The composition and volume of amniotic fluid is one of the main components of a normal pregnancy. Being in this liquid, the fetus is protected from many negative factors: from noise, from infections, from mechanical influences. In addition to protection, amniotic fluid provides the unborn child with nutrients and comfortable conditions. Therefore, throughout pregnancy, its constant balance is so important. If changes occur in the volume of fluid (oligohydramnios, polyhydramnios), then both mother and child suffer, and various complications arise.

Normally, amniotic fluid should leak only before the onset of labor after the rupture of the amniotic sac. If a slow or copious outpouring of fluid occurs during gestation and long before the onset of labor, then various complications for the health of the fetus and the woman are possible. This is a situation in which nothing depends on a woman’s desires and actions. An examination and further recommendations from specialists are necessary on how the pregnancy will proceed in the future.

Signs of amniotic fluid leakage

If the amniotic sac has a small rupture or crack in the fundus or side of the uterus, fluid will leak slowly. This process can continue for a long time and will remain unnoticeable, since the liquid is constantly renewed and restored. It is difficult for a woman to notice the beginning of the problem and is easily confused with vaginal discharge or urinary incontinence. But over time, she can pay attention to the following changes in her body:

the discharge became liquid and constant;

aching pain appeared in the lower abdomen;

The fetal movements have changed - they have become slow and irregular.

Amniotic fluid is colorless, and its smell has nothing in common with the smell of urine. With incontinence, urine leaks from small physical efforts: coughing, laughing, straining. Amniotic fluid seeps out spontaneously, without outside influence.

If there is excessive leakage of water, it is already difficult to confuse the problem with other ailments:

discharge of a light liquid (may have a brownish or greenish tint) heavily wets the underwear and can flow down the legs;

the stomach decreased in size and became denser;

fetal movement has almost stopped;

contractions began.

In the first and second cases, the instructions are the same: consult a doctor immediately.

Test for leakage of amniotic fluid

Most women prefer to independently verify the presence of a problem and only then contact a doctor with a complaint. What can a woman do at home if she suspects a water leak? First, make sure that the fluid being released is not urine or vaginal discharge. If you regularly use light-colored knitted underwear and pads, it will be easier to detect unusual discharge. Urine has a specific odor that is difficult to mistake for anything else. Dark underwear will help identify vaginal discharge. There will be a light leucorrhoea residue left on it. If the laundry is damp, odorless and has mucous whitish residue, it is most likely amniotic fluid.

Another recommendation to test leakage at home is to empty your bladder as much as possible, wash your genitals and wipe dry. After this, use a light, clean napkin as a pad. If after half an hour a wet spot remains on it, there is every reason to suspect leakage of amniotic fluid. Also, after a shower, you can lie down on a clean sheet and turn on your side. In a lying position, amniotic fluid leaks out faster. If you find a wet spot, you need to go to the hospital for help.

More accurate information can be provided by special tests that can be purchased at the pharmacy. Test pads are impregnated with a special reagent that detects high levelspH. Normally, a pregnant woman's vaginal discharge should be acidic. If water leaks, the levelpHwill be neutral or alkaline. If there is a problem, the gasket indicator will turn blue-green.

The disadvantage of such tests is false positive results if a woman has vaginal dysbiosis, inflammation of the mucous membrane, or shortly before diagnosis, douching or sexual intercourse took place. In all such situations the level changespH.

Tests for the detection of protein-1 and placental microglobulin will be more reliable, since they are based on the identification of components that are contained only in amniotic fluid.

Only a doctor can definitively make a diagnosis. He will also conduct testing, examine the woman using mirrors, and send her for an ultrasound. Based on all the data obtained, tactics for further pregnancy management will be chosen.

