Leakage of amniotic fluid. Leakage of amniotic fluid - what is dangerous and how to recognize the condition? What are the consequences for a pregnant woman with suspected water leakage

Pregnancy is a time of happy expectation, but also a time of excitement and worry. A pregnant woman is worried about the health and well-being of the unborn baby and is afraid to miss something important, especially if the pregnancy is the first, and all processes and sensations are new.

Among other things, many expectant mothers are afraid of not noticing signs of water leakage, which can happen at any stage of pregnancy. In this article, we will look at the causes, symptoms and consequences of this disorder during pregnancy, and also find out how to determine at home that amniotic fluid has begun to leak.

What is amniotic fluid

Amniotic fluid or amniotic fluid is a unique filling of the fetal bladder, in fact, the baby's habitat. Amniotic fluid protects the baby from external influences, from the penetration of pathogenic infections, from the pressure of the walls of the uterus. The amount of fluid increases as pregnancy progresses, reaching a volume of 1.5 liters, and decreases immediately before childbirth.

In the normal course of pregnancy, the outflow of amniotic fluid occurs in the initial period of childbirth, for a period of more than 38 weeks. In this case, it is quite difficult to make a mistake, because about 0.5 liters of liquid comes out at a time, which has an unexpressed specific smell, as well as a temperature of about 37 degrees Celsius. The process is accompanied by growing contractions.

It is quite another matter if amniotic fluid leaks during pregnancy. Various factors can provoke this, regardless of the gestational age. An interesting video on the topic of pregnancy and amniotic fluid is presented below.

Causes of amniotic fluid leakage

• External physical impact, fall;
• Inflammatory processes or infectious diseases of the cervix or vagina (for example, colpitis or endocervicitis, in which the integrity of the membranes of the fetal bladder is violated);
• Isthmic-cervical insufficiency of the cervix;
• The occurrence of neoplasms in the uterus (both benign and malignant);
• Careless diagnostic procedures such as amniocentesis or chorionbiopsy.

The above causes damage the fetal membranes, which leads to leakage.

But the insidiousness of this problem lies in the fact that the amniotic fluid can literally leak drop by drop over a fairly long period. Under such conditions, even a gynecologist with a standard examination cannot always detect the symptoms of this disorder in the development of pregnancy.

However, doctors should not be accused of unprofessionalism and negligence: signs of leakage can often be determined only with the help of special studies.

Symptoms of amniotic fluid leakage

How can you still determine whether amniotic fluid is leaking or not? The difficulty lies in the fact that very often leakage is confused with ordinary vaginal discharge, the intensity of which increases towards the end of pregnancy. However, this is just the case when it is better to play it safe, because if the amniotic fluid is leaking, this is a direct threat to pregnancy.

How to check if water is leaking at home

At the first suspicion, you can conduct a home rapid test. To do this, you need to empty your bladder as much as possible, wash yourself and wipe yourself dry. Then lie down on a clean, dry sheet and lie down at rest for about fifteen minutes. If during this time a wet spot appears on the sheet, you should immediately call an ambulance.

Timely seeking medical help is extremely important in order to save the unborn baby (more on this later).

Even without such a test, a signal for contacting a doctor should be detected odorless, greenish or colorless discharges that flow involuntarily, without the ability to control the process with muscle tension.

The doctor will conduct the necessary laboratory tests to determine the nature of these discharges. The method consists in taking a swab from a woman, in which, in case of leakage, elements of amniotic fluid are found.

Why is leakage dangerous?

After it was possible to determine that it is the amniotic fluid that is leaking, it is necessary to take immediate measures, because the life of the unborn child is at risk. As mentioned at the beginning of the article, amniotic fluid protects the child from infections and external influences.

In this regard, with premature discharge of water, antibiotic therapy will be required to prevent infection of the fetus. It is carried out in the early stages of pregnancy if the uterine cavity is not yet infected.

Therefore, timely seeking help will save the pregnancy. If time has been lost, the pregnancy will have to be interrupted, since attempts to save threaten with severe septic complications, leading to the death of both the child and the mother.

At a later date, the decision is unambiguous - the woman is given birth.

Informative video will tell you even more details about pregnancy.

Leak test

Fortunately, in recent years, a test has appeared on the market that allows you to determine at home whether there is leakage of amniotic fluid or not.

The use of such a test does not require special conditions and knowledge; you can conduct it yourself at home. It will help you quickly get the result and in case of a positive result, consult a doctor without delay.

The accuracy of the express test is close to one hundred percent. One of the constituent substances of the test reacts with the placental microglobulin protein, which is mainly found in the amniotic fluid, with a minimum presence in the woman's blood and in the discharge from the vagina and cervix.

A video of the most popular misconceptions during pregnancy is presented below.

Where to buy and how much

It is not difficult to buy an amnio test - it is sold in pharmacies and sold without a prescription. The price of the test may differ depending on the brand of the test and the place of its sale and ranges from 450 to 1500 rubles.

Perhaps, to someone such a cost will not seem very affordable. But it is worth taking into account the complexity of the issue, the importance of timely diagnosis, and then the price of the test will not be so high.

How to use the express test

As already mentioned, the application of the test does not require special skills and conditions, it is enough to follow the attached instructions. First you need to take a swab from the vagina using the supplied swab, which is then lowered into a test tube with a reagent.

A minute later, an indicator strip is placed in the test tube. Then - as with a pregnancy test: one strip - the answer is negative, two strips - positive.

The effectiveness of such a test is confirmed by all physicians. One of the most popular amnio tests is the Amnishur test, the price of which is about one and a half thousand rubles.

So, a rapid test is often an exceptional opportunity to understand that amniotic fluid is leaking without resorting to the help of specialists. But it is very important to know that you need to urgently consult a doctor, without even wasting time on a test, if you have vomiting, pain in the lower abdomen, signs of poisoning of the body and similar symptoms.

We wish that you do not have to apply these tips in practice, the pregnancy proceeded without problems, and the baby was born healthy and right on time!

During pregnancy in the mother's womb, the fetus is surrounded by amniotic fluid, which is commonly called amniotic fluid. They are important in relation to the development of the fetus, so their outflow normally occurs only during a certain period of labor.

If the waters begin to recede prematurely, this threatens with premature resolution and becomes a serious risk factor. It is necessary to understand how dangerous such situations are for a woman and a baby. The question of how to understand that the waters have broken should be studied by every expectant mother.

