The changes that occur during pregnancy surprise even the women themselves. For example, vaginal discharge should normally be colorless and odorless. However, over the nine months of bearing a baby, their character can change several times. Under the influence of hormonal levels and many other factors, they can be transparent or beige, thick or liquid. During pregnancy, such changes are considered normal.
However, doctors recommend monitoring this process and if alarming and uncharacteristic signs appear, contact them immediately, since vaginal discharge may indicate a problem that threatens the baby and requires immediate medical intervention.
Why is such a process dangerous? How to make sure that the cause of discharge is leakage amniotic fluid? You will find the answers in this article.
What are the consequences of water leakage during pregnancy?
Traditionally, the leakage of amniotic fluid signifies the beginning of labor. When a woman experiences severe pregnancy, the cervix opens and the membranes rupture, causing the fluid in which the baby was present all the time to come out of the bladder. It also happens that the fetal membrane bursts even before labor begins. In this case, you must urgently go to maternity hospital without waiting for contractions to begin.
But sometimes amniotic fluid can leak long before the appointed date. Firstly, such discharge indicates a violation of the integrity of the fetal membrane, which means that the sterility inside the bladder is at risk, and there is a risk of infection. If the response is untimely, such a process may result in premature birth, if we are talking about later carrying a child. If leakage occurs in the first or second trimester, then there is a risk of miscarriage or fetal death. In other words, the closer to childbirth the leakage of amniotic fluid is observed, the more favorable the medical forecasts.
How to determine a pathological process?
It is not always possible to accurately determine that vaginal discharge indicates a violation of the integrity of the fetal membrane, since the water does not have a characteristic color or specific odor. Amniotic fluid can have a wide variety of colors: from transparent to greenish.
Basically, leakage occurs in small portions, and this also creates difficulties in identifying the pathology, since a woman may confuse such discharge with ordinary vaginal secretion or urinary incontinence.
But still, some symptoms of water leakage during pregnancy can be identified:
- Constant feeling of moisture in the perineal area.
- Wet laundry.
- Increased discharge when the vaginal muscles tense (sneezing, laughing, lifting weights, etc.).
But such signs may not always mean water leakage. Similar symptoms often appear with the problem of urinary incontinence, which usually occurs in the last months of pregnancy. Therefore, in order to confirm or refute suspicions, you need to promptly seek qualified help and undergo the necessary examination. Only after this can the doctor determine the nature of the vaginal discharge.
How to test for water leaks at home?
If you have vaginal discharge and its nature worries you, then you can test it at home. You can buy a special amnitest at a pharmacy. The kit includes instructions for use and a gasket, which is impregnated with a chemical reagent that reacts to the high hydrogen index of acids (pH level). If the cause of the discharge is water leakage, then the pad will change color while being worn. In this case, it is necessary to urgently consult a doctor, since only in a clinical setting can the presence of pathology be confirmed or refuted.
is one of the main problems in modern obstetrics.
This is a complication that occurs in 10% of women with a normal pregnancy and ranks first among the causes leading to premature birth. About 38% of all preterm births are caused by PPROM, and 20% of all perinatal deaths occur as a result of complications associated with leakage of amniotic fluid and preterm birth.
Why do so many complications arise, how to determine that you are at risk, and most importantly, what to do in this case? Let's try to understand everything, starting with the most basic.
The role of amniotic fluid
Amniotic fluid is produced by the inner layer of the amniotic sac - the amnion, which forms a closed, hermetically sealed cavity. The outer shell, the chorion, is denser and protects the amnion from damage.
Amniotic fluid plays the role of a kind of shock absorber, protecting the child from shocks when the mother turns or falls, and does not allow strong uterine muscles to compress the fetus and umbilical cord. Amniotic fluid is involved in the nutrition and development of the child. But most importantly, amniotic fluid is sterile. The amniotic sac acts as a barrier to microorganisms that can harm the developing baby. This is why violating the integrity of the bubble is so dangerous.
