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 effusion 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 amniotic fluid or selection.

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 appearance 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 before the onset of pregnancy or on early dates.
• 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 ultrasound.
• 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.

V ideal outpouring must be precisely timely. 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 violations, 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 passes laboratory research 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.

The nature of vaginal discharge during pregnancy changes repeatedly. Under the influence of hormones and other factors, they become either transparent, or whitish, or liquid, or thick, and sometimes even normally they can be beige or brown. Of course, the expectant mother has to be a little nervous while she makes sure that this is how it should be.

But it is not without reason that doctors urge to contact them with the appearance of the slightest disturbing or incomprehensible signs. Because very often vaginal discharge during pregnancy is evidence of pathological processes that require urgent medical intervention.

Gynecologists classify such conditions as amniotic fluid leakage. If you notice that your underwear is systematically getting wet and moist from vaginal discharge, then you should definitely make sure that it does not leak water.

Normally, the outflow of amniotic fluid accompanies the onset of the birth process. At the moment of the strongest contraction, the cervix opens, and the fetal bladder bursts, after which the water immediately leaves. Sometimes this happens even before the contractions begin, and then the pregnant woman should go to the hospital immediately, without waiting for the contractions to begin.

However, it often also happens that the water begins to leak in small portions long before the due date. First of all, this suggests that the integrity of the fetal bladder is broken, which means that the sterility inside it is now under threat. The closer to childbirth this happens, the more favorable the medical prognosis will be.

Leakage of amniotic fluid threatens the development intrauterine infections able to get to the baby through the cracks formed in the bubble. If you do not notice or miss the leakage of water in time, then on later dates childbirth can begin prematurely, and in the early stages, an abortion will occur or the fetus will die in utero. In addition, the risk of poor birth detail in the event of childbirth, as well as the occurrence of infectious complications in the mother, increases.

That is why it is very important to be able to recognize a leak as early as possible. And we must admit that this is not easy to do ...

How to identify water leakage during pregnancy

amniotic fluid, as a rule, does not have either a characteristic color or a specific smell by which it could be unmistakably recognized. It is completely transparent, although, nevertheless, it can have a yellowish tint, which confuses expectant mothers even more (and green in case of pathologies), and contain flakes of original lubricant.

The greatest difficulty is that the leakage occurs in small portions, and it can be very difficult for women to distinguish: this is urinary incontinence, vaginal discharge or amniotic fluid - what does water leakage look like?

There are few signs of amniotic fluid leakage. This is mainly sensation of moisture in the perineum: a woman notices that from time to time a certain amount of fluid flows out of the vagina, because of which the underwear becomes wet all the time, it has to be changed frequently and daily pads are used. Discharge during leakage occurs or increases with tension of the vaginal muscles: after sneezing or coughing, prolonged laughter, when a woman stands up or picks up something heavy.

But such symptoms do not always mean that water is guaranteed to leak. Similar signs are also characteristic of urinary incontinence, which often occurs in late pregnancy. It may also be normal vaginal discharge. Therefore, without additional research, it is impossible to accurately determine whether water is leaking.

Amniotic fluid leak test

If there is a suspicion of leakage of amniotic fluid, then the simplest and most affordable thing that a pregnant woman can do in such a situation is to buy and spend at home a special leak test. It contains a pad impregnated with a reagent that reacts only to substances with a high pH, ​​like amniotic fluid. If the color of the pad changes while wearing it, you should immediately consult a doctor. detailed instructions how to conduct a leak test at home is included in each amnitest package.

Analysis for amniotic fluid leakage

A more reliable result can be obtained by passing amniotic fluid leak test. To do this, you need to visit a gynecologist, and he will take a swab from the vagina. If cells contained in the amniotic fluid are found in the smear, then leakage will be confirmed.

Will ultrasound show amniotic fluid leakage?

In fear of the worst and possible consequences, pregnant women are ready to undergo any examinations to make sure that everything is in order. In this regard, many women are interested in whether they see leakage of amniotic fluid on ultrasound.