Symptoms of loss of amniotic fluid

Many women, even at the beginning of their term, are interested in how to understand that the waters have broken. The physiology of a woman is designed in such a way that during the third trimester of pregnancy, the discharge is more abundant, and this is the absolute norm. It is necessary to identify the nature of such manifestations, which should be done by the gynecologist leading the pregnancy. But the expectant mother, for the sake of her own safety and the health of the baby, must herself be able to determine that the premature discharge of fluid has begun. It is important to know and understand what is happening in the body: leakage of amniotic fluid or discharge.

The main symptoms that can make you wary lie in the following factors:

• The outpouring of fluid increases with a change in position and movement.
• If there has been a significant rupture of the fetal bladder, the fluid begins to flow down the legs. A woman, even with the effort of her genital muscles, cannot stop the flow.
• If the damage to the bladder is microscopic, the leakage is determined solely with the help of a smear in the antenatal clinic or special tests.

External differences

It is possible to distinguish two conditions - leakage of amniotic fluid or discharge - by the appearance of formations on underwear or hygiene products. The waters have a transparent color (sometimes with a pinkish, greenish, brownish tint) and are a bit cloudy. The discharge may have a thicker consistency and a white, yellowish-white, brownish tint. Amniotic fluid, which is far from transparent, should also alert the expectant mother.

Special home check tests

To understand what is really happening (leakage of amniotic fluid or discharge), tests that are specially designed to test women at home will help. The most effective are two research methods, the essence of which is as follows:

• Before checking, you must go to the toilet, wash the intimate area, pat dry with a towel. After that, it is recommended to lie down on a clean, dry sheet or diaper. If stains appear on the surface of the fabric after twenty minutes, there is a high probability of premature outflow. The reliability of this technique is about 80%.
• The possibility of loss allows you to identify special accessories. Gaskets for the outpouring of amniotic fluid can be purchased at a pharmacy for an average of 300 rubles.

Special testing tools

Some pharmaceutical companies produce special pads for amniotic fluid leakage. According to external characteristics, this is a completely standard hygienic package. The main difference is that each product contains special reagents. They help to reliably determine even the smallest fraction of the outpouring.

The test is quite simple: the product is attached to the underwear and left for 12 hours. The reagents react exclusively with amniotic fluid and stain the pad aquamarine. The study allows you to distinguish the presence of discharge from the main problem. The hygiene bag simply won't change color.

At the first signs of outflow, you should immediately contact a gynecologist, because such a condition can threaten the health of the fetus and mother. It is also better to consult a doctor if a woman is concerned about any suspicions. Only a specialist will help remove unnecessary fears and reliably establish whether a woman has leakage of amniotic fluid or discharge, which are a sign of the healthy functioning of the body. In any case, you need to carefully listen to your condition.

How to recognize amniotic fluid leakage with a high level of confidence?

Professional methods of examination give high efficiency. During a medical examination, a more detailed diagnosis is carried out. By manipulating a special tool - a gynecological speculum - the obstetrician examines the cervix. It is likely that the woman will have to specifically push. If a copious discharge of fluid begins at this point, the fetal bladder may be damaged, and the doctor determines how the amniotic fluid is leaking. Depending on the results of the study, further tactics of action are built.

Additional manipulations

The medical test for amniotic fluid leakage is to determine the pH level of the vagina. If the environment is normal, high acidity will be detected. With the loss of amniotic fluid, it becomes slightly alkaline or neutral. This method also allows you to determine the presence of various infectious diseases.

Often, an obstetrician conducts a cytological examination - this is a special test for amniotic fluid. The substance to be separated is applied to the glass. After drying, it is determined what it is: water or physiological secretions. At the 40th week of the term, the technique is not used

If the doctors justified their suspicions, at the end an ultrasound examination is performed to determine the exact amount of amniotic fluid. If their volume is less than normal, oligohydramnios is diagnosed.

Risk factors

• Infectious lesions of the genital tract that occurred even before the onset of pregnancy or in the early stages.
• Malformations of the uterus (mostly congenital).
• cervical insufficiency. The cervix is ​​poorly closed and cannot cope with the pressure from the growing fetus.
• Polyhydramnios. The diagnosis is made after an ultrasound examination.
• Chorionic biopsy, cordocentesis, amniocentesis. Genetic disorders.
• Mechanical injury received while waiting for the baby.
• Insufficient pressing of the presenting part of the fetus. Most often observed in women with a narrow pelvis and in the presence of anomalies in its development.
• Multiple pregnancy.

What is a norm?

A healthy pregnancy and childbirth implies the following sequence of events: when the 38th, 39th, 40th week of pregnancy comes, labor can begin at any time. When one of the contractions proceeds, the bubble in which the amniotic fluid is enclosed breaks, and they come out in one stream. If this does not happen, the obstetrician performs a forced puncture, which is called an amniotomy.

Classification

Depending on the time when the outflow occurs, and on how the amniotic fluid leaks, the following classification has been developed:

• Timely. It begins at the end of the first birth period with full or almost full disclosure of the cervix.
• Premature. When it's 39, before the onset of stable labor.
• Early. Leakage during labor but before cervical dilatation.
• belated. Occurs due to the high density of the fetal membranes. The effusion begins in the second birth period.
• High rupture of shells. Occurs at a level above the cervical os.

Ideally, the outpouring should be just in time. But in terms of full-term pregnancy, the period of which exceeds 37 weeks, any option may be favorable if, as a result, normal labor activity develops. A similar condition is considered dangerous if the period is less than 37 weeks.

Why is leakage dangerous?

In order to understand all the consequences that threaten premature rupture, it is necessary to understand the functions that amniotic fluid carries:

• barrier to infection. Infection through the mother's genitals can get to the child in a vertical way.
• Prevention of compression of the umbilical cord. The waters help create a free flow of blood to the baby.
• mechanical function. The fetus receives protection from negative external influences, such as shocks or falls. Conditions are created for the free movement of the baby.
• biologically active environment. There is a constant exchange and secretion of chemicals between mother and baby.

In the event of the development of disorders, all functions suffer, but intrauterine infection becomes the most dangerous complication, because leakage occurs due to loss of integrity of the membranes. As a result, the tightness of the medium is lost, protection from external influences is lost, and sterility is violated. Viruses, bacteria, fungi can penetrate the fetus.

If a leak is found...