Causes of premature rupture of membranes
- Infectious diseases of the genital organs and inflammatory diseases of other organs and systems in the mother.
This is one of the main reasons why PROM develops. Toxins released by bacteria during their life processes lead to thinning of the walls and, as a result, to microcracks or ruptures of the fetal membrane. Often women do not even suspect that they have an infection, but even a simple one can already cause PROM.
- Clinically narrow pelvis and incorrect position of the child
Bladder rupture occurs already during childbirth. In the normal position of the child, when the head is inserted, a zone of contact is formed, and the waters are divided into anterior and posterior. For transverse or breech In the baby, a contact belt is not formed, and all the waters rush to the lower part of the amniotic sac. This leads to the fact that the shells cannot withstand the pressure and rupture.
- Cervical insufficiency
In this case, the cervix is not completely closed, which leads to the fact that the amniotic sac protrudes into the cervical canal, becomes easily infected and can rupture even with slight physical exertion.
- Amniocentesis and chorionic villus sampling
These diagnostic methods can sometimes lead to rupture of the membranes.
- Mother's bad habits
Women who smoke and drink alcohol are more at risk for PPROM.
- Multiple pregnancy and uterine abnormalities
Any developmental anomaly or multiple pregnancy greatly increases the likelihood of PROM.
How to recognize that PROM has occurred and there is leakage of amniotic fluid?
If there is a massive rupture of amniotic fluid, it is difficult to confuse it with anything else. But the problem is that when examining a woman with suspected PROM, 47% of doctors doubt the correct diagnosis. With microcracks or lateral breaks, water can leak drop by drop almost imperceptibly, and it is quite difficult to determine that this is a PRPO.
Signs that should alert you
- Normal discharge has become more abundant and watery.
- The discharge increases as the position of the body changes.
- The abdomen visually decreases in size or the height of the uterine fundus becomes lower.
If the above symptoms occur, it is necessary to exclude leakage of amniotic fluid as soon as possible.
Complications
Premature rupture of membranes quadruples infant mortality. The most common complications of PROM are infection and respiratory distress.
- Respiratory distress syndrome. The most severe complication occurs in premature infants. The child’s lungs have not yet developed and cannot independently participate in the act of breathing. They stick together from the inside, preventing air from circulating. These children require expensive surfactant injections and artificial ventilation.
- Infectious complications in mother and child. The most common complication. It develops regardless of the duration of pregnancy 6-32 hours after rupture and causes severe consequences. Sometimes they are so serious that it is not possible to save the child.
In addition, children suffer from hypoxia, premature or abnormal labor may begin.
Standard diagnosis of amniotic fluid leakage
Today, there are several methods for determining leakage.
- The most common and known to many women is the nitrazine test, or litmus strip. This indirect diagnostic method determines the acidity of the vagina. A healthy vagina has an acidic environment, and when amniotic fluid enters, it shifts to the neutral side, which is what the test indicates. But the acidity of the vagina also changes with infection, presence or leakage of urine. Therefore, in 30-40% of cases, tests give false results positive result, and the woman is subjected to unnecessary hospitalization.
- Symptom of arborization. The vaginal contents are collected. In the presence of impurities, amniotic fluid crystallizes to form a pattern similar to fern leaves. Infection, presence of semen, or leakage of urine may also affect the test result.
- Amniocentesis. If other diagnostic methods gave negative result, but the pregnant woman’s condition raises concerns, amniocentesis is performed with dye. A harmless dye is injected into the cavity of the amniotic sac, and a clean tampon is placed in the vagina. If the tampon is stained, it means 100% that there is a leak. This method is used very rarely and in extreme cases, as it itself can provoke a rupture.
Modern immunological diagnostic method using the Amnishua test (AmniSure)
Unlike previous methods, the test does not require the assistance of medical personnel and can be performed by a woman independently at home.
The principle of operation of the Amnishua test is based on the determination of placental alpha-1-microglobulin (PAGM-1), which large quantities With early dates pregnancy is present in amniotic fluid and is not found in other physiological fluids of the body. The Amnishua test reacts even to traces of PAMG-1 in the vagina. Its sensitivity is 98.9% and is equal in accuracy to dye amniocentesis.
