How to do a water leak test. Possible options for outflow of water. Symptoms of a slow leak

Good day, my dear future moms! Do you know what complication of pregnancy any of you should be warned about? It provokes every fifth preterm 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 amniotic fluid how to determine this formidable state, 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. They are sometimes judged by the nature of the amniotic fluid during childbirth, for example, about approximate date pregnancy. A woman is unlikely to be able to collect and examine 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 a 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 at 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 laundry, pad stains, liquid copious 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:

Go to the toilet and get rid of excess fluid.
Rinse and dry off.
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 this method managed to detect a problem, this is good (in terms of the fact that now you will not lose 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 Frost patterns- "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:

For the definition of PSIFR-1
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 positives. 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 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 decide 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

Amniotic fluid (or amniotic fluid) is the environment surrounded by the fetal membrane, where future child grows and develops during 9 months of pregnancy. Amniotic fluid is a flavoring "pillow", their task is to protect the child from factors environment, in particular from pathogenic microorganisms, and deliver nutrients to it.

By the time of the onset of childbirth, the volume of amniotic fluid approaches 1500 ml. In a normal pregnancy, rupture of the amniotic membranes occurs at 38 weeks of gestation or later. However, for some women, this process occurs prematurely, which often leads to unpleasant consequences.

Causes of amniotic fluid leakage

Leakage of amniotic fluid is a serious complication that requires urgent treatment. Sometimes the cause that caused this pathology cannot be established, but to the most common factors rupture of the amniotic membranes include:

mechanical damage (for example, a fall or bruise) that injures the fetal membrane;
infections and inflammation of the pelvic organs (endocervicitis,), causing destructive changes in the fetal membranes;
isthmic-cervical insufficiency - an opening in the cervix through which the fetal bladder can fall out;
multiple pregnancy - increased load on the amniotic bladder.

Symptoms of amniotic fluid leakage

Rupture of the membranes recent weeks pregnancy without pathologies is characterized by discharge a large number fluids at a time and the onset of contractions some time after. This physiological process can be easily recognized, however, it is not always possible to independently determine the leakage of amniotic fluid.

If the integrity of the amniotic bladder is violated, the discharge becomes more watery and exuberant nature, their number increases with walking, increasing physical activity.

But these symptoms of amniotic fluid leakage are subjective, and a woman may simply not notice them.

Diagnosis of amniotic fluid leakage

You can diagnose amniotic fluid leakage at home using the procedure below. A woman should urinate, then rinse the external genitalia and dry them well with a towel. After that, put a clean, light cotton diaper in the perineum for 1 hour. If the woman's fears are correct, the diaper will gradually become wet.

In addition to the diaper method, there are special pharmacy tests, for example, AmniSure (AmniSure) and Frautest (Frautest). They include a swab or pad, a reagent, and a test strip. A swab or pad is placed in the vagina or perineum for a specified time, then transferred to a vessel with a reagent, where the strip is lowered. Lines appear on the test strip: one indicates the absence of amniotic fluid leakage, two indicate the presence of a complication.

Treatment of amniotic fluid leakage

At break amniotic membrane Treatment will vary depending on how far along you are in your pregnancy.

Leakage of amniotic fluid at 20 weeks of gestation or less (sometimes up to 22 weeks).

Antibiotics are prescribed to prevent infection, and the amount of loss is also estimated. When it makes sense (with timely treatment), tocolytic therapy is performed. Required during treatment bed rest. In case of late contact with specialists, there is a high chance severe complications in the fetus, therefore, with a massive loss of amniotic fluid, doctors recommend an artificial termination of pregnancy.