If an outflow occurs during this, it can cause infection of the fetus with various infections, which, without barriers, can overcome all protection. As soon as the obstetrician makes sure that there is leakage, the woman is sent for ultrasound diagnostics. This study helps determine the degree of maturity of the baby in the womb. If the kidneys and respiratory system of the fetus are ready for full-fledged functioning outside the uterus, this is done to prevent infection of the child with an infection.

If the fetus is not ready for independent life, measures are taken to prolong the pregnancy - doctors will expect the fetus to be ready for childbirth. The therapy is as follows:

• Prescribing antibacterial drugs. This will help prevent intrauterine infection.
• Strict bed rest. Rest and a stable position facilitate the therapy.
• Permanent monitoring of the health and condition of the child, as every day is considered important. The baby has every chance to grow to a viable state in the mother's womb. An assessment of its blood flow, perturbation is carried out.
• Mother undergoes laboratory tests, body temperature is measured.
• In the absence of signs of infection, expectant management continues. The child's airways can be prepared for independent functioning, for which hormonal drugs can be prescribed. It is not dangerous, all activities are aimed at maintaining the health of the mother and child.

Instead of a conclusion

Premature leakage of water can be prevented if a woman, in the presence of risk factors, carries out appropriate prevention. For example, timely treatment of cervical insufficiency is implemented, when a suture can be applied to the cervix, a special one is introduced. In some cases, preservation therapy, sanitation of the genital tract and other potential infectious foci (pyelonephritis, caries, tonsillitis) are carried out. The most favorable prognosis is formed with effusion in full-term pregnancy. However, the expectant mother should not panic, it is advisable to remain calm and follow all the doctor's instructions.

There is no need to remind that amniotic fluid is a vital, natural environment for the active growth and development of the unborn child. The waters contain fetal cells, metabolic products and biologically active components such as hormones.

Therefore, the amount of fluid, the biochemical composition have certain parameters, the shift of which in one direction or another is fraught not only with complications, but is a danger to the viability of the unborn baby.

Causes of untimely discharge of water

Normally, the outflow of amniotic fluid occurs during physiological labor after 38-39 weeks of pregnancy. As the cervix opens and contractions intensify, the membranes of the fetal bladder break and some of the water comes out.

However, in some situations, leakage during pregnancy occurs either earlier or later.

If signs of rupture of the membranes appear before the onset of labor, then this is called early or premature discharge of amniotic fluid.

The reasons for this can be both pathological changes in the membranes themselves, the cervix, polyhydramnios, the anatomical features of the pregnant woman, and the pathology of the fetus:

• large sizes;
• hydrocephalus;
• wrong position in the uterus.

Sometimes the rupture does not occur in the lower pole of the bubble, but on the side. In this case, the leakage of water occurs slowly. Signs of pathology do not appear immediately. You can diagnose this condition by conducting a special examination.

Diagnosis of early rupture of amniotic fluid

Like any diagnostic measures, the examination procedure includes several stages:

1. Questioning a pregnant woman about a watery discharge or an increase in its amount. We should not forget that by 38-39 weeks the amount of physiological secretions increases. Some have more, some have less. Moreover, the enlarged uterus puts pressure on the bladder and any minimal load can provoke the release of urine.
2. Examination of a pregnant woman on a gynecological chair.
3. The amount of fluid in the uterus can be assessed using ultrasound diagnostics.
4. If it is possible to collect the discharge, then tests are carried out for the presence of hairs and epithelial scales in them.
5. In doubtful cases, amnioscopy is used - examination of the presenting part of the fetus. This is an informative, but difficult research method, carried out using a special apparatus - an amnioscope, which allows you to assess the quantity and quality of amniotic fluid.

How can a future mother determine the leakage of water?

How to tell if it is amniotic fluid leakage or discharge? Of course, the best way to dot the i's is to visit a gynecologist.

However, in life there are situations when it is not possible to urgently get expert advice and conduct the necessary tests in the doctor's chair. In this case, in order not to waste precious time, it is recommended to take into account the following tips and recommendations:

1. The life of the fetus is impossible without amniotic fluid.
2. Normal amniotic fluid is a colorless and clear liquid. Their color changes in case of infection - they become cloudy, greenish or yellow.
3. A simple home test to determine the nature of leakage (water, urine, mucous discharge from the genitals). After the toilet of the genitals, you need to lie down on a white sheet. The perineal area should be dry. If after 15–25 minutes wet colorless spots appear on it, then it is highly likely that this is water leakage during pregnancy. If during the experiment a yellowish liquid with a typical odor is obtained, then this is most likely urine. Vaginal discharge is usually thicker and whitish. It is advisable not to be alone at this time, but to invite someone from your loved ones.
4. The same experiment can help to conduct sanitary pads.
5. In pharmacies, there are special pads that allow, at the right time, to distinguish between early discharge of amniotic fluid and urine leakage.

What to do in this situation?

It is important to notice the leakage of water in time. This situation is fraught with serious complications:

• infection of the fetus and the mother's body with the development of endometritis, inflammation of the membranes;
• premature birth;
• the weakness of the ancestral forces.

At the slightest suspicion of signs of water leakage, a pregnant woman must, without wasting time, appear to a gynecologist for examination and laboratory tests. This is an occasion for emergency treatment in the inpatient department.

The final decision regarding the further management of pregnancy and the timing of delivery is made by the doctor, depending on the time left before delivery and the readiness of the mother's body for childbirth.

When a woman's body is not ready for childbirth

If everything happens before 35 weeks, then all efforts are directed to maintaining the pregnancy. A woman is hospitalized in a hospital, prescribed strict bed rest and special drugs that block uterine contractions.

Before childbirth

With a period exceeding 36–39 weeks, it all depends on the condition of the woman. If we are talking about a problematic pregnancy and the risk of complications is high, then, given the age of the fetus, sufficient for life outside the mother's womb, the issue of caesarean section is being decided.

In other cases, the woman in labor and the fetus are observed, in the conditions of preparation and provision of physiological childbirth.

Prevention

It is recommended to exclude sexual contacts 2 months before the expected date of delivery. If a woman is at risk, then for a period of 38–39 weeks it is better to go to the pregnancy pathology department for control and observation.

In a home first aid kit, it is better to have a special pharmacy test that allows you to find out at any time what fluid is excreted from the body - urine or water.