The fact that the wall of the fetal bladder, through which the amniotic fluid is released, is not intact, is not visible on ultrasound. However, the specialist, of course, diagnoses oligohydramnios, one of the reasons for which may be prolonged leakage of water. Dynamic ultrasound can confirm amniotic fluid leakage if it decreases.

How long can amniotic fluid leak?

Most often, pregnant women begin to suspect leakage in the later stages, especially when there is less and less left before the expected date of birth.

During this period, the risks of loss of integrity by the fetal bladder increase, and the woman herself becomes more and more suspicious and worries about every occasion and even without. However, trouble can happen at an earlier date.

Water leakage in early pregnancy

This happens infrequently, and even more rarely can it be detected. This means that not even every experienced doctor is able to diagnose leakage of amniotic fluid in the early stages of pregnancy or even suspect it. After all, the amount of amniotic fluid during this period is still insignificant, and vaginal discharge, as a rule, is abundant, watery and transparent. Leaking in scanty portions, the waters mix with whites and thus “hide”. Difficulties in diagnosis often lead to the fact that for this reason the pregnancy is terminated in the early stages.

In most cases, water begins to leak late in pregnancy. This significantly increases the chances of its preservation. But you still need to understand that it is impossible to stop the process somehow. If there is not much left before the expected date of birth, and the child is already ready to be born without serious consequences for his health, then the doctors will most likely decide on the birth on an emergency basis: they will perform stimulation or a caesarean section. Otherwise, the mother will be admitted to the hospital for preservation and prescribed therapy that will reduce the risks of intrauterine infection of the child and help to safely wait for the period when the lungs and other vital organs of the baby mature in order to carry out early delivery.

Leakage of water during pregnancy: causes

From the very beginning of its development future baby securely protected from possible negative impacts outside world. One form of this protection is a sealed amniotic sac filled with sterile amniotic fluid. Here, in a small cozy dwelling of the crumbs, the necessary conditions for its favorable development are preserved and maintained.

As the baby grows, the amount of amniotic fluid increases, providing, among other things, the nutrition necessary for the baby and the environment for comfortable movement. And if the water began to leak, then this only means one thing: the integrity of the fetal bladder is broken, which, of course, should not be normal. But there may be several reasons leading to thinning of the bubble walls, ruptures and microcracks:

• bad habits during pregnancy;
• infectious diseases, including genitourinary infections suffered by the expectant mother, inflammatory processes in the vagina or uterus (most often, leakage occurs due to colpitis, endocervicitis);
• some chronic diseases of a pregnant woman;
• isthmic-cervical insufficiency (when the cervix is ​​not able to hold the fetus inside the uterus properly);
• carrying multiple pregnancies;
• polyhydramnios;
• trauma during pregnancy;
• neoplasms on the uterus;
• pathology of the structure of the uterus or pelvic bones (most often a narrow pelvis during pregnancy);
• rupture of the amniotic sac prior to leakage (eg, after amniocentesis, cordocentesis, or chorionic villus sampling).

Whatever the reason for the trouble, it is always necessary to act in the same way. If amniotic fluid began to leak, then without medical supervision there is practically no chance that the pregnancy will end safely. Be sure to tell the doctor if something confuses or worries you: competent medical support will help the baby be born without any risks.

If there was a premature rupture of amniotic fluid, then you need to urgently go to the hospital!

Especially for - Larisa Nezabudkina

Good day, my dear future moms! Do you know what complication of pregnancy any of you should be warned about? It provokes every fifth premature birth. It is the cause of every fifth intrauterine death of a child. Even a doctor may not recognize it in time. And at the same time, it is easy to identify it at home - you just need to know what to do. Leakage of amniotic fluid, how to determine this formidable condition, what is it in general, and what are its signs? Calm down, now we will arm ourselves with the necessary knowledge!

I think any expectant mother has a rough idea of ​​what amniotic fluid is. But I will repeat myself a little in order to systematize the information. A child lives in the uterine cavity before birth for 9 months. There he is surrounded by his own protective shell - the fetal bladder. It is something like an egg shell, only soft. The fetal bladder is completely sealed and reliably protects the baby from premature contact with the outside world.

Especially from a meeting with pathogenic bacteria, for which the child is still completely unprepared. Normally, this barrier is not violated until the very birth.

