How to determine the leakage of amniotic fluid: important signs. Tests to determine the outpouring. Management of pregnant women with leakage

It is no secret that the fetus in the womb is surrounded by amniotic fluid, which is also called amniotic fluid. They play very big role in the development of the fetus, so their outpouring occurs already during childbirth. If the fluid begins to leak earlier, it is fraught with complications or premature birth. In the publication, we will figure out what are the signs of amniotic fluid leakage and how dangerous this situation is for a woman and a child.

The main symptoms of leakage

In the third trimester is the physiological process of increasing secretions. At this stage, it is very important to determine what kind of discharge a woman has begun. Naturally, this should be done by a gynecologist in the LCD, who observes a pregnant woman. But life circumstances do not always turn out well and it happens that a woman cannot see a doctor in the next few days. Therefore, it is very important for the expectant mother to independently recognize the premature discharge of amniotic fluid.

the released fluid becomes larger when moving or changing position;
if this is a small rupture of the fetal bladder, then water can flow down the legs and the woman, even with tension in the pelvic muscles, cannot contain the discharge;
if the gap is very tiny, then leakage can only be determined with the help of a test or a smear in the LCD (antenatal clinic).

What does amniotic fluid look like?

Quite often, women try to determine by the color of the discharge on the gasket whether leakage has begun. This is quite difficult to do, mostly waters have a transparent, less often pink, greenish, brown or cloudy hue.

Amniotic fluid leak tests

You do not need to purchase any equipment for this test. Go to the toilet in a small way, wash yourself and dry very thoroughly with a towel so that there is no moisture left anywhere. After that, lie down on a dry, clean sheet. If after 15-20 minutes wet spots appear on it, there is a high probability of leakage of amniotic fluid. The reliability of this method is approximately 80%.
A gasket that allows you to determine the likelihood of leakage can be purchased at a pharmacy for literally 290-330 rubles.

Dear women, remember, at the first sign of leakage, immediately contact your gynecologist in the LCD or in the maternity hospital. If the baby will be without water for a long time, it is dangerous for his health and even for the life of the baby.

How does the flow of amniotic fluid normally occur?

In most cases, the following sequence of events occurs:

at 38-42 weeks of gestation begins generic activity;
during one of the contractions, the amniotic sac breaks and the fluid pours out in one stream;
if there is no bladder rupture, then the obstetrician-gynecologist on the chair independently performs a puncture amniotic sac This process is called Amniotomy.

What threatens a woman and a fetus with leakage?

If the waters completely break in the second trimester, this can lead to infection of the fetus with an infection, which in this case will easily pass through all the protection.

As soon as the obstetrician-gynecologist determines that it is the amniotic fluid that is leaking from the pregnant woman, the woman will be sent for ultrasound diagnostics to determine the degree of maturity of the child in the womb. If the respiratory system and the kidneys of the fetus are ready to function outside the uterus, then labor will be stimulated. This is necessary to prevent the consequences of infection. If the baby is not yet ready for the birth, then a number of measures will be taken to prolong the pregnancy. The woman will be prescribed antibacterial drugs and means to stop labor, and they will begin to wait until the child reaches the threshold in development that will allow him to breathe on his own.

The worries that arise in pregnant women before childbirth are not in vain, because the birth of each child is individual and can occur in different ways, even if a woman already has children. The discharge of water is always a reliable indicator of the onset of labor. However, for some, they are poured out completely, and for someone gradually. How to determine that amniotic fluid is starting to drain, and what to do about it? Is it possible not to notice the outpouring of liquid? These are the main issues that are relevant for all pregnant women and especially for nulliparous women. They require detailed explanation.

Signs of breaking water

The fluid that surrounds the baby throughout pregnancy is called amniotic fluid, or amniotic fluid. When the fetus grows up and is completely ready for its birth, it presses hard on the walls of the bubble, and it bursts, and water pours out.