How to use the test?
Diagnostics takes about 5 minutes and does not require the use of mirrors. The Amnishua kit includes a test strip (outwardly similar to a pregnancy test), a bottle of reagent and a sterile swab. Using a tampon, a small amount of vaginal discharge is collected, after which the tampon must be placed in a bottle, shaken slightly, then the test strip is lowered into the bottle, and you can read the results. Two red lines - there is a gap, one line - there is no gap. Even if one of the lines has a faint pink tint, this also indicates that there is leakage.
Is a test necessary if there is no suspicion of leakage?
It is advisable for every pregnant woman to have such a test for leakage of amniotic fluid in her purse, especially if she travels out of town or on vacation. A rupture may occur spontaneously, and the nearest medical center may be too far away. If the test gives a positive result, it means 100% there is a gap, and you need to urgently go to the maternity hospital. And if the test is negative, then you can safely continue to enjoy your vacation. The fact is that during pregnancy, under the influence of progesterone, vaginal secretion increases, and sometimes it can be so abundant that some women confuse it with amniotic fluid. In this case, adequate diagnosis is also necessary to avoid unnecessary hospitalization and preventive measures aimed at eliminating leakage.
It is worth noting that the test only determines the fact of rupture, and does not indicate the degree and presence of complications. The Amnishua test is not therapeutic or prophylactic - it is only diagnostic, and if the result is positive, you should immediately seek medical help.
The advent of the Amnishua test has revolutionized the diagnostic algorithm for premature rupture of membranes throughout the world. Never before has it been so easy and fast. If the result is positive, no additional examination is required. And where traditional diagnostic methods previously failed, Amnishua gives amazing results. It makes it possible to start preventing complications in case of rupture in a timely manner and avoid unnecessary hospitalization in its absence.
Management of pregnant women with PROM
There are two tactics for managing pregnant women with PROM.
- Premature pregnancy before
Pregnancy is maintained for as long as possible. In some cases, up to two months or more. But only in a hospital setting! The woman is in a sterile maternity unit, where constant monitoring of the fetus’s condition is carried out. Antibiotics, drugs that accelerate lung maturation, and tocolytic drugs that prevent uterine contractions are administered. If the condition of the fetus worsens, infection occurs or abruption begins, the woman is given an emergency delivery.
- Full-term pregnancy or more
In this case, the woman is also placed in a hospital and observed. Carry out a thorough sanitation of the vagina and monitor the child’s condition. Stimulation is carried out only if the child’s condition worsens.
Remember that leakage of amniotic fluid is not normal! Water cannot seep or accumulate. If the test shows a positive result, be sure to seek help from doctors - they will help you maintain your pregnancy and give birth to a healthy child.
Amniotic fluid is a substance that normally has no color or strong odor. 97% is water, which includes a variety of nutrients: proteins, mineral salts. Also in the amniotic fluid, upon closer examination, skin cells, hair and alkaloids can be found. In addition, the smell of the liquid, according to scientists, resembles the smell of mother's milk. That is why, immediately after childbirth, she reaches for her mother’s breast.
The discharge of amniotic fluid is one of the sure signs that labor has already begun. However, it is not uncommon for the water to break earlier. And it is very important not to miss this moment, because the fetus can live without them for only 12 hours.
If there are any problems with the fetus, the waters may turn green or even brown. If the expectant mother sees dark water leaking, she should immediately call ambulance.
What does waste water look like?
Normally, if everything is fine with the mother and the child, the water looks like ordinary water. Very often, women at the initial stage of labor go to the shower to make it easier, so they may not notice that their water has broken, because... against the general background they will be completely invisible. In some cases, after the water breaks, a woman may feel uterine contractions, which signal that labor has entered a new phase.