The fetal bladder will burst with the onset of attempts. And some children manage to be born in it - that's where the expression "was born in a shirt" came from.

The cavity of the fetal bladder is filled with liquid in which the baby floats like an astronaut in weightlessness. It is secreted by the amnion, the inner layer of the membranes. Therefore, another name for amniotic fluid is amniotic fluid.

It has several important functions:

• She straightens the uterus so that the baby can move freely.
• Absorbs shocks and shocks.
• Stabilizes the temperature around the baby.
• Participates in the nutrition of the fetus.
• Does not allow the umbilical cord to pinch during childbirth.

And in the first stage of labor, the fetal bladder filled with amniotic fluid, like a wedge, opens the cervix from the inside ...

What amniotic fluid looks like

The type and amount of amniotic fluid changes during pregnancy. At first they are yellowish, then brighten, and in the third trimester, at 38, 39, 40 weeks, they become whitish and opalescent.

It is clear that only obstetrician-gynecologists can appreciate these beauties. By the nature of the amniotic fluid during childbirth, they sometimes judge, for example, the approximate duration of pregnancy. A woman is unlikely to be able to collect and examine the amniotic fluid.

You just need to remember that amniotic fluid:

• Light
• Liquid
• Warm
• Without smell
• They can pour out in any amount.

Amount of amniotic fluid

The amount of amniotic fluid during pregnancy increases with the growth of the fetus. The maximum they can collect is 1.5-2 liters. Anything more is already considered a pathology.

But it is not necessary that all this amount will pour out at once. Imagine balloon filled with water. If you poke a tiny hole in it, water will ooze drop by drop. A similar situation is possible during pregnancy. A woman may misunderstand this condition. And this is fraught with disaster.

How long can water leak? On any. Why this happens is not exactly known. Provoke early rupture of amniotic fluid:

• infection,
• narrow pelvis in a woman
• polyhydramnios,
• multiple pregnancy,
• abnormal presentation of the fetus,
• bad habits and serious illnesses in the mother,
• injury.

As a result, large or small gaps occur in the shells, which should reliably protect the child. This situation requires the immediate intervention of doctors. But the problem is that diagnosing such conditions is sometimes difficult.

How to identify amniotic fluid leakage

We have reached the main question: how to determine the leakage of amniotic fluid. This problem worries not only pregnant women, but also obstetricians and gynecologists. After all, if there was a "depressurization" of the membranes, then an infection can penetrate the child. And the gap can also increase, and then there will be a premature outflow of amniotic fluid - and premature birth ...

Signs of a leak

It may seem that the symptoms of such a "leak" are obvious. When some kind of foreign liquid flows out, it is difficult not to notice it. But a woman, when she feels water leaking, may confuse this with two conditions:

• Urinary incontinence.
• Inflammatory secretions.

Wet underwear, stains on pads, heavy liquid discharge - how to understand that this is amniotic fluid?

It is best if you trust your doctor. But if it’s far away or a long wait, there is an easy way to check yourself. To do this, take three simple steps:

1. Go to the toilet and get rid of excess fluid.
2. Rinse and dry off.
3. Lie naked on a light dry sheet and lie down for 15-20 minutes.

Are there damp spots on the sheets? In this case, you can suspect a "leak". Urgently to the gynecologist!

If by this method it was possible to detect a problem - this is good (in terms of the fact that now you will not waste precious time and ask for help in time)! But how often does it happen that the liquid oozes drops. How to distinguish drip leakage from secretions?

Previously, only gynecologists could answer this question. Now you can find out everything at home. How can a doctor determine that it is amniotic fluid that is leaking, and not urine or vaginal secretions? It has several ways:

• Examination: the doctor may simply see clear moisture when viewed in the mirrors.
• Smear: when dried, the amniotic fluid forms a pattern on a glass slide that resembles frosty patterns - a “fern leaf”.
• Ultrasound : ultrasound can be used to judge the level of amniotic fluid, the condition of the fetus and membranes.
• The nitrazine test is the determination of the pH of secretions. When water leaks, the pH changes from acidic to neutral.
• Amniocentesis: A safe dye is injected into the uterine cavity through a puncture in the abdomen. If after that there is a staining of the tampon in the vagina, it means that there is a water leak. This method is used only in particularly difficult cases.
• immunological tests.