Depending on the size of the crack and the location of the rupture of the bubble, the liquid is poured out completely or gradually. In the first case, it will not be difficult to determine that the waters have departed, and in the second, difficulties usually arise. How to understand that the waters have broken? You can determine that the bubble has burst, and you can recognize the onset of labor by the following signs:

Basically, the water leaves at night, when the pregnant woman is sleeping. Women in labor note that they wake up from the feeling of a wet bed. Those who have a bladder tear during the day feel some pressure in the lower abdomen before pouring out the liquid. Many do not feel anything before the discharge of amniotic fluid. It is not uncommon for fluid to be poured into the toilet when urinating, when a woman strains a little. This situation is a reason to fear that the waters will depart imperceptibly.
A pregnant woman may feel cotton inside herself, and then abundant moisture, sometimes similar to urinary incontinence, which is a reliable sign of a rupture of the intrauterine bladder.
Experts say that at the beginning of the outpouring, the volume of amniotic fluid is equal to one glass (200-250 ml), but in practice the amount of outgoing water may differ.
When the rupture of the amniotic sac is formed from above, the waters leave gradually, which leads to oxygen starvation of the baby due to the slowly decreasing volume of amniotic fluid. This is very dangerous for the health of the child.

Passage of amniotic fluid before contractions

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When contractions begin, doctors do not recommend rushing to the hospital, because they can be training. It happens that preparatory contractions last for a month. However, if the nature of cramping pains is periodic and regular, we can assume that the birth process has begun.
With early discharge of amniotic fluid, professional monitoring of the condition of the mother and child is necessary. If, after the outflow of water, labor activity is poorly developed or does not exist at all, doctors will take appropriate measures for a successful delivery. Untimely seeking help can lead to complications and harm the life and health of not only the baby, but also his mother.

Timely outpouring of water
Although nature allots 40 obstetric weeks, the baby may appear earlier than this period. Most often, primiparous women give birth at 38 weeks, while the baby is considered full-term. It is in primiparous mothers that a feeling of anxiety arises, why the water does not pour out when the contractions have already begun.
There is no need to worry about this, because the outflow of intrauterine fluid during childbirth is considered timely, when contractions have a regular cycle, and the cervix has opened at least 4 cm. if he didn't break himself.
belated process
In some situations, the amniotic sac does not open on its own. The reason for this is:
excessive bubble density;
delayed pregnancy;
preeclampsia;
violation of labor activity;
Rh-conflict of the child and mother;
weak labor activity.

If the amniotic sac does not rupture naturally before or during childbirth, then there are indications for amniotomy - artificial piercing with medical instruments (more in the article:). This procedure is absolutely painless, and you should not be afraid of it. After opening the bladder, the amniotic fluid departs and labor activity becomes more intense.