Baby. However, unfortunately, the further deterioration of the ecological situation in the world as a whole, the increase in the number of unhealthy people lead to the fact that carrying a baby for 40 weeks without encountering any problem or getting sick turns out to be quite difficult, and this happens not like that. often. In the article we will talk about one of the complications - leakage of amniotic fluid. We will tell you how to understand that amniotic fluid is leaking, and what symptoms indicate this.

The role of amniotic fluid

Important! If you find any of these symptoms in yourself, you must immediately inform the gynecologist. A copious outpouring of fluid means that you need to call an ambulance.

Methods on how to determine the leakage of water during pregnancy are medical and independent.
The first ones are:

• gynecological examination,
• smear microscopy,
• aminotest,
• cytological study.

During a gynecological examination, the doctor may suspect leakage if he finds clear discharge in the area of ​​​​the posterior fornix of the vagina of the pregnant woman.

In this case, he will ask the woman to cough, if after that the liquid flows from the cervical canal, then it is likely that the fetal bladder is damaged. The gynecological method is the most common and least informative.

When taking a smear, the analysis is placed on the glass. If there is a leak, after it dries, it will take the form of a fern leaf. The method is also uninformative, since a similar pattern can occur in the presence of sperm.

Aminotest is an analysis during which an indigo-carmine solution is injected into the woman's abdomen with a syringe. After 30 minutes, a swab is inserted into the pregnant woman's vagina.
Its staining indicates a rupture of the fetal bladder. Aminotest is accurate, expensive and painful. It has a number of side effects: the possibility of infection, the appearance of bleeding and other complications.

A cytological examination involves taking a smear from the zone of the posterior fornix of the vagina and detecting the presence of amniotic fluid in it.

Express test at home

There are two ways to determine leakage at home. At the first time, a woman needs to urinate, then wash well, wipe dry.

After she needs to take a diaper or a sheet and lie on it. The presence of wet spots after 15 minutes indicates a violation of the bladder membrane.
In pharmacies, you can buy a test pad for leakage of amniotic fluid. The pad has an indicator that allows you to distinguish amniotic fluid from other secretions and urine by pH.

It sticks to the underwear for 12 hours or until the moment when the woman feels the discharge.

After removing the gasket, check the color of the indicator. Staining it in bluish-green requires immediate medical attention.

What amniotic fluid looks like when leaking, you can see in the photo.

Danger of premature discharge of water

Premature leakage of a liquid medium from the fetal bladder carries a number of dangers for both the pregnant woman and the baby.

For woman

When there is a violation of the surface of the fetal bladder, its content becomes non-sterile, so there is a high risk of infection entering both the child and the uterus.

Infection of the uterus usually leads to the death of the child and provokes the development of severe septic complications in the mother.

Did you know? The uterus is a unique human organ that is able to increase in volume by about 500 times during the bearing of a baby, and then return to its original state. Thus, the weight of a woman's uterus in a normal state is approximately 40-60 g, the volume of her cavity is 5-6 cubic meters. cm, and by the end of pregnancy - 1-1.2 kg and 500 cu. cm respectively.

For the fetus

If the leakage began before the 20th week, then additional tests will be required in order to decide whether it makes sense to prolong.
Most likely, the cause of the complication was infection, and this is fraught with the development of a number of pathologies in him.

Often children in such cases are born blind, deaf, suffer from severe respiratory failure or cerebral palsy. Therefore, doctors often decide to terminate the pregnancy. Bladder rupture at 25-27 weeks is usually due to the development of a urogenital infection.

The council of doctors must determine the possible risks for the child and decide on the further preservation of the pregnancy or its termination. The risk of developing disability in the baby is quite high.

At a period of 38-40 weeks, a slight rupture of the bladder and the outflow of a liquid medium from it does not pose such a strong threat to the baby as in previous periods. Usually doctors at the moment resort to expectant tactics.

Important! The longer the period of leakage of amniotic fluid lasts, the more serious complications can occur in the child and mother..

What to do if amniotic fluid leaks

If the problem was discovered by a woman on her own at home, then she should call an ambulance team or contact a antenatal clinic.
If a leak is detected by a gynecologist during a routine examination, depending on the specific situation, they will be prescribed treatment, recommendations will be given, additional tests will be prescribed, and a decision will be made on the further management of the pregnancy.

If a complication is detected in the period from the 20-22nd week, in most cases the child can be saved.

A waiting tactic is used, taking tocolytics and glucocorticoids (sometimes antibiotics), bed rest, sterile conditions, blood tests and vaginal cultures, daily monitoring of the volume and condition of the water.

Prevention of premature discharge of water

In order to prevent premature discharge of amniotic fluid, it is necessary:

• timely treat infectious diseases of the genitourinary system, teeth, throat, kidneys;
• to carry out timely treatment of istvico-church insufficiency;
• adhere to preservation therapy if there is a risk of premature termination of pregnancy;
• give up heavy physical exertion, be careful when walking, running to avoid falls;
• observe personal hygiene.

Leakage of amniotic fluid is a serious complication of pregnancy. However, with its timely detection and treatment, the child in most cases is born full-term and healthy.

In order not to miss the problem, it is necessary to visit the gynecologist according to the plan, undergo the necessary examinations, be attentive to yourself and your body.

Pregnancy is a hectic time, full of worries and alarming symptoms. One of the reasons for concern is the fear of not recognizing the leakage of amniotic fluid. Women are often interested in the symptoms and mechanism of this phenomenon: how to distinguish when amniotic fluid flows out, and when the discharge is completely natural and does not require concern. In many cases, such leakage goes unnoticed only because the woman confuses the release of amniotic fluid with intense natural vaginal discharge. Often in practice there are moments when women worry absolutely in vain. The secretions that they mistook for amniotic fluid actually turn out to be natural secretions or urine.

Therefore, it is so important to have at least elementary knowledge in this area and independently distinguish between pathological and normal discharges. The course of further actions already depends on this. If there really is leakage of amniotic fluid - you need to act immediately - call an ambulance, consult a doctor. If the liquid is of a different nature, it is worth making sure of this as soon as possible and not worrying for a single extra minute.

It is necessary to understand that amniotic fluid refers to the fluid that acts as the habitat of the fetus. It provides reliable protection, supplies nutrients, removes decay products, toxins. Also, thanks to this environment, the child is completely safe and protected from the damaging effects of mechanical factors. The fluid contributes to a comfortable position, in which the walls of the uterus do not squeeze the fetus, provides turgor, serves as a shock absorber of movements, and ensures normal and complete formation.