Outflow Tests

Immunological tests react to specific substances that are found only in amniotic fluid. There are two types of tests:

1. For the definition of PSIFR-1
2. For the determination of PAMG-1.

Both of these tests detect specific proteins. I will not decipher their names - you will forget them immediately anyway. The following is important for you and me: the accuracy of tests for PAMG is 1 - 98.8%. On PSIFR-1 - four times lower.

The test for PAMG-1 Amnishur is recognized as the gold standard. Its accuracy is almost 99%, it allows you to determine even traces of amniotic fluid.

In addition, there are tests for home use that are based on pH determination. For example, the famous Frautest amnio pads. They are much cheaper than enzyme immunoassays. But give 17% false negative results and 13% false positive. Whether or not to use them is up to you. In any case, when purchasing diagnostic test strips or pads, take an interest in the mechanism of their action and the accuracy of the results.

Premature rupture of amniotic fluid

Strictly speaking, everything that we have discussed, including the dripping of water, is considered to be their premature outflow. However, in everyday life, this is more often called a massive outpouring of water before the onset of attempts.

In this case, the symptoms are obvious. You suddenly find yourself wet, a warm clear liquid flows down your legs, which you cannot hold. Her pressure increases with coughing, straining, contractions.

I understand that the situation is exciting. But for doctors, remember two things:

• discharge color,
• their number (what size spot or puddle did you see?)

And without delay - to the hospital! It is highly desirable that your baby be born within the next 6 hours.

For those who still do not believe that you need to go to the hospital right away, or delay it from fear of childbirth, I will list the complications that threaten you and your baby:

• Infections, sepsis.
• Lack of oxygen in a child.
• Placental abruption and severe bleeding.
• Anomalies of labor activity.
• Intracranial hemorrhage in a child
• Deformation of the arms and legs of the fetus.

I hope everything is clear. In each case, if water leakage is detected, obstetrician-gynecologists have to solve a difficult question: “to give birth or not to give birth?” Or rather, give birth now or let the baby grow up, despite the depressurization of the fetal bladder.

If the child is full-term, then the issue, as a rule, is resolved in the direction of childbirth. The main thing is to seek medical help in time, and not wind yourself up with doubts at home!

May this problem not touch you, my dear! But still. If you are going on a long trip in the third trimester, take the Amnishur test with you. To be fully armed in case of emergency. After all, now you know how to determine the leakage of amniotic fluid! And if there are pregnant girlfriends in your environment, share the article with them, maybe it will be useful for them too.

See you soon, Anastasia Smolinets

And the leakage of amniotic fluid long before the expected date of birth is a dangerous complication of pregnancy, which is not always easy to identify. Therefore, in this case, special diagnostic methods are often required.

From the moment of fertilization of the egg to the birth of a new person, 9 months pass. During this time, the organs and systems of the unborn child are formed, their growth and development, as well as maturation and preparation for birth. During this period, the baby needs help and protection. Nature took care of it. The maternal organism supplies it with everything necessary, the fetoplacental complex protects against various infectious agents. The fetus itself is surrounded by amniotic membranes, or the fetal bladder, which is also a barrier to the penetration of infections, and in the first stage of labor helps to open the cervix.

Damage to the fetal bladder

One of the membranes of the fetal bladder (amnion) produces amniotic fluid, or amniotic fluid. The amount of amniotic fluid increases during pregnancy. Replenishment occurs due to the fluid that sweats from the blood vessels of the mother, as well as the urine of the fetus. In this environment, the baby spends the entire period prenatal development.

The most dangerous condition is when, when the fetal bladder is damaged, there is no pronounced (massive) separation of amniotic fluid, but there is only a slight leakage. Amniotic fluid is secreted little by little, literally drop by drop, and mixes with the secret of the vagina. The amniotic fluid itself is transparent (sometimes cloudy), colorless, and odorless. A pregnant woman may not even notice this, especially if, against the background of the inflammatory process, the discharge is already abundant. But a slight leakage of amniotic fluid does not reduce the risk of complications, but, on the contrary, increases the danger. This is due to the fact that a sufficient amount of time can pass from the moment of violation of the integrity of the membranes to the detection of this pathology.