What sensations does a woman in labor experience when amniotic fluid is discharged?
What sensations does a woman in labor experience when amniotic fluid is poured out? This question is mainly of interest to primiparous mothers. After childbirth, women compare the sensations that occur when the waters are completely poured out with a feeling of emptiness. When the bladder ruptures, the large and round abdomen suddenly becomes smaller. Contractions intensify after that. pain reach their peak.
If the rupture of the bubble is small and occurs before the onset of contractions, then the woman may not even feel that it has burst. She will feel only copious watery discharge, which is sometimes compared to spontaneous urination.
How much liquid should go?
For most pregnant women, it is important to know how much fluid should pass. With a normal pregnancy and a lower breakthrough of the fetal sac, the anterior part of the amniotic fluid is poured out immediately. Such an outpouring is compared by many with a sharp squelching and sometimes an intense stream, so it is difficult to miss it. New moms usually compare the amount of discharge with a bucket of water. It seems to them that there is a lot of liquid, but this is not so.
When the fetal bladder breaks, about 600-1000 ml of fluid is immediately poured out. The rest (about 200 ml) will go away little by little.
What color is amniotic fluid?
It is important for every woman who is preparing to become a mother to know in advance about the color of amniotic fluid during childbirth and what does it mean when it differs from the norm? If the waters have broken at home, mommy should definitely pay attention to their shade. This will make it possible for the woman herself and the specialists to decide what actions need to be taken for a subsequent successful delivery. The color of the liquid may look like this:
Transparent waters are an indicator of the norm. Their smell, while some compare with breast milk that after childbirth provokes the child to look for the mother's breast. A woman in labor can call an ambulance and calmly prepare for a trip to the hospital.
A cloudy yellowish color of the liquid is also considered normal if a woman feels well. Water may break while going to the toilet when urinating. In this case, the liquid will turn into yellow, which is not a cause for concern.
Water may have pink and red blotches. This is usually the result of mucus from the dilating cervix entering the amniotic fluid from the start of its discharge. With a natural color (yellow or colorless), you should not worry.
If amniotic fluid green color, this indicates the presence in the amniotic fluid of a large amount of meconium in the process of defecation of the baby or oligohydramnios. Both of these reasons can cause irreparable harm to the health of the child. With oligohydramnios, the baby experiences oxygen starvation, causing brain hypoxia, which sometimes leads to the death of the child. Ingestion of meconium by a baby also leads to negative consequences such as pneumonia and pulmonitis.
If the waters have broken and their color is brown, it is urgent to call an ambulance, describing your situation. How darker color, the greater the risk of death of the child.
The situation is no less dangerous if there is blood in the waters, especially with a bright red color. This is a sign of open bleeding. This situation threatens the life of not only the child, but also his mother. In this case, the woman needs urgent health care. While the team of doctors is traveling, you need to take a horizontal position and limit your movements.

How to act during the discharge of water?
Usually women prepare for childbirth in advance. They collect things in the maternity hospital according to the list issued by the doctor. For most, the package of necessary supplies is ready from the beginning of the 3rd trimester, so if contractions occur or the fetal sac breaks at home, the question of what to take to the hospital is not worth it. Each mother should understand that without amniotic fluid, the child will live for about 12 hours, therefore, when opening the fetal sac, mandatory hospitalization is necessary.
The actions of the mother in this case should be as follows:
calling an ambulance with a description of the situation;
if there is blood in the waters, it is imperative to lie down and not move;
if the color of the liquid is normal, the woman can rinse and change her underwear;
it is not recommended to wash away when the waters break, so as not to infect the child;
slowly collect the prepared things and wait for the ambulance;
keep calm.

Amniotic fluid or amniotic fluid is the first habitat of the unborn child. They are formed as a result of sweating of the liquid part of the blood of the blood vessels. Normally, the volume of amniotic fluid should be from 600 to 1500 ml, and changes up or down are considered a pathology that requires special examinations and treatment. We will consider what amniotic fluid looks like in normal and pathological conditions, and also characterize their main functions.

Functions, color and smell of amniotic fluid are normal

The main function of amniotic fluid is protective. So the amniotic fluid protects the baby from the negative effects of the outside world (poorly conducts noise and absorbs shocks). The content of immunoglobulins in the amniotic fluid protects the baby's body from infection. It is very important that this fluid prevents clamping of the umbilical cord and prevents the violation of blood flow in it. A sufficient volume of amniotic fluid provides the baby with complete freedom of movement. Until the 14th week of pregnancy, while the umbilical cord and placenta are not yet formed, the amniotic fluid plays a nutritional role, giving the baby the necessary nutrients for growth and development.

What color is amniotic fluid?

Normally transparent, it contains amino acids, fats, carbohydrates, vitamins and microelements (calcium, chlorine, sodium). It also contains lanugo (baby skin hair) and skin cells. Amniotic fluid is odorless, but some doctors believe that the smell of amniotic fluid is similar to mother's milk, which helps the baby find the mother's breast after birth.

What color is amniotic fluid in pathology?

By changing the amount, color and smell of amniotic fluid, one can judge the presence of a particular pathology. So, pink amniotic fluid can talk about placental abruption and staining of water with blood. This is a formidable complication of pregnancy, which requires the immediate provision of qualified assistance. Yellow or green amniotic fluid may indicate intrauterine hypoxia of the fetus or the presence of an infection (, intrauterine pneumonia). Brown or black amniotic fluid indicates a critical condition of the baby. In such cases, emergency operative delivery is necessary.