Causes of leakage of amniotic fluid

Loss of amniotic fluid occurs through cracks in the amniotic sac. Damage to its shells can occur for many reasons:

inflammation of the vaginal mucosa, which is based on infection. The most common pathogens are mycoplasmas, chlamydia, trichomonas, streptococci. Many women hope that the body will cope with the disease on its own and do not seek treatment. Bacteria continue to develop, penetrate the area of ​​the amniotic sac and dissolve its membrane. In 30% of cases of amniotic fluid leakage, the culprit is infection;

infections that enter the fetal membrane through the blood or from the genital tract without damaging the bladder. Continuing to develop inside, the pathogens violate the integrity of the shell and provoke leakage;

falls, injuries, blows to the abdominal area. Any mechanical impact can cause a shell rupture;

Normally, the baby's head is at the bottom, and not much anterior water (before leaving the uterus) accumulates. In other positions of the fetus, the volume of fluid in the lower region is increased and constantly puts pressure on the membrane, causing cracks. For the same reason, leakage is possible during multiple pregnancies and ;

pathological structure of the uterus and cervix. These conditions cause abnormal positioning of the fetus, and a short cervix allows the amniotic sac to protrude and become susceptible to infection. For this reason, leakage occurs mainly in the third trimester;

study of amniotic fluid, which consists of puncturing the amniotic sac and collecting amniotic fluid. For this reason, cracks occur very rarely.

Treatment for leakage of amniotic fluid

When choosing a treatment method, the duration of pregnancy, the size or number of cracks, the volume of fluid leaking, and the condition of the fetus are taken into account. If the problem occurs in the first trimester, there is almost no chance of saving the pregnancy. Constant loss of amniotic fluid will not allow the fetus to develop normally. Therefore, pregnancy up to 22 weeks is terminated in a hospital.

In the second trimester, if water leakage is detected, the woman is admitted to the hospital under constant observation. Prolonging pregnancy is associated with risks to the fetus. Babies born at 25 weeks are not yet fully formed. Their chance of survival is slim. And the surviving children may remain disabled. In this situation, the decision to prolong such a pregnancy is made by the woman.

After 25 weeks, with slight leakage of water, specialists monitor the woman’s health and the condition of the fetus in a hospital setting. Based on the results of the ultrasound, the readiness of the child’s internal organs for life outside the mother’s body is assessed. If necessary, pregnancy is extended for as long as possible. The woman is prescribed antibacterial therapy aimed at protecting the fetus from infection through ruptures, and bed rest. In this situation, you will have to eat, wash and defecate in bed, since there is a risk that the rupture of the amniotic fluid will increase under its own weight. If the situation does not change for the worse and the child continues to develop normally, obstetricians continue expectant management.

If, despite all the measures taken, fluid continues to leak, a decision is made to induce labor. Childbirth can be spontaneous, if contractions begin after puncture of the membranes, or by caesarean section, if all stimulation of labor does not lead to results.

If the water breaks 2 weeks before birth and a large amount of fluid leaks out, the pregnancy does not continue. This is usually followed by contractions. Such a pregnancy is considered full-term and should not cause panic in the expectant mother.

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

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

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

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

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

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

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

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

Causes

Most common causes of premature leakage of amniotic fluid are:

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

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

How to recognize leakage of amniotic fluid

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

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

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

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

Analysis for leakage of amniotic fluid

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

1. Gynecological examination. Its effectiveness is low, but as a primary examination it is quite acceptable. At the same time, the doctor asks the patient to cough or move. In the case of POV, liquid always appears after this. But it can easily be confused with any other possible substance.
2. Fern effect. If a smear of the released liquid, drying on a glass slide, has a crystalline appearance, similar in design to a fern leaf, then this is most likely amniotic fluid. Most likely, since sperm also creates a similar pattern.
3. Cytological examination of a smear from the posterior vaginal vault reveals the presence of water more reliably than previous methods.
4. Aminotest. In this case, a dye is injected intramuscularly into the patient's abdomen. And after half an hour, a sterile tampon is placed in the vagina. If it is stained, it can be reliably confirmed that there is leakage of amniotic fluid. The disadvantages of this diagnosis are its pain, high cost, possibility of infection and provoking bleeding and termination of pregnancy. Such complications occur in one case out of two hundred.
5. The most modern, error-free and easy way to determine leakage of amniotic fluid is the use of special tests. It is also good because it can be done at home.