How to be in such a case? How do you know if your baby's protection has been violated?

Types of diagnostics

As always during pregnancy, if any warning symptoms appear, you should contact the observing gynecologist. And as soon as possible. Especially if there are discharges from the genital tract, the amount or nature of the already existing discharges has changed. But, unfortunately, the doctor can not always notice that the rupture of the fetal bladder has occurred.

And here laboratory tests come to the aid of the obstetrician-gynecologist and the expectant mother. There are methods that allow you to diagnose damage to the membranes, accompanied by leakage of amniotic fluid. The purpose of these studies is to detect in the test material the elements that make up the amniotic fluid.

Sometimes a cytological examination of vaginal discharge is performed. The material is taken from the posterior fornix of the vagina and applied to a glass slide. In the laboratory, it is stained with special method and assessed under a microscope. As a result of the analysis, cells of various colors are sometimes found, these may be torn cells of the skin, urinary and genital organs of the fetus. These signs reliably indicate damage to the fetal bladder.

Another way to determine amniotic fluid in vaginal discharge is to determine the fern symptom, or the phenomenon of arborization. In this case, doctors tell the patient that a swab is taken to arborize the mucus. The fern phenomenon is based on the ability of cervical mucus to form crystals when dried. The reason for crystallization is a change in the physicochemical properties of mucus under the action of hormones contained in the amniotic fluid. The discharge from the vagina is applied to a glass slide and dried, crystallization is assessed under microscopy under low magnification. When amniotic fluid leaks on the glass, a pattern is visible that looks like fern leaves.

However, at present, the test (amnitest) is increasingly being used, which does not require special laboratory conditions. It is carried out in obstetric institutions, directly during the examination of the patient. The principle of the study is to detect a substance that is normally practically absent in the contents of the vaginal secretion, but a lot in the amniotic fluid - placental alpha-1-microglobulin. A special tampon is inserted into the vagina, which absorbs the secretions. Then the tampon is lowered into a test tube with a substance that removes the discharge from the tampon into a solution. After that, a test strip is lowered into the test tube. If a control band appears, it means that placental alpha-1-microglobulin is present in the test material. This is evidence of a violation of the integrity of the membranes.

When a rupture of the fetal bladder is detected future mother must be hospitalized. Depending on the period of pregnancy in which the membranes were broken, on a number of other factors, doctors determine the tactics - they decide whether to carry out treatment aimed at continuing the pregnancy or initiate labor.

Ella Domnina, general practitioner,
laboratory consultant, Moscow

Discussion

Thanks Ella! Very interesting article, you don't often see such an informative and useful information. I am not just interested in this topic, I myself had to endure premature leakage of amniotic fluid, it was not without complications, my child was treated for a month after giving birth. I also met interesting articles on the Internet on the problem of water leakage, here is a link to one of them. - [link-1], this is a study of the largest center of obstetrics and gynecology named after. Kulakov.

Everything is very true, one of the few articles in Runet that gives a complete picture of the problem, an important and insidious problem. Thank you Ella. Personally, I learned a lot for myself from this site, which completely and completely reveals the problem of premature leakage of water and rupture of shells. Here it is - [link-1] But here I also found a solution to my problem - a wonderful test, which, moreover, was approved by my attending physician. It is rightly called accurate and convenient - it can be carried out at home itself. In addition, he also helped prevent complications for me and the baby.

27.04.2011 23:01:40, Inna2011

Comment on the article "Leaking amniotic fluid"

More on the topic "Leaking amniotic fluid: causes, symptoms, diagnosis":

Girls, tell me, maybe you know. My friend is 18 weeks. Transparent liquid began to leak. Let's go to the doctor. The kind, type all can be. They insisted on an ultrasound. There is a softening of the neck, and an opening of 5 mm. Urgently to the hospital. I understand that they put a system with magnesia, pokapali. They said to lie down, they say tomorrow morning, they will look for a couple of days, if it doesn’t get better, then clean it. It seems to me that this is not correct. What to do? Can anyone come across?