The liquid with fetal membranes has bactericidal properties, which prevents contamination by microorganisms from the external environment.

The reservoir of this fluid is the fetal bladder, the development and formation of which occurs as the child develops. The amount of fluid also increases as the baby develops, up to 1-1.5 liters by the expected date of birth. It is formed by perspiration of maternal blood components through the placental vessels.

ICD-10 code

O42 Premature rupture of membranes

Epidemiology

Despite the fact that such a phenomenon takes place, a lot is said and written about it, it does not occur very often. Leakage occurs in about one in 30,000 cases. There is constant debate among scientists and practitioners as to how much amniotic fluid should be taken as the norm. Doctors agree that the volume is in direct proportion to the gestational age and is approximately 35 ml at the tenth week. By the fourteenth, this volume increases by about 3 times and averages 100 ml. At the twentieth week, this volume is 400 ml. The largest volume of fluid is observed at week 38 - approximately 1000-1500 ml. Immediately before the birth of the baby, these figures decrease and reach about 1000 ml.

The composition of amniotic fluid is quite interesting: approximately 98% of it is formed by water, the rest is substances dissolved in it. In 85 women, water is poured out on time, in 15% it happens prematurely.

Causes of amniotic fluid leakage

The ability to take the right measures is directly proportional to the knowledge of the reasons for which the amniotic fluid leaks. The problem is that determining the exact cause of leakage is a rather complicated and time-consuming process. It is not always possible to identify one specific cause.

Knowing the causes of leaks is essential in order to be able to take the right action. Determining the exact cause of leakage is quite difficult. Especially when the amount of water is negligible. The study of this issue is still being conducted by scientists from around the world, and there is still no exact answer. Most researchers identify a number of reasons that can directly or indirectly affect this phenomenon. On average, there are five main reasons.

Most researchers tend to assume that leakage is the result of infectious and inflammatory diseases affecting both external and internal reproductive organs. These processes are closely related to the development of pathogenic microflora. As a result, the placenta and fetal membranes soften. The process may result in severe bleeding, the fetus may undergo hypoxia.

The process can also begin because the fetus is incorrectly presented, and the pelvic region is narrowed. This provokes leakage and is accompanied by a slow opening of the cervix. Also, if there is cervical insufficiency (which occurs in a quarter of pregnant women), the water will leak. The fetal bladder protrudes, becomes highly vulnerable, which significantly increases the risk of developing an infectious process. The amniotic cavity becomes inflamed, inside which the development of pathogenic microflora occurs.

The action of chemical, narcotic, harmful substances, nicotine, pathological lesions of bone tissue, the large size of the fetus, twins entail cervical insufficiency, which can cause leakage.

Often, leakage begins because the woman underwent invasive research methods. The taking of amniotic fluid is especially negative if the woman underwent a biopsy of the chorionic villi.

After sex, intense discharge is observed, often mistakenly confused with amniotic fluid. It must be remembered that natural vaginal discharge is quite intense. After sex, they intensify. In addition to all the liquid, semen is added. In addition, semen contains prostaglandins, which stimulate additional mucus synthesis. Leakage takes place only with the likelihood of miscarriage, excessive tone. During intercourse, excitement occurs, the tone increases. For your own peace of mind, it is better to test.

Risk factors

If a woman has an infectious process in the genital area, she automatically falls into the risk group. Especially if problems arose long before the woman became pregnant. Women in labor with congenital uterine defects and cervical insufficiency require increased attention, as the cervix loses its ability to resist the pressure of a growing baby. With polyhydramnios and multiple pregnancy, part of the fluid may leak.

Pathogenesis

The pathogenesis is based on the pathological condition of the cervix, in which it does not close enough and part of the fluid is poured out. In this position, microorganisms easily penetrate the neck, which cause an inflammatory and infectious process. As a result of vital activity, reproduction of microorganisms, the inflammatory process spreads further, the walls of the uterus become thinner, the fetal membranes also become thin and lose their elasticity. They are unable to fully perform their functions. The process is aggravated, and the fluid begins to be released through the cervix. It can stand out in drops, almost imperceptibly, or abundantly. In later pregnancy, leakage can occur as the pelvic floor muscles relax and fluid outflow becomes uncontrollable.

Symptoms of amniotic fluid leakage

It is quite difficult to detect leakage if a woman is in the early stages. First, the volume of liquid is still small. Secondly, all secretions are intensified, which can confuse a woman, confuse sensations. Amniotic fluid can be recognized by a transparent or greenish tint and the absence of any smell. The discharge is aggravated by lying in a horizontal position. They are spontaneous and cannot be controlled.

In the later stages, it is much easier to detect leakage, more precisely, it cannot be overlooked: there is an abundant separation of liquid, about 0.5 liters. At these stages, the liquid already acquires a slight specific smell, accompanied by contractions. This is a sign of an approaching birth, which usually occurs in the next 3 hours.

First signs

If wet spots appear on the underwear, these are the first signs. At the initial stages, the amount of liquid is insignificant, later - plentiful. If at first the liquid may leak out in small drops and it may not be noticed, then in the later stages the liquid is poured out, it has an unusual smell.

The rate of leakage of amniotic fluid

Normally, the outflow of fluid should occur only when labor has already begun. It shouldn't be there any other time. Water flows out through the genital tract. This should happen no earlier than 38 weeks. 500 ml of liquid is poured at a time. The smell comes out unusual, specific. All this is accompanied by contractions, the strength and intensity gradually increases.

Feelings of leakage of amniotic fluid

There is a feeling of a sharp or gradual flow of fluid from the female genital tract. There are no specific sensations observed. Pain, burning, itching is not felt. With the outflow of fluid immediately before childbirth, contractions immediately follow the outflow, which can be painful.

Leakage of amniotic fluid in the 1st, 2nd, 3rd trimester

The only way out of the situation is an abortion. Until now, in practice, there are no cases of conservation that would be crowned with success. Most attempts ended in severe sepsis of the mother and fetus. Leakage is accompanied by the active spread of pathogenic microflora and the inflammatory process, the walls of the amniotic cavity become thinner and lose their elasticity. In many cases, leakage is the result of a woman's fall. It is also often observed in people who have been subjected to violence.

Up to 20 weeks, leakage is always accompanied by inflammation. At this stage, it is impossible to save the baby. If it was possible to save, the newborn had multiple disorders, often incompatible with life.