We examined what amniotic fluid looks like in normal and pathological conditions. To prevent the development of pathological conditions, it is necessary to follow the prescriptions of your doctor and undergo all recommended studies.

Pregnancy is a joyful and exciting period for future parents, which is associated with many experiences and anxieties. The health of the baby directly depends on the conditions of its existence in the mother's womb. There it is surrounded by amniotic fluid, which is called amniotic fluid. They play an important role in the development of the unborn baby, their complete discharge occurs during full-term pregnancy during childbirth. Leakage of amniotic fluid ahead of time is considered a pathology and requires medical attention.

Causes

Each stage of pregnancy has its own causes of pathology.

Up to 24 weeks, the provoking factors are:

infection of the fetus;
development of the inflammatory process.

Even a slight leakage of amniotic fluid before 25 weeks is considered the beginning of a miscarriage.

From 25 to 35 weeks, pathology is also dangerous. The most common cause of leakage during this period is urogenital infections (inflammation of the urinary tract).

At 39-40 weeks, the situation is not dangerous and doctors often choose expectant tactics and find safe way delivery.

The main causes of water leakage include:

Injuries, falls.
Careless (rough) sexual intercourse.
Bad habits of the mother.
Diabetes.
Hormonal disbalance.
Multiple pregnancy. Due to the excessive load on the body of a woman carrying 2 or more babies, the risk increases premature birth. With such a pregnancy, "steal syndrome" can occur.
Rhesus conflict. If the blood type of the mother and child is incompatible, then the body of the pregnant woman is "cleansed", resulting in an outpouring.
Inflammatory processes and infections in the cervix, vagina, fetal bladder.
Pathologies of the cervix, anomalies of its structure, manipulations, diagnostic procedures (punctures and sampling of cells for analysis), fibroids. These reasons provoke the rupture of the fetal bladder.

Symptoms

The physiology of a woman is arranged in such a way that the amniotic waters are constantly updated and in the 3rd trimester of pregnancy, the discharge is more abundant, which is the norm. It is quite difficult to independently determine whether they are flowing and within the power of a specialized specialist leading a pregnancy. However, it is important for expectant mothers to be able to recognize the onset of premature discharge of fluid.

What should be of concern:

The gasket gets wet quickly, you have to change it often (a lot of water flows out).
After lying on your back for a long time (30-60 minutes), a wet spot forms on the fabric.
When changing the position of the body, an outpouring of fluid (leakage) is felt.
Water can move away during urination, incontinence.
Sticky discharge smells fetid, unpleasant.
If there is a significant rupture of the amniotic sac, fluid flows down the legs. Even by strongly squeezing the intimate muscles, abundant discharge cannot be stopped.
With ruptures lasting more than a day, a woman has a temperature increase of up to 38 degrees, chills, pain in the lower abdomen, which are aggravated by palpation. In the discharge, an admixture of pus, ichor may appear.

What they look like: external signs of discharge

To distinguish the leakage of amniotic fluid from urine, it is advisable to pay attention to their appearance.

Amniotic fluid is characterized by shades:

Yellow color. There is no need to worry though, this is acceptable.
Yellow with red veins. In 98%, this is a consequence of the fact that the uterus began to open, and the body is preparing for the birth process.
Green. In this case, you need to sound the alarm. This color of the amniotic fluid is typical for intrauterine defecation or a small amount of amniotic fluid. In this case, the baby suffers from intrauterine starvation.
A woman who notices such signs in herself should immediately consult a doctor in order to save the life and health of the child.
Brown. Here we are talking about the intrauterine death of the baby and saving the life of a woman. Such cases are rare.
Red. scarlet or pink color speaks of a serious danger to the life of the baby and mother. Caught in similar situation it is necessary to take a prone position, do not move until the ambulance arrives.