Are the waters leaking? What is amniotic fluid leakage and what does it threaten? 13. Is it possible to determine the leakage of water using litmus paper?

Leakage of amniotic fluid. It is difficult to determine on your own whether amniotic fluid is leaking or not. Kaleidoscope. Poster. In the first and second births, the waters receded quickly and ...

Leakage of amniotic fluid. Water from 1.5 diters and sometimes more. There are usually no painful sensations, just warm water flows out. If she gets wet all the time, then it's leaking ...

It is difficult to determine on your own whether amniotic fluid is leaking or not. Leakage of amniotic fluid. This is both a physiological increase in vaginal secretion, and slight urinary incontinence. If these discharges are prenatal discharge of water, then water will not be given ...

About the leakage of water .... 1. During the examination, the doctor somehow determines whether there is leakage or not, or thanks, after tomorrow to the maternity hospital for an examination, I will ask you to do this analysis Leakage of amniotic fluid. The first symptom is leakage when lying down, but...

Leakage of amniotic fluid. the first sign is leakage in the supine position, but it is water, and not mucous discharge. For a period after 20-22 weeks, they may leak ...

Water leakage. Good evening! Today I noticed that my discharge is more abundant and watery. I read on the Internet about the leakage of amniotic fluid and now I am horrified.

I have a pregnancy of 20 weeks, it seems to me that I have leakage of water, the doctor saw the doctor, he says it is difficult to determine. All the same, how can this be determined and what it threatens.

Leakage of amniotic fluid. Conference "Pregnancy and childbirth" "Pregnancy and childbirth". Section: Medical issues (water leaked from the vagina somewhere about a liter, test After ...

instead of analysis? Amniotic fluid leakage test. Leakage of amniotic fluid. But I personally had strong discharge in the later stages, I bought and did an amnio test. Leakage of amniotic fluid. Determine if it's leaking...

water leakage? Medical questions. Pregnancy and childbirth. I opened - a kit for determining the leakage of amniotic fluid, the price is 1500 rubles. tel - 749-59-98 and 971-16-72, and also ...

Section: (Analysis for leakage of amniotic fluid). Violation of the integrity of the fetal bladder and leakage of amniotic fluid long before the expected date of birth is a dangerous complication of pregnancy, which is not always easy to identify.

Water leakage. Personal impressions. Pregnancy and childbirth. Leakage of amniotic fluid. Childbirth signs. Pregnancy at 37-40 weeks is full-term and labor can begin at any time.

How to recognize "leakage of water"?. Personal impressions. Pregnancy and childbirth. water leaks are no big deal. It happens two weeks before the birth. Only they don’t let me go home right away, because the analysis is done for 1 three days. This is what I saw in the hospital.

For two weeks now I have felt the wetness of the laundry. And last night specifically, for example, I felt these moments, just changed clothes, again a transparent spot of 10 centimeters. Could it be water? Or could it just be highlights? It seems not a cork, because just a liquid. Sometimes there is mucus, but it seems to be thin for a cork and without any blood. I had a bladder pierced twice during childbirth, I always had dry underwear during pregnancies before that.

water leaking? Medical questions. Pregnancy and childbirth. Leakage of amniotic fluid during pregnancy. Print version. 4.1 5 (173 ratings) Rate the article.

Girls, tell me, please, what are the signs of amniotic fluid leakage, and at what stages of pregnancy can it appear?

One question for those who gave birth. Is it possible to confuse the leakage of water with abundant secretions? Or does it look different. And another question: does the baby move less before giving birth? Is it quiet? Or vice versa is actively pushing? Those who gave birth say: not a single woman has missed her birth yet. :-)

Leakage of amniotic fluid. Medical questions. Pregnancy and childbirth. Pregnancy and childbirth: conception, tests, ultrasound, toxicosis, childbirth, caesarean section, giving. Leakage of amniotic fluid. Girls, please share information about leaking and...

For normal intrauterine development, a baby needs a harmonious environment that will provide him with warmth, nutrients and protect him from negative external influences (infections, temperature changes, physical impact, loud sounds, etc.).