Fluid spillage in the second trimester still carries a number of risks and threats to life. Optimal conditions are formed for the penetration of the infection inside, its spread and reproduction. As soon as there are all grounds for making a diagnosis, an ultrasound is prescribed. With the help of ultrasound, they determine how mature the fetus is, determine the degree of its readiness for existence outside the mother's body.

With a sufficient degree of development of the kidneys and respiratory organs, they begin to stimulate labor activity. This is the best option because it saves the life of the child. If the child is not yet mature enough, it is necessary to prolong the pregnancy and wait for the fetus to be ready for birth.

If the amniotic fluid leaks in the third trimester, an ultrasound is performed, which makes it possible to assess the degree of maturity of the fetus. If the fetus is ready to exist outside the uterus, labor is stimulated. With insufficient maturity of the fetus, prolongation of pregnancy is carried out.

Leakage of amniotic fluid at 38, 39, 40 weeks of pregnancy

In any of these periods, you can expect the onset of labor, so if there is an outpouring of fluid, you should expect an early birth. Usually, immediately after the outflow of fluid, contractions and further childbirth begin. If this does not happen, after a while, labor should be stimulated to avoid complications. The baby is ready for birth.

Leakage of amniotic fluid without contractions

Contractions usually start right away. But there are times when there are no contractions for a long time.

If a fluid leak occurs, you need to quickly go to the maternity hospital, where you must tell the doctor the exact time when the fluid began to leak.

This is information by which the doctor determines the child's condition and potential threats. In some cases, after the outpouring of contractions does not happen. This period can last up to 72 hours. Usually, if there are no contractions within 12 hours after the outflow of water, stimulation is performed. At the risk of infection, stimulation is carried out after 5-6 hours.

Leakage can be observed both at night and during the day. Usually, wet marks on the sheet indicate nighttime leakage.

stages

There are three stages of amniotic fluid leakage - leakage at an early stage of pregnancy is the most dangerous and often ends in a forced abortion.

Leakage in the middle stage of pregnancy is also dangerous, entailing the risk of infection of the fetus. With sufficient maturity of the baby, childbirth is artificially induced. If the baby is not yet ready for independent existence, prolongation of pregnancy is carried out.

In the third, late stage, leakage is relatively safe. Usually at this time the fetus is already mature and childbirth occurs: natural or artificially induced. If the fetus is immature, the pregnancy is prolonged until maturity.

Forms

Leakage of amniotic fluid can develop within the normal range, and may be pathological. In the first case, such a phenomenon is part of natural childbirth, it occurs at the moment when the first stage of childbirth is nearing its end. In this case, the cervix opens completely or partially. If the leakage is pathological, effusion can occur at absolutely any stage, even in the first trimester. There are 5 main types of leakage: timely, premature, earlier, late and rupture due to high cervical rupture.

Complications and consequences

Leads to unpredictable consequences. They will not be only if the fetus is full-term and is already able to live an independent life, outside the uterus. If the pregnancy is premature, serious consequences and complications can occur, up to intrauterine infection of the fetus and infectious damage to the body. Chorioamnionitis is a common complication. Endometritis also often develops, during which the uterus itself becomes inflamed. The result is the spread of the infectious process throughout the body.

What is dangerous leakage of amniotic fluid?

Leakage is an unsafe process. The danger lies in the fact that only part of the liquid remains, and the rest lose their ability to function normally. The fetus becomes vulnerable, the risk of infection, sepsis increases. As a result, both the fetus and the mother may die.

This is due to the violation of the natural barrier, which protects the fetus from infection, mechanical damage. Various microorganisms can penetrate through this barrier: viruses, bacteria, fungi. It is possible to compress the umbilical cord, as a result of which normal metabolism is disturbed. The conditions under which free movement and full development of the fetus are possible are violated. The synthesis of the necessary components, tightness and sterility are violated.

Diagnosis of amniotic fluid leakage

Diagnosis can be carried out independently, or at a medical consultation. Assess the nature of the secretions that remain on the sheet, underwear. Commercial test systems are on sale. For example, special pads, express tests, the action of which is based on the difference in pH. Amniotic fluid is characterized by the highest acidity. The system contains an indicator that reacts to the liquid that falls on it. In this case, the hue of the indicator and the medium change.

At the doctor's appointment, special laboratory and instrumental methods of research are available.

How to determine the leakage of amniotic fluid at home?

You should resort to the help of a small test. The bladder needs to be empty. The perineum should be clean and not wet. A white cloth should be laid on the bed. You should lie on it, lie quietly, without moving, for about an hour. After that, you can get up. If there are no discharges, you don't have to worry.

Express tests for amniotic fluid leakage

Most of the tests are easy to use, absolutely not complicated. Their principle of operation is to determine the level of acidity. The indicator interacts with various media, resulting in chemical reactions. Initially, the tests are yellow. When the indicator is exposed to natural vaginal discharge, pH 4.5, no reaction occurs. Because it initially corresponds to this level of acidity. The reaction occurs when other liquids enter, then a color change occurs.

For example, urine has a pH of 5.5, which corresponds to a greenish-blue tint. The amniotic fluid has the highest acidity, pH = 7. When they hit the indicator, it turns into an intense blue-green color.

Amniotic fluid leak test strips

A method that makes it possible to clarify the nature of the discharge. The appearance of two strips indicates the presence of leakage, one strip indicates that the secreted fluid is not amniotic. If there are no strips, the test is not suitable, or it was performed incorrectly. The procedure must be repeated.

Amniotic fluid leak test

Instructions for the amniotic fluid leak test

Specialists and manufacturers have developed a special step-by-step instruction. You need to prepare the test, print the package, read the instructions. The test contains a special test tube with a solvent.

It is necessary to conduct a sampling of biological material to be examined. To do this, you need to take a swab and make a smear yourself, collecting vaginal discharge on it. After that, the swab is placed in a test tube with a solvent and a further reaction is observed. The first reaction occurs within 1 minute. If amniotic fluid is excreted, it contains placental immunoglobulin. It is he who reacts with the solvent.

After that, a special indicator, presented in the kit in the form of a strip, must be placed in the test tube. The result will be known after 5-10 minutes. In the presence of amniotic fluid, a blue-green color will appear.