It is important to evaluate the smell of amniotic fluid. If it is fetid, sour, unpleasant, this indicates the presence of infection of the membranes.

The watery consistency of the discharge indicates various diseases or pathologies. Therefore, pregnant women who have such discharge should immediately consult a gynecologist for diagnosis.

How to determine

Only a doctor will reliably determine the likelihood of amniotic fluid discharge. For this, a set of diagnostic measures is carried out:

Examination on a gynecological chair. A pregnant woman should cough, thereby increasing pressure on the intra-abdominal zone, which determines the pathology. If there is a rupture, a new portion of amniotic fluid will be thrown out.
Study in mirrors. In most cases, when examining the mucous membrane of the vagina and cervix, the gynecologist manages to understand whether this is an outpouring or just a discharge.
Uzifetus. The method can indicate the symptoms of oligohydramnios, but it is not always provoked by prolonged leakage of water. Many women after passing the ultrasound are interested in if the pharynx is closed, whether water can flow. The answer is yes, they can, because we are talking about the integrity of the bladder, while the neck is in any state.

Analyzes

Laboratory studies include:

Vaginal swab. Microscopy shows a characteristic symptom of leakage: placed on a glass slide, the amniotic fluid dries up in the form of fern leaves. However, if there is sperm in the smear, the pattern will be the same.
cytological method- taking a smear from the posterior fornix of the vagina, protrudes simple method diagnostics. As a result, cells of the skin, urinary and genital organs of the child are found, which reliably indicates the leakage of water.

Test

Pregnant women at home apply methods of what to do before a visit to the doctor and how to understand whether water is leaking or not. Tests that are sold freely available will help to find out and determine the pathology.

The tools are accompanied by instructions on how to use and what the result will show:

At home

To quickly determine the presence of pathology will allow a test carried out at home.

Pregnant woman empty completely bladder, then perform thorough hygiene procedures of the genital organs, wipe the perineal area until it feels dry. Lie on the bed with a piece of cloth, preferably white, under you, check for wet spots after 25-30 minutes. If they are present, then it is likely that the amniotic fluid is leaking.

Management of pregnant women with leakage

After a gynecologist detects a prenatal leakage of amniotic fluid in a pregnant woman, an appropriate management tactic is established. In many ways, it depends on the gestation period.

In the 1st trimester

The term is considered early: from the first day of the final menstruation to the 13th week. If at this time profuse bleeding occurs, then doctors prescribe a medical or surgical termination of pregnancy.

When there is an opportunity to fight for healthy life baby, bear fruit, future mother are placed in the hospital “for preservation”, which increases the likelihood of a positive outcome.

In civilized countries, this is done extremely rarely, since pregnancy up to 12 weeks is considered to be untenable.

In the 2nd trimester

From the 14th to the 27th week, everything is much more complicated: if the waters have broken, doctors equate this with the onset of a miscarriage. In the second trimester, the gynecologist makes a decision, based on the individual case of the patient, to maintain and carry out treatment against the background of regular monitoring of the condition of the fetus and the pregnant woman, or to stimulate a miscarriage followed by curettage. Women with multiple pregnancy a pessary is installed, an obstetric ring that allows you to save the baby and avoid premature birth.

In the 3rd trimester

From the 28th week immediately before the birth of a child, doctors use expectant and active tactics. In the third trimester, doctors resort to techniques to prevent leakage of amniotic fluid, which helps to grow the baby in utero. The patient is in a special sterile unit, taking a number of drugs, it is important to prevent infection. With detachment, inflammation, delivery can be immediate. Antibacterial therapy is used after the diagnosis of chorioamnionitis.

In all cases, the gynecologist makes a decision using individual approach to every pregnant woman to save her life and health.

What threatens: consequences

Amniotic fluid fills the fetal bladder, creating a comfortable and safe environment for the development of the baby throughout pregnancy. Thanks to this, the fetus can move freely and actively, without sudden shocks. An additional function of the fetal bladder is the assistance provided to the cervix during childbirth, when internal pressure increases due to contractions. As a result, the amniotic fluid in the lower part of the bladder presses on the cervix, accelerating its opening.