All these functions are performed by the amniotic fluid. But quite often pregnant women are faced with its leakage. How to identify pathology in a timely manner and why it is dangerous, you will learn in this article.

What is amniotic fluid

OV is a liquid that is located inside a sealed bladder (fetal membranes) and serves as the first habitat and life activity for the future baby. The composition of this substance includes everything that the fetus needs for nutrition and growth.

How to distinguish and determine your own leakage of amniotic fluid from discharge: symptoms and signs

It can be difficult to independently determine the leakage of OM and this is due to the fact that the liquid is easily confused with natural secretions or urine leakage, in addition, the volume of secretions can be very scarce.

Smell

Some women note that the aroma of OB is a little sweetish, while being very light, but there is no clear specific smell, so it is very difficult to detect leakage solely on this basis.

What does it look like

In terms of consistency and viscosity, OBs really resemble water.

Color

Normally, OBs have no color. By the end of pregnancy, a slight turbidity of the liquid is allowed due to the accumulation of various impurities in it that form during the development of the baby (epithelial scales, fluffy hair, sebaceous gland secretions, etc.).

Sometimes there is a greenish, brown, red tint - all this is an alarming sign, because. may indicate violations of the physiological state of the baby.

Quantity

The amount of OB increases as the baby grows. But by the prenatal period is gradually reduced. On average, the number of OVs at various times has approximately the following picture:

• 10 weeks 30 ml;
• 20 weeks 400 ml;
• 35 weeks 1200 ml;
• 40-41 weeks 700 ml.

Water can leak drop by drop, or it can gush in a stream. If, after a sharp change in body position, a woman notes an increase in secretions, then this should alert the expectant mother.

Causes of leakage of amniotic fluid at different times

The main cause of leakage is a violation of the integrity of the fetal membrane. There are several factors that can lead to this condition:

1. Urogenital infection. Under its influence, many pathological changes are triggered. Leakage is more common in women who suffer from colpitis, cervicitis, adnexitis, etc.
2. Injury. Intense mechanical impact on the abdomen (fall, blows) can lead to rupture of the amniotic sac.
3. Features and pathologies of pregnancy. Multiple pregnancy, incorrect intrauterine position, polyhydramnios, etc. create increased pressure on the walls of the membrane, which can cause it to rupture.
4. Violation of the uteroplacental blood flow. The risk of sheath damage increases with placental insufficiency, premature detachment of the placenta, isthmic-cervical insufficiency, etc.
5. instrumental medical examination(chorionic biopsy, amniocetesis, abdominal ultrasound, etc.).

How long can amniotic fluid leak?

Most often, OB leakage is encountered in late pregnancy, especially when there are several days left before the expected date of birth. This problem is much less common in the early stages.

First trimester

It is very difficult to determine that water is leaking in the first trimester, because there are very few of them in volume, respectively, they leak in scanty portions - drip. At the same time, they can be mixed with natural vaginal discharge (which becomes more abundant in the early stages of pregnancy), which makes it impossible to suspect an existing problem.

Even an experienced gynecologist will not always be able to identify pathology.

If, nevertheless, leakage has been diagnosed, doctors in most cases advise termination of pregnancy, because. there is a high probability of the development of multiple pathologies in the baby.

Second trimester

The middle of the term is considered the safest, but pathological deviations can occur during this period. It is very important to determine how much time has passed since the integrity of the amniotic sac was broken. The further prognosis of pregnancy largely depends on this. If a pathology is detected at the very beginning, then with the help of relief of symptoms with special drugs, doctors prolong the pregnancy as much as possible. But, unfortunately, due to the difficulty in diagnosing and the lack of timely treatment measures taken, pregnancy is often interrupted.

third trimester

A problem that has arisen in the later stages significantly increases the chances of maintaining a pregnancy. After diagnosing the pathology, the woman is placed under the constant supervision of doctors and prescribed therapy aimed at:

• reducing the likelihood of infection with OS;
• early maturation of the fetal respiratory system;
• prevention of increased uterine tone.

If it leaks before childbirth

The later a woman encounters this problem, the more favorable the prognosis for her and the baby. After 38 weeks, this may mean the onset of labor and is considered acceptable. In this case, doctors decide on an emergency delivery by caesarean section or stimulation of natural childbirth.