Its principle is based on the color of the indicator changing upon contact with different media. So, its original color is yellow. It corresponds to the normal pH level in the vagina (4.5). Other liquids color it greenish-blue. Various secretions have a pH of about 5.5. And in amniotic fluid this indicator is the highest - about 7. In this case, the color of the indicator is intense. During the examination, which lasts half a day, the pad with the identifier is glued to the underwear. And then the nature of the discharge is judged by the color of the indicator.

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

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

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

Prevention

What kind prevention of premature leakage of amniotic fluid:

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

Consequences of premature rupture of amniotic fluid

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

Complications

Frequent consequences of premature leakage of amniotic fluid are:

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

Early leakage of amniotic fluid

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

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

Why is POV dangerous?

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

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

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

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

Knowing that she will soon become a happy mother, a woman always tries to reduce to zero the risks that could be dangerous for the normal course of pregnancy and the development of the baby. Unfortunately, not always and not everything in this case depends only on the expectant mother: it also happens that the threat lies behind situations that are quite harmless at first glance. One of them is leakage of water during pregnancy: a condition that, if not diagnosed in time, can lead to complications and very unpleasant consequences.

Amniotic fluid is the liquid that is the natural habitat for the baby in the womb. Another name for amniotic fluid is amniotic fluid. But, no matter what the amniotic fluid is called, throughout pregnancy it acts as a reliable protection for the baby from noise penetrating from the outside, allows him to move freely in the uterus, “smoothing out” his movements, and thereby protects the mother from the active tremors of the baby. The amniotic fluid is located in the amniotic sac, the formation of which occurs along with the development of the baby. The amniotic sac holds the amniotic fluid, preventing it from leaking out, maintaining the environment necessary for the normal development of the fetus, and also protecting the baby from all kinds of infections.

As the baby grows, both the amniotic sac and the amount of amniotic fluid increase - by the end of pregnancy their volume can reach 1-1.5 liters. Normally, the outpouring of amniotic fluid occurs at the first stage of labor: at the peak of one of the contractions and the opening of the cervix, spontaneous rupture of the amniotic membranes occurs, after which we can say that the labor process has started. However, it also happens that water leakage during pregnancy is detected long before the due date. And this situation must be identified and eliminated as quickly as possible, otherwise the consequences could be very dire.

The fact is that leakage of water during pregnancy indicates that the membranes of the fetal bladder have become thinner and its integrity is compromised. And this threatens, firstly, with infection of the fetus, and secondly, with a high probability that the birth process will begin. Any change in the number and nature of vaginal changes should alert the expectant mother and become a reason for urgent consultation with a doctor managing the pregnancy.

The most dangerous situation becomes when water leakage during pregnancy occurs in very small quantities: the amniotic fluid has neither a specific color nor a specific smell. That is, if the leakage of water during pregnancy is insignificant, then the amniotic fluid, mixing with other vaginal secretions, does not make itself felt. However, its leakage is almost always indicated by the fact that a pregnant woman’s underwear begins to constantly get wet, and if you put a diaper between your legs, a wet spot will form on it in the near future. In this case, you should under no circumstances delay a visit to the gynecologist: the doctor must determine whether there is leakage of water, and if so, correct the situation.

The reasons for leakage of water during pregnancy can be very different, but most often the thinning of the amniotic membranes is provoked either by inflammatory diseases suffered by the expectant mother, or by current ones. The most common of them are endocervicitis: gynecological diseases of the vaginal and uterine zones, which lead to violations of the integrity of the fetal bladder. Other reasons for this situation may be benign or malignant neoplasms of the uterus, isthmic-cervical insufficiency, invasive methods of prenatal diagnosis (cordocenesis, amniocentesis, chorionic villus biopsy).

There are several ways to determine water leakage during pregnancy. So, a pregnant woman can take a smear from the vagina, the analysis of which will determine or refute the presence of amniotic fluid in the vaginal discharge. But the most common way to detect leakage is through special rapid tests: the expectant mother can do such a test under the supervision of doctors, or can do it at home. If the results of the study are disappointing, and leakage of water during pregnancy is discovered, it is necessary to urgently take appropriate measures. They will depend on how far along the expectant mother is: if the time for childbirth has not yet come, hospitalization is necessary - in a hospital setting, the woman will be able to receive the necessary treatment to maintain the pregnancy. If leakage of water during pregnancy occurs closer to the scheduled due date, the doctor may decide to stimulate labor.