However, it often happens that water begins to leak long before labor begins - sometimes even 2 days before. In this case, you need to very carefully monitor the amount that comes out. For example, it is believed that normally this can be a natural discharge of liquid in a volume of approximately one tablespoon. Sometimes pregnant women even confuse this with urinary incontinence. This loss of amniotic fluid is completely natural and does not cause any harm to the child, especially since the water is restored.
On average, the amount of amniotic fluid before childbirth is 1.0-1.5 liters. Their role is difficult to overestimate: they contribute to the normal development of the fetus, protecting it from compression by the walls of the uterus and from external physical influences.
If there are still more than three months before giving birth, and the amount of amniotic fluid leaking exceeds the norm, then you need to urgently consult a doctor. Ideal option- call an ambulance. Exceeding the norm may indicate the onset of premature birth.
How to calm yourself down
If you're worried about your water leaking, don't sit at home and be afraid. You have two options. The first is to go to the doctor for a consultation. The gynecologist will carry out all the necessary manipulations and determine whether this is the case. If you are suspicious, and it seems to you that your water is constantly leaking, naturally, you won’t rush to the doctor. In order not to torment yourself once again, just go to the pharmacy and buy a special test. Outwardly, it is quite similar to what is done at the very beginning of pregnancy. This test quite accurately determines water leakage and allows the expectant mother to gain peace of mind and confidence that everything is going well and nothing threatens the health of her baby.
First pregnancy - how new life, in which unfamiliar and sometimes unexpected phenomena await a woman. Once you get used to growing body size and weight, changes in mood and taste preferences, new discoveries begin. Some of them are pleasant and encouraging, brightening up the 9 months of waiting for the baby. It’s better to learn about others early, preferably only in theory, without encountering them in practice. For example, about how amniotic fluid leaks and what needs to be done in this case. For most pregnant women, leakage of amniotic fluid is a nightmare with which they scare themselves and each other.
In fact, amniotic fluid does not leak in everyone and not as often as it might seem if you stress yourself out. But every woman should know what to do in case of leakage of amniotic fluid - at least just in case. This will help determine whether amniotic fluid is actually leaking or not. Moreover, leakage is possible not only during the first pregnancy, and the information will be useful to you or your loved ones in the future. As you know, fear has big eyes, but in everything related to pregnancy and health in general, you cannot rely on intuition and fragmentary information. It is necessary to clearly understand how amniotic fluid leaks and what to do in this case.
Amniotic fluid and its leakage
Amniotic fluid is the fluid surrounding the embryo. Amniotic fluid, or amniotic fluid, surrounds the baby throughout intrauterine development and protects it from all infections, physical and any other dangers. By chemical composition amniotic fluid is rich in vitamins, salts, hormones, amino acids, and also contains waste products, vellus hairs and particles of fetal skin. This determines the functions and capabilities of amniotic fluid:
- Fetal nutrition in the early stages of development occurs by absorption of substances from amniotic fluid directly through the skin. At later stages, the baby takes in amniotic fluid in small sips.
- Protection from external physical influences based on the principle of shock absorption. Amniotic fluid is protected from chemical threats and infections due to the tightness of the amniotic sac plus active immunoglobulin proteins in the fluid itself.
- Creating an environment that is comfortable for the embryo: free “swimming” in a liquid, under conditions of constant pressure and constant temperature. In addition, amniotic fluid muffles noise and other harsh sounds coming from outside.
- Perinatal diagnostics: by analyzing samples of amniotic fluid, diseases (genetic, congenital), possible disorders and the condition of the fetus as a whole are determined. In addition, amniotic fluid allows you to find out the sex and blood type of the embryo.
How and why do amniotic fluid leak?
Normally, amniotic fluid is released at the end of the first stage of labor, when the cervix opens. Premature rupture, which began long before the onset of labor, and especially at less than 37 weeks, is called leakage of amniotic fluid. The reasons for leakage are different:
- Physical trauma.
- Weak cervix that cannot withstand the pressure of the weight of the fetus.
- Incorrect position of the fetus due to the mother's body type or other problems.
- Infectious disease.
- Excess amniotic fluid (so-called polyhydramnios).