What threatens water leakage:

Prolapseamniotic sac. The diagnosis is difficult and requires medical attention. Isthmic-cervical insufficiency, when the bladder prolapses, creates a high risk of abortion.
Premature rupture- 4% increase in child mortality.
Infection and respiratory distress syndrome. The lungs of a child stick together from the inside, not allowing air to circulate. Such children need expensive treatment and artificial ventilation.
Infectious complications in mother and child. However, it is not always possible to save a child's life.

How long can a baby be without amniotic fluid

It is believed that 10-12 hours is the maximum allowable period, which can be an anhydrous period before childbirth.

In such cases, antibiotics are considered to avoid the development of intrauterine infection, while the woman should drink more fluids. If there are problems with the pressure of the mother and the heartbeat of the child, emergency delivery is indicated.

What does amniotic fluid look like, how does it differ from vaginal discharge, and can it be confused with urine leakage? Amniotic fluid is required condition for the full development of the child. In it, he is inside the womb until the onset of childbirth (this is normal). It protects the fetus from any possible injury due to bruising of the mother's abdomen. A holistic fetal bladder, which is filled with amniotic fluid, is a guarantee that an infection from the vagina will not penetrate into the child. That is why it is so important to notice the rupture of the fetal bladder in time, and even better - to do everything to prevent it.

How can you protect yourself from premature discharge of amniotic fluid? It is advisable to think about this long before pregnancy. Sexually transmitted infections are one of the main causes of intrauterine death of a child, which occurred, among other things, due to water leakage. That is, a woman does not need to lead a promiscuous sexual life. And pregnancy should be planned, after being checked for various infections and, if necessary, treating them.

Another common cause of this pathology is isthmic-cervical insufficiency, as a result of which the cervix begins to shorten and open much earlier than the onset of childbirth. As a result, the child sinks lower, the bladder bursts under pressure. And the most common cause of isthmic-cervical insufficiency are abortions. So, their prevention, reliable contraception is another preventive measure, which will help prevent premature rupture of the fetal bladder during pregnancy.

Ultrasound specialists also monitor the amniotic fluid. It is mandatory to determine its quantity. Polyhydramnios and oligohydramnios are common pathologies. Some experts still determine the composition of amniotic fluid, in conclusion they reflect it with the word "suspension". Many Russian experts consider them a marker of chromosomal pathology or intrauterine infection. In fact, suspensions are vellus hair of the fetus, epidermis, etc. And with the gestation period, suspensions usually become more normal. Especially if the pregnancy is delayed.

Very important information- what color is the amniotic fluid, but you can find out only after the rupture of the fetal bladder. If the child feels well, there are no obvious pathologies - the amniotic fluid does not have an unpleasant odor, it is generally odorless and colorless. The color of the amniotic fluid is slightly whitish - this is also a variant of the norm. Since they may contain white flakes in a small amount. In some cases, the coloring of the amniotic fluid is a signal for an emergency ultrasound and, possibly, even an unscheduled one. caesarean section. This is if green amniotic fluid is excreted in a pregnant woman. This is one of the clear signs of oxygen deficiency in the fetus. They are green because in a child with an intrauterine lack of oxygen, the original cal - meconium is spontaneously released, which stains the amniotic fluid. What green amniotic fluid can have consequences for the baby? If there is acute hypoxia, then these are likely to be neurological disorders. Much will depend on the amount of time during which the child did not have enough oxygen, as well as on the extent to which resuscitation was carried out in the hospital.

It remains to deal with the external difference between amniotic fluid and vaginal discharge (which normally becomes more during pregnancy) and urine. In fact, with a slight tear of the bladder, when the water comes out literally as droplets from the vagina, they are almost invisible. Therefore, all expectant mothers who notice a wet daily and sanitary pad or underwear should seek medical advice. A simple examination on the chair and an amniotic test for the composition of the secretions will help to say for sure whether there is amniotic fluid there.