Especially for - Tatyana Argamakova

Not all expectant mothers, especially those pregnant for the first time, know what leakage of amniotic fluid is. But this is a serious symptom that often requires urgent action. The life of a woman and child may be in danger. This pathology does not occur in everyone, but knowledge is never superfluous, especially when carrying a baby.

Function, appearance, smell and color of amniotic fluid

Amniotic fluid is a cozy environment that surrounds the baby inside the mother’s tummy throughout pregnancy. They fill the entire amniotic sac and are produced by its walls. Water has a very important function - it protects the child from infection from the genital tract. They prevent tissue fusion or flattening of the umbilical cord, allowing the baby to feel free and actively move. In addition to protective functions, amniotic fluid (the second name for amniotic fluid) is involved in metabolic processes - it is from it that the child receives a significant part of the nutrients.

The composition of amniotic fluid is variable and complex. It includes:

• vitamins;
• fats;
• hormones;
• proteins;
• carbohydrates;
• enzymes;
• immunoglobulins;
• microelements;
• antigens;
• carbon dioxide.

As pregnancy progresses, the composition of the water changes. In the first months it is a liquid similar to blood plasma, and in the last weeks most of it consists of fetal urine, particles of its epidermis, vellus hair, and vernix.

In the first trimester, the waters are colorless and transparent, and towards the end of pregnancy they become cloudy. Amniotic fluid may have a specific odor, but not very intense.

Green, reddish or brown water, sometimes with a sharp, unpleasant odor, occurs with intrauterine infection.
Normally, amniotic fluid in the last trimester of pregnancy is cloudy and colorless.

Why amniotic fluid leaks

Ideally, the amniotic sac should be intact until delivery. If the amniotic fluid begins to leak long before the due time, it means that microcracks, ruptures have formed in the membranes surrounding the fetus, and the walls of the bladder are too thin. The reasons for this phenomenon may be:

• infections, including diseases of the genitourinary system, suffered by a pregnant woman;
• inflammatory processes in the vagina or uterus;
• some chronic diseases;
• , in which the cervix does not sufficiently hold the fetus inside;
• multiple pregnancy;
• abdominal injuries during pregnancy;
• neoplasms on the uterus;
• pathologies of the structure of the uterus or pelvic bones;
• puncture of the amniotic sac during amniocentesis or other manipulations;
• bad habits of a pregnant woman - excessive smoking or drinking alcohol.

How and when should the water break?

Normally, the waters break if the cervix is ​​ready for the baby to be born (dilated) or the membranes have ruptured. This occurs during the first stage of labor. , will “tell” the location of the bubble rupture. Mostly this happens right above the cervix, then the effusion is abundant and immediate. If the rupture site is covered by the uterine wall, then the leakage is insignificant, gradual, and can be mistaken for discharge or uncontrolled emission of urine.

The phenomenon when the membranes rupture before the cervix is ​​ready for labor is called premature rupture of the fetal membranes or early breaking of the waters.

Consequences and risks of water leakage

In the second half of pregnancy, premature release of water occurs for the following reasons:

• injuries;
• penetration of infections;
• inflammatory processes.

All these problems can cause a violation of the integrity of the amniotic sac. This means that the sterility of the environment surrounding the child is under threat. Through microcracks, microorganisms can enter the water and cause severe pathologies in the fetus. At the end of pregnancy, this threatens premature birth. The closer a woman is to the baby's date of birth, the more favorable the prognosis.

In the second trimester of pregnancy, this pathology is especially dangerous, since its treatment is not always possible. Before the 22nd week, termination of pregnancy is recommended due to the high risk of developing multiple pathologies in the unborn baby. After this period, the chances of maintaining the pregnancy increase, but it is important to determine how much time has passed since the rupture of the amniotic sac.