- External intervention during diagnostics.
Signs of leakage of amniotic fluid. How amniotic fluid leaks
It is important to promptly notice and identify water leakage, but not to confuse it with other natural body secretions, urination, etc. It's not hard to make a mistake, especially with the excitement associated with pregnancy. Therefore, remember how amniotic fluid leaks:
- Premature rupture of amniotic fluid occurs profusely, approximately half a liter in volume. You cannot help but notice the release of clear liquid in such quantities. It indicates rupture of the amniotic sac.
- The amniotic sac may not rupture, but only slightly tear, then the leakage of fluid is scanty, but constant. You can distinguish it from other secretions by smell and color, but not always.
- If the smell and color of the discharge are clearly expressed, then, without a doubt, this is a sign of a disruption in the progress of pregnancy. Reddish, brown, or green-tinged liquid requires immediate medical attention.
What to do if amniotic fluid leaks? First of all, do not panic and soberly assess the situation. You may need to confirm the diagnosis, but this is best done by a doctor. Leakage of amniotic fluid cannot be ignored or “observed” longer. But what exactly to do depends on the circumstances, your well-being and the duration of your pregnancy. Here is a list of basic actions when detecting leakage of amniotic fluid:
The main thing a pregnant woman needs to do when amniotic fluid leaks is to consult a doctor, in no case waiting for a routine routine examination. If you act quickly and correctly, you will be able to avoid bad consequences. Timely diagnosis and treatment for leakage of amniotic fluid increases the likelihood of normal labor and protection from infections. The safety of amniotic fluid leakage is directly proportional to the duration of pregnancy. The longer the period, the less risk to health and life. In any case, now you know how amniotic fluid leaks and the strategy for dealing with this. And we sincerely wish you not to encounter this problem and give birth to a healthy, beautiful and happy baby!
Often during pregnancy there are situations when a pregnant woman may notice signs of leakage of amniotic fluid in her underwear.
Amniotic fluid is the fluid in which the baby remains throughout the entire 9 months of pregnancy.
Amniotic fluid is a nutrient medium for the baby, thanks to which it can fully develop and is protected from external noise, shock and temperature changes.
Normally, amniotic fluid drains during the birth of a child at 8-10 cm dilatation of the cervix. This is called timely discharge of amniotic fluid.
However, there are situations when the water begins to break much earlier due date– this is called premature rupture of amniotic fluid.
Most pregnant women, starting from 33-34 weeks of pregnancy, begin to suspect leakage of amniotic fluid.
Often this turns out to be completely wrong, since at this stage the body actively begins to prepare for childbirth and an absolutely normal phenomenon occurs - an increase in vaginal discharge. This situation is in no way related to amniotic fluid.
- Your gasket gets wet very quickly and you have to change it often.
- When you change position, for example, when bending, squatting, you feel a slight leakage of liquid.
- After a night's sleep, you notice a small stain on the bed.
All these situations are quite subjective, and on the one hand it can be heavy vaginal discharge, or slight urinary incontinence, or indeed amniotic fluid.
In order to determine water leakage, you can use the following methods:
- Diaper test.
Go to the shower, wash yourself, wipe your genitals dry and instead of a pad, put a piece of white cotton diaper in your panties.
If the diaper gets wet within 15 minutes, and the liquid is not mucous in nature (which is more like vaginal discharge), then most likely it is actually leaking water.
- Perform a test to determine amniotic fluid.
Such tests are sold in pharmacies, and the most common at the moment is the Amnishuer test. The price of tests ranges from 690 rubles. up to 1200. However, the test can be done at home, and you will get the result within 5-10 minutes.
- Vaginal smear.
If the second point is not available to you, then it is best to go to the antenatal clinic and tell the doctor about your suspicions. The doctor will take a swab from the vagina and place the swab with vaginal contents in a special solution. You will receive the result within 15 minutes.
If there are signs of amniotic fluid leakage, there is no need to be afraid and wait, wasting precious time. Best option action - to make sure whether you have reasons for fear or not.
