diagnostic methods. A smear is taken from the area of ​​the posterior fornix of the vagina. If the integrity of the amniotic membranes is violated, water elements will be detected in the smear.

There are ways to detect intrauterine water leakage on your own.

Dry sheet test

The simplest and most common test. Allows you to distinguish amniotic fluid from simple secretions, the volume of which increases closer to the end of pregnancy.

The sequence of actions is as follows:

  • the pregnant woman goes to the toilet;
  • washed and wiped off;
  • lays down on a dry sheet (a diaper or a piece of other clean and dry cloth is also suitable);
  • waits for about 15 minutes.

If wet marks appear on the sheet within the specified time, there is water leakage.

In such a situation, you must immediately call an ambulance.

FRAUTEST amnio

A modern method for home determination of intrauterine water leakage. With this test, intrauterine fluid can be distinguished from urine and vaginal discharge.

The test is equipped with a special yellow colorimetric indicator. When interacting with a high pH environment, the indicator becomes green-bluish... Under normal conditions, the pH of the vagina does not exceed 4.5. A similar indicator for amniotic fluid is about 7. The indicator changes color on contact with fluids whose pH exceeds 5.5.

The test was found to be quite accurate. Moreover, it is extremely easy to use. The check is performed as follows:

1. The test is taken from the foil bag. It is important to keep your hands clean and dry.

2. The pad is glued to the underwear so that the yellow indicator is located opposite the entrance to the vagina. The test can be left on for 12 hours just like a normal pad. It can also be removed earlier, at the first sensation of water leakage.

3. After the appearance of a feeling of leakage, or after 12 hours, the test is removed from the underwear.

4. The color of the indicator is checked. If it changed to bluish green, you need to seek medical help.

The test is not only easy to use and accurate, but also relatively inexpensive. The average cost is about 350-400 rubles. The product is popular, so you can buy it in almost every pharmacy.

How to distinguish intrauterine fluid from urine and discharge

Often, pregnant women mistakenly identify fluid leakage, confusing it with urine and simple vaginal discharge, the volume of which can increase significantly closer to the end of pregnancy.

Methods for self-determination of leakage were given in the previous section. In general, it is extremely difficult to distinguish amniotic fluid from vaginal discharge and urine without medical help. Therefore, if you suspect a problem under consideration, immediately contact the hospital and follow the doctor's instructions.

What to do if premature leakage of fetal waters is detected?

Outpouring of fluid indicates damage to the fruit membranes. This, as already noted, can lead to extremely unfavorable consequences.

If the problem is found at home, you must immediately consult a doctor, or even better - call an ambulance.

If a doctor discovers a problem, he will prescribe treatment and give recommendations in accordance with the specifics of a particular situation.

Treatment of fetal fluid leakage

The order of treatment is prescribed in accordance with the period and characteristics of the situation.

Pregnancies lasting less than 20-22 weeks cannot be maintained in most situations.

If fluid begins to drain after 20-22 weeks, doctors make every effort to maintain the pregnancy. The main method as noted is - this is a wait and see tactic... It is aimed at prolonging pregnancy so that the baby has the maximum chances of being born full-term and healthy.

To prevent premature birth, doctors usually prescribe tocolytics to the patient.

The volume and quality of the discharged water is regularly checked. The nurse changes the diaper every four hours. Sowing of vaginal discharge is done at intervals of 5 days. The condition of the fetus is checked using cardiotocography.

If the problem appears before 34 weeks of pregnancy, glucocorticoids may be added. They are used to prevent development distress syndrome The child has.

If it was not possible to prevent the appearance of chorianamnionitis, or if a deterioration in the condition of the fetus was detected, the doctor may prescribe antibiotics. The choice of the method of delivery that is appropriate in a particular situation will also be carried out.

In the case of fluid drainage during a full-term pregnancy with absent contractions, the doctor may prescribe labor induction or recommend expectant tactics until natural childbirth. Stimulation with oxytocin is most commonly performed. It allows the pregnant woman to enter labor faster.

Prevention of amniotic fluid leakage

In order to prevent premature rupture of amniotic fluid, doctors recommend:

  • eliminate any foci of infection. These include diseases of the genitourinary system, pyelonephritis, dental diseases, tonsillitis and other problems;
  • timely treat isthmic-cervical failure;
  • take measures to eliminate the risk of termination of pregnancy. For this, preserving therapy is prescribed to the pregnant woman.

In any case, if there is a suspicion of water leakage, you should immediately seek medical help.

The sooner you do this, the more chances you will have of maintaining a pregnancy and having a full-term baby.