In the last trimester, they try to prolong the pregnancy as long as possible, at least until the 37th week. The woman is advised to stay in a sterile maternity ward under the supervision of a doctor. The condition of the fetus is monitored, and the expectant mother is prescribed medications that prevent infection from penetrating into the amniotic fluid, which promotes the rapid maturation of the child’s lungs. If infection, placental abruption or deterioration of the fetal condition occurs, emergency delivery is performed. After the 37th week, inpatient observation is indicated. If the situation worsens, labor may be induced.

Diagnostics

If you suspect leakage of amniotic fluid, you should immediately contact your gynecologist. He will conduct an examination and, if necessary, prescribe tests. Leakage is difficult to detect with a normal speculum examination, so the doctor may ask you to change position or cough. However, if liquid leaks in small quantities, you can make a mistake when examining “by eye”.

Laboratory methods

Laboratory diagnostic methods are as follows:

• cytological examination;
• microscopy;
• nitrazine testing.

The study under a microscope has a beautiful name - “fern symptom”. When the amniotic fluid dries, it crystallizes, forming a pattern resembling the leaf of this plant. The information content of the method is no more than 80%. Sometimes discharge from the cervical canal and even the fingerprints of a careless worker who took the smear are mistaken for amniotic fluid. In addition, both false positive and false negative results are possible.

For cytological examination, the material is stained, after which elements that differ in color are determined. These can be particles of skin, vernix, meconium or baby's hair that are in the amniotic fluid. The presence of these particles indicates damage to the amniotic sac.

Nitrazine testingdetermines the acidity of the analyzed material. The vaginal environment is normally acidic, while the amniotic fluid is neutral or slightly alkaline. If amniotic fluid leaks through the vagina, its environment changes to acidic. The nitrazine testing method may be misleading because some infectious diseases also change the vaginal environment.

The reliability of the test decreases if the bubble ruptured a long time ago.

Is it possible to see water leakage on an ultrasound?

The information content of an ultrasound examination in this case is insignificant - if there is no massive rupture of the bladder and a maximum reduction in the amount of liquid, it will not show leakage of water in small portions. However, if an existing problem is suspected, an ultrasound scan is recommended to rule out oligohydramnios. The study is carried out several times to assess the dynamics and danger of the problem.

Home method for checking for water leaks

The most affordable home way to check for water leaks is the “clean diaper” method. A woman should wash herself thoroughly and lie down on material that does not absorb liquid. For the purity of the study, it is important not to go to the toilet “in small ways.” If after 1–2 hours wet marks are found on the diaper, then water is leaking.

A more modern version of this method is pharmaceutical test pads impregnated with a special composition that reacts to amniotic fluid and is inactive in relation to other secretions. This pad is worn for 10–12 hours. If its color has changed, then you need to consult a gynecologist as soon as possible.

An option for home diagnostics of water leaks, known all over the world, is special tests. At the moment they are available in two versions:

1. A test sensitive to placental microglobulin, which determines the presence of a rupture in the membranes. It can be used to determine water leakage in early pregnancy and with a high lateral rupture, when there are few traces of amniotic fluid.
2. A test that determines the presence of insulin-like growth factor protein-1. It is less sensitive and is most informative in the first 12 hours after damage to the amniotic sac.

I learned from my gynecologist that amniotic fluid can leak only during my third pregnancy and only because I was expecting twins. Somewhere around week 30, I started experiencing excessive flow that required changing my regular panty liner every 3-4 hours. I was in no hurry to give up on the doctor; I decided to check everything myself first. The clean diaper method showed that everything was normal, but I was scared. I bought a test pad at the pharmacy (it looks like a regular one, only without the wings), however, I couldn’t wear it for 10 hours, it somehow burned in the area where it was supposed to fit, possibly due to the summer heat. It turned out that there was no leakage, and the discharge was a banal thrush, which I had to deal with throughout the pregnancy and several months after giving birth.