Amnishur test for the determination of amniotic fluid leakage

Testing should be carried out in accordance with the standard instructions for using such systems. The reaction is manifested by a change in color if placental microglobulin is present in the smear. The main reaction takes place in the test tube between the reagent, the swab with the swab and the indicator.

The method is absolutely reliable and effective, it is used both in home practice and in professional practice to detect the outflow of amniotic fluid. The advantage of the test is that it reacts even to minimal amounts of liquid, which makes it possible to detect pathology long before the first visible signs appear.

Gaskets for leakage of amniotic fluid

Today you can buy special gaskets that make it possible to determine the cause of leaks. Outwardly, the pads are the same as ordinary sanitary pads, the difference is that they include an indicator that reacts even to a slight release of amniotic fluid. The test is surprisingly simple: the pad is attached to the underwear and left for the whole day. Then check its condition. If there is leakage of amniotic fluid, the pad changes color, becoming blue-blue. If it is any other selection, there is no change in color.

Frautest for leakage of amniotic fluid

The test, which is produced by the FRAUTEST company, whose products are used in professional obstetric practice and are recognized by experts around the world. The test is issued in the form of gaskets, which include an indicator. For the ingress of amniotic fluid, a change in the color of the test system is characteristic. The test takes 12 hours.

Grandma's method for determining the leakage of amniotic fluid

Analysis for amniotic fluid leakage

Sometimes it can be difficult to make a correct diagnosis. Difficulties arise even when the inspection is carried out by a professional. Therefore, analysis is the basis of diagnostics, which allows you to get absolutely accurate results. Even instrumental diagnostics does not give accurate results.

Color of amniotic fluid when leaking

Color is an important diagnostic feature by which the doctor determines a lot. Normal amniotic fluid is clear. Turbidity and a different color indicates various pathologies. With the appearance of a yellow tint and slight turbidity, you can also not worry, since such a picture is considered as a variant of the norm.

If a reddish tint and slight inclusions appear against the background of yellow waters, the process is accompanied by contractions - we can safely say: childbirth has begun.

The green color of the water is a negative sign, the fetus is seriously damaged. Talks about defecation in the womb, deficiency, the likelihood of developing intrauterine pneumonia. Possible hypoxia.

The appearance of a dark brown hue is a catastrophic situation. In 99% indicates intrauterine fetal death. There is an urgent need to save the mother's life urgently. However, at present, this pathology is quite rare, since women regularly visit a doctor and such a pathology can be noticed in a timely manner.

The appearance of a red color, which indicates the discovery of bleeding.

Smear for leakage of amniotic fluid

For analysis, you need to take an ordinary smear from the vaginal environment and apply it to a glass slide. If, upon drying, the smear forms a structure resembling a fern leaf, or a maple leaf, it is amniotic fluid.

Instrumental diagnostics

It is preferable to focus on the results of the analyzes, since instrumental diagnostics is uninformative.

Ultrasound to detect amniotic fluid leakage

Perform an ultrasound. This study makes it possible to indirectly confirm the diagnosis. According to the results of ultrasound, a diagnosis is made: oligohydramnios or polyhydramnios, does not directly indicate leakage.

Differential Diagnosis

A differentiated diagnosis is carried out, during which amniotic fluid, urine or ordinary vaginal discharge are differentiated. Laboratory diagnostics prevails over instrumental.

The smell of amniotic fluid when leaking

Amniotic fluid is odorless. In late pregnancy, they may have a slight specific odor.

How to distinguish leakage of amniotic fluid from discharge?

You can distinguish between these two types of secretions in appearance. The waters are clear and slightly cloudy. Vaginal discharge is thicker and slimy, has a different shade, often white or yellowish.

Amniotic fluid leakage or urinary incontinence

Amniotic fluid leaks constantly and cannot be controlled by muscle effort. Urine has a yellow tint and the smell of urine, which cannot be said about amniotic odes. They are usually colorless and odorless. With pathology, amniotic fluid acquires green, brown, red and other shades.

Cervix with leakage of amniotic fluid

The cervix opens directly during childbirth. Leakage does not depend on the state of the cervix, but is determined by the state of the fetal bladder. Most often, leaks are observed with a closed cervix, but sometimes it is also open.

Treatment of amniotic fluid leakage

Treatment for leakage of amniotic fluid is not carried out. The doctor determines the likelihood of infection and, in accordance with this, takes further actions: prolongs the pregnancy or stimulates labor activity. Sometimes antibiotic therapy may be used to prevent infection. They also use funds aimed at relaxing the muscles, uterus, general strengthening agents, vitamins.

What to do with leakage of amniotic fluid?

If you find leakage of amniotic fluid, you should immediately call an ambulance or consult a doctor. It is important to remain calm and not panic. If hospitalization is offered, in no case should you refuse. Only with the constant supervision of doctors and proper treatment can the further development of pathology be prevented.

How to stop the leakage of amniotic fluid?

It is impossible to stop the leakage of amniotic fluid. You can only consult a doctor in a timely manner and take the necessary measures to prevent infection and maintain pregnancy.

Medications

Any medicines must be taken strictly on the recommendation of a doctor, preferably with inpatient treatment. Means that regulate the tone of the uterus are extremely dangerous, have many side effects. Many of them are taken under strict control of blood pressure, pulse, electrocardiogram indicators.

In order to ensure the prolongation of pregnancy, ginipral is taken, which reduces the excessive tone of the uterus. It contracts less frequently and less intensely. The active substance is hexoprenaline sulfate. Tablets contain 500 mg of active ingredient. Tablets are taken first, 1 pc. every 3 hours, then every 4-6 hours. The daily dose is 4-8 tablets. Taking pills should be accompanied by constant monitoring of the work of the heart of the mother and fetus. With a heart rate of more than 130 beats / min, the dosage is reduced. The drug has numerous side effects, both for the mother and for the baby. Up to cardiac and respiratory failure, hypoxia. In newborns, anemia, acidosis, and hypoglycemia are possible.

Salbupart is a drug in which the contractile activity of the uterus is significantly reduced. The drug is administered intravenously. One ampoule is mixed with 500 ml of saline and infused at a rate of 5 drops per minute.

Brikanil - relieves spasm, hypertonicity, provides muscle relaxation. Applied with the threat of spontaneous miscarriage, cervical insufficiency. The drug is prescribed 2.5 - 5 mg 3 times a day (1-2 tablets).