How long can they leak

Much depends on the amount of liquid released. The first 12 hours after the complete discharge of water for the fetus are not dangerous. Further anhydrous stay in the womb is fraught with the development of complications for both.

How is it diagnosed in the hospital?

Any alarming symptom should be a reason to see a doctor. The gynecologist will be able to diagnose the pathology with the help of a comprehensive diagnostic examination, which includes:

• inspection;
• transabdominal ultrasound;
• taking a smear;
• amnitest;
• amniocentesis.

What tests are prescribed

The studied material (a smear from the vagina) is applied to a glass slide and examined in the laboratory under a microscope. After drying, the organic matter crystallizes and forms a characteristic pattern resembling fern leaves.

How to do an amniotic fluid test

The nitrative test helps to determine the presence or absence of leaking RH. Normally, the acidity of the vagina is increased, in the OB they have a slightly alkaline environment. When the agents leak, the environment in the vagina approaches neutral and this is determined using a special litmus strip.

The accuracy of the test is also not absolute, because the results are affected by infectious inflammatory processes, the presence of urine or sperm.

Is it possible to determine the test at home amniotic fluid leakage

You can fix the problem at home. Pharmacies sell a special test for determining the leakage of agents - AmniSure. It has high accuracy regardless of the duration of OB leakage and gestational age.

The principle of the study is to introduce a special tampon into the vagina that absorbs the woman's natural secretions. Then the swab is removed and dipped in a solution that removes the absorbed secretions from it. A special strip, subsequently dipped into this solution, is an indicator of the presence or absence of violations of the integrity of the membranes.

How to treat

Treatment depends on the gestational age and the amount of water released. Until 22 weeks, the fetus is not viable, the prognosis is unfavorable, so it is recommended to terminate the pregnancy.

After 22 weeks, pregnant women are shown hospitalization and maximum physical rest. The tactics of treatment is expectant with regular monitoring of the condition of the child and mother. Additional treatments are added as needed.

What is prescribed

1. Antibiotics - to prevent bacterial infection.
2. Medicines to prevent respiratory distress syndrome - to accelerate the maturation of the lungs and accelerate the synthesis of surfactant: glucocortioids.
3. Tocolytic therapy - prevents uterine contractions by relaxing smooth muscles.
4. Amnioinfusion - the introduction of isotonic saline into the amnion in order to increase the RH.

How long is the treatment

A pregnant woman should be under the supervision of doctors until specialists make sure that nothing threatens the fetus and mother. Therefore, the duration of treatment in each case is individual.

What is dangerous early discharge of water

Early discharge of OB poses a danger to both the mother and the child.

For mother

The danger to the mother is the high risk of infection. The result of which can be chorioamniot - inflammation of the fetal bladder.

Due to the close relationship with the uterine mucosa, this complication almost always develops into endometritis - infection of the uterine walls.

A single inflammation can cause a chronic process, as a result, lead to miscarriage or infertility.

Other serious complications include:

1. The formation of single or multiple polyps of the uterine cavity.
2. Weakness of labor activity and protracted course of childbirth.

For a child

With an early departure protective functions RH is significantly reduced, as a result, the likelihood of infection increases. Pathogenic microorganisms spread rapidly by ascending penetration and affect the decidua, placenta, chorion, amnion. As soon as the OV is colonized by pathogenic microorganisms, infection of the fetus occurs. Aspiration by infected OV leads to the development of fetal pneumonia. Infection can also result in:

• uteroplacental disturbance of blood flow;
• intoxication, etc.

Another common complication is prolapse of the umbilical cord or small parts of the fetal body (such as a pen). Approximately 5% of cases of early discharge of OB ends with placental abruption. This condition requires immediate medical care, because threatens the life of the baby (violation of his cardiac activity, the development of severe hypoxia, etc.), as well as his mother, due to the high risk of uterine bleeding.

A pregnant woman should be as attentive as possible to her health and, if there is the slightest suspicion of leakage of OM, immediately consult a doctor. The earlier the pathology is detected, the higher the likelihood of a favorable outcome of pregnancy.

Useful video