Treatment

There is no special treatment for amniotic fluid leakage, but we can talk about a medical strategy that helps keep the problem within limits that are safe for mother and baby:

• to avoid premature birth, tocolytics are prescribed;
• if water leakage occurs before the 34th week, glucocorticoids can be prescribed to prevent distress syndrome (respiratory distress in a newborn);
• If the leakage of water does not stop, antibiotics are prescribed to prevent infection.

In each specific situation, the method of delivery is chosen - cesarean, vaginal birth, stimulation, if the pregnancy is considered full-term (after the 37th week for a singleton pregnancy and the 36th for a multiple pregnancy, but possibly earlier when the situation threatens the life of the child).

Preventing water leaks

• Eliminate foci of infection - treat diseased teeth, check for genitourinary infections, chronic tonsillitis, and other diseases;
• if you suspect an isthmic-cervical insufficiency, take the necessary measures, and if necessary, apply a pessary or sutures to the cervix (after undergoing an ultrasound of the isthmic-cervical canal and confirming the extreme need for such actions, since these manipulations are not entirely safe);
• take all measures to prevent abdominal injuries - wear comfortable shoes (in winter, ice drifts are very useful to slow down sliding), clothes that are not tight around the stomach, and avoid excessive stress.

Video: doctors’ opinion about leakage of amniotic fluid

During pregnancy, the female body is characterized by various types of discharge. The reason for this is changes in hormonal levels, the presence of diseases, colds. The discharge may be clear, watery, or thick. It is quite natural to have beige or brown clumps. This phenomenon can seriously frighten the expectant mother, who does not yet know how to recognize their character, which is quite logical.

Large table diagram
baby inside measurements
pain observation development
pregnant mother drinking

Very often, discharge indicates the development of a pathology that requires urgent medical intervention. This type of pathology includes leakage of amniotic fluid.

What is dangerous and does smell matter?

What is amniotic fluid? Amniotic fluid or amniotic fluid is a biologically active substance located inside the fetal membranes. It provides protective, shock-absorbing and other functions and is fully responsible for the vital functions of the fetus.

It is normal for the amniotic fluid to leak before natural labor begins according to the established timing. During contractions, the cervix dilates and the membranes burst, after which the waters break. Rarely can the process begin without contractions. In this case, the pregnant woman is immediately sent to the maternity ward.

When the situation is not happy

There are cases when amniotic fluid is released in small amounts long before labor begins. This phenomenon indicates that the integrity of the fetal bladder is compromised. As a result, the sterility inside it is at risk. The closer to birth a pathology is detected, the less threat it poses to the child, which means the medical prognosis will be better. It is important to know how to distinguish leakage of amniotic fluid from pathological discharge, sexually transmitted infections and other diseases.

Leakage of amniotic fluid contributes to the development of infection, which can reach the baby through cracks in the bladder. Untimely provision of medical care for the release of amniotic fluid in late pregnancy leads to premature birth, termination of pregnancy, and fetal death in utero. In addition, the pathology leads to weak labor at the onset of labor, as well as the development of infectious complications in the mother.

Causes of amniotic fluid discharge

It is difficult to determine the cause, as well as to understand how the pathology occurs. There are several main reasons for this phenomenon. These include the following.

1. Infections affecting the genitals. This reason often occurs during premature pregnancy, in particular at 39 weeks.
2. The cervix develops rapidly, as a result, enzymes are released that have a stratifying effect on the placenta. The fetal membrane softens. Lack of medical intervention can lead to fetal hypoxia during labor, as well as severe bleeding from the uterus.
3. Incorrect presentation of the fetus or narrow pelvis of the expectant mother. In this case, the pathology develops in the first stage of labor, the opening of the uterus occurs very slowly.
4. Cervical insufficiency leading to rupture of membranes and leakage of amniotic fluid at 40 weeks of pregnancy. This pathology occurs in approximately a quarter of all pregnant women in the last trimester. As a result, the amniotic sac protrudes, making the fetus vulnerable. Viruses that enter the amniotic fluid lead to rupture of the membranes with minimal physiological impact.
5. Bad habits, chronic diseases. This includes women with alcohol addiction, smokers, anemia, dystrophic pathologies, and connective tissue diseases.
6. When carrying two or more babies.
7. Anomalies in the development of the uterus. This includes a shortened uterus, isthmic-cervical insufficiency and the presence of a uterine septum. Diseases such as colpitis, endocervicitis, tumors of various kinds also cause pathology. The use of invasive methods of prenatal diagnosis is indicated, that is, amniotic fluid sampling and biopsy.