Partusisten is a drug that is prescribed to relax smooth muscles. Enter intravenously. The optimal dosage is individual, varies widely from 0.5 to 3.0 mcg / min. During the infusion, 2 ampoules of the drug (10 ml) are added to a 230 ml saline solution.

Utrozhestan and leakage of amniotic fluid

The secretions formed when the suppository melts are often confused with the leakage of amniotic fluid. To get an accurate answer, it is better to test for amniotic fluid leakage.

vitamins

A pregnant woman, both in the normal course of pregnancy and in pathology, needs vitamins. It is recommended to take vitamins in the following daily concentration:

• vitamin H - 150 mcg
• vitamin C - 1000 mg
• vitamin D - 45 mg
• vitamin K - 360 mcg.

Physiotherapy treatment

When carrying out the prolongation of pregnancy, some physiotherapeutic procedures can be used, for example, exposure to ultrasound. Physiotherapy is used to relax smooth muscles (electric procedures), to eliminate and prevent further spread of the inflammatory and infectious process. Electrophoresis is also often used, which ensures deep penetration of drugs into organs.

Alternative treatment

When referring to folk remedies for the treatment of leakage of amniotic fluid, it is better to first consult a doctor. Folk remedies are effective and safe when used correctly, as well as as part of complex therapy.

One of the effective means to help relax the muscles of the uterus are therapeutic baths. Baths are carried out at home. The duration of the bath is 15-20 minutes, the frequency of admission is 3-4 times a week. A bath with coniferous extract has proven itself well. To prepare a bath, a decoction of pine needles is made separately, about 2-3 liters. Then fill the bath, make a comfortable temperature and pour in the extract of the needles. If desired, you can add a few branches of needles, cones. After taking a bath, do not immediately wipe yourself off, wait 3-5 minutes until the moisture is absorbed by the skin.

Therapeutic rubdowns have a positive effect. For this, salt concentrate is used. About 1 teaspoon of salt is dissolved in a glass of water. Make water at room temperature, wipe the body with the resulting solution. The duration of rubdowns is 5-10 minutes. You can not immediately wipe yourself, you should wait until all the moisture is absorbed. Salt helps to eliminate toxins, excess fluid. Blood pressure decreases, metabolic processes normalize.

Oriental incense in combination with relaxing, meditative music has a long relaxing effect. It is recommended to light candles and incense sticks. Place around the room. Turn on calm, relaxing music. Lie down in the center of the circle, close your eyes and try to relax as much as possible. It is necessary to feel every cell of the body, to feel how they relax, become light and motionless. At the same time, all thoughts and worries should be released. Just enjoy the aromas and music without doing anything and without thinking about anything. Moving is also not recommended. You need to listen to your heartbeat, breathing, try to feel the movements of the baby. The duration of this procedure is at least 30 minutes. Conducted daily for at least 1 month.

Herbal treatment

When treating with herbs, it is necessary to carefully study their properties. It is better to first consult with a doctor who will help you accurately and correctly select the necessary remedy, dosage and correctly include it in complex therapy.

Grass blue cornflower helps to relax, reduce the tone of the uterus. To prepare a decoction, about 5 grams of herbs are poured into a glass of boiling water and drunk throughout the day.

Chamomile herb has an anti-inflammatory effect. To prepare a decoction, approximately 15-20 grams of herbs are poured with 2-3 cups of boiling water and drunk throughout the day. You can also include chamomile in your tea by simply adding a few tablespoons of the herb to your teapot.

Useful decoction of nettle and stevia. Herbs are taken in equal proportions, mixed together. To prepare a decoction, you need to take 30-40 grams of grass, pour 1-2 cups of boiling water. Drink as tea throughout the day. You can add sugar or honey to taste.

Homeopathy

Homeopathic remedies, contrary to popular belief, are not safe. They can have numerous side effects. Some homeopathic remedies may have an abortive effect. Therefore, it is important to take precautions. First of all, you need to consult a doctor for advice, and only after that take any funds.

• Nutrient Blend

A mixture is prepared from an equal amount of dried apricots, raisins, prunes, figs. These substances are ground through a meat grinder, 25 pieces of finely chopped walnut are added. Fill the resulting mixture with honey. Insist 3-4 days, use 1 tablespoon 1-2 times a day. It has an immunostimulating effect, relieves fatigue, weakness. Increases the efficiency and endurance of the body.

• Rosehip decoction

Rosehip broth is drunk in its pure form, or added to taste in tea. Helps eliminate edema, remove excess fluid from the body. Saturates the body with vitamins and nutrients.

• Mix "Healing"

To prepare the mixture, take about 200 g of juicy aloe leaves. Approximately 250 grams of honey and 400 grams of grape wine are added. Insist 7 days in a dark place. Drink 1 teaspoon 3 times a day. Helps to reduce the outflow of fluid, stabilize the state of the body, normalize metabolism.

Remedy for fatigue and excessive fluid secretion

It is recommended to take powder from the dried fruits of lemongrass, 0.5 grams per day, pouring honey on top. The course of treatment is 30 days. Increases efficiency, improves well-being, eliminates swelling and excessive discharge of their female genital tract.

Surgery

If delivery is necessary, and it is impossible to carry out childbirth through natural routes, a caesarean section is performed. If labor has already begun, no outflow of water is noted, an amniotomy is performed, in which the fetal bladder is pierced, as a result of which the fluid is poured out.

Prevention

If a woman is exposed to risk factors, she can be placed in conservation, where careful monitoring and monitoring of the main indicators of the mother and fetus is carried out. If a pathology is suspected, preventive measures are taken to prevent the further development of the pathology. If a woman has cervical insufficiency, the cervix is ​​sutured and an obstetric pessary is inserted. Special care, adherence to the daily regimen, proper nutrition, listening to the doctor's recommendations are the main preventive measures.

Forecast

If the pregnancy is full-term and the baby is ready for independent existence outside the uterus, the prognosis is favorable. Then labor is stimulated, or caesarean section. With the immaturity of the respiratory system of the fetus and its unpreparedness for independent existence, prolongation of pregnancy, expectant therapy is carried out. The forecast can be both positive and negative. Infection, sepsis may develop, which increases the risk of death of both the mother and the fetus.

If amniotic fluid leakage occurs at the very beginning of pregnancy, the prognosis is poor. An abortion is required, it is impossible to save the child, there is a threat to survival. Otherwise, the closer to childbirth leakage begins, the more favorable the prognosis.