It is very important for a woman to know how to determine leakage of amniotic fluid at home using special tests.

Examination by a doctor

Symptoms of pathology development

There are cases when the amniotic fluid comes out all at once when the amniotic sac ruptures. Then the selection becomes obvious. However, there are cases of periodic leakage of a small volume. At the same time, it is difficult for a woman to determine the development of pathology.

Many women mistakenly confuse the signs of amniotic fluid leakage during the third trimester with urinary incontinence. In rare cases, pathology is normal in late pregnancy. During pregnancy, the amount of vaginal discharge increases, which is quite possible in the early stages. Thus, the presence of colpitis, mistaking amniotic fluid for normal discharge, causes the development of symptoms of amniotic fluid leakage in the third trimester.

Mommy is worried

The symptoms of amniotic fluid leakage are simple. However, not everyone knows how to recognize them correctly. Many women wonder what amniotic fluid leakage looks like. There is only one rule for determining them. Amniotic fluid is odorless and colorless.

Many women wonder what amniotic fluid smells like? There is only one answer - the discharge has no odor.

If at any month of pregnancy a woman detects discharge of an unknown nature, even if it is a false suspicion of leakage of amniotic fluid, she must immediately seek help from a doctor. It is difficult to independently determine the presence/absence of pathology even with the help of a special test. Medical attention will be required here. The photo shows what leakage of amniotic fluid looks like.

Diagnosis of amniotic fluid discharge

Only a doctor confirms the presence/absence of amniotic fluid in the third trimester. To do this, an examination is carried out on a gynecological chair. During examination, a pregnant woman should cough to increase pressure on the intra-abdominal area. So, if the bladder ruptures, a new portion of amniotic fluid will be released.

This is what fetal development looks like

Additionally, a smear is taken on the water elements, and a test is performed for the presence of leakage of amniotic fluid. How to check for leakage of amniotic fluid at home using medical supplies? A test pad for determining the leakage of amniotic fluid, the price of which starts from 2000 rubles, is based on the determination of placental microglobulin. If the strip changes color upon contact, it means there has been a leak. To determine what amniotic fluid looks like when leaking, an ultrasound is performed.

How to prevent water leakage

When treating amniotic fluid leakage at 34 weeks or any other period, there is no specific technique or single therapy that would help all women equally. All treatment is aimed at eliminating the problem that caused this type of pathology, as well as maintaining the health of the fetus and mother within the framework of safety. The time of the last exit plays an important role; a safe period is considered to be no more than six hours. A pregnant woman is prescribed antibiotics to prevent infection of the fetus.

Leakage of amniotic fluid, as in the photo of the pad, in the long term indicates an imminent birth. If after three hours there are no contractions, stimulation is carried out medically. To do this, a hormonal background is first created for the ripening of the cervix. An alternative is a caesarean section.

If the pregnancy is premature, expectant management is generally used. It is very important to monitor the viability of the fetus. The woman is under the supervision of doctors at all times and is on bed rest.

At the slightest signals from the body, consult a doctor

To prevent the release of amniotic fluid at week 25, it is recommended to carry out antiseptic treatment of the genital tract, as well as other mucous membranes to prevent and remove infection. To determine the leakage of amniotic fluid, there are special pads for home use, the Amnishur test. The test pad shows, depending on the color of the inner shell, the presence/absence of pathology.

When amniotic fluid is released, the expectant mother remains powerless. Therefore, it is important to prevent the development of pathology in advance. Do not neglect testing and hygiene. If you detect suspicious discharge, you should immediately consult a doctor. As support, you can visit forums of mothers who share their experiences, you can find friends who have had the pathology, and read a lot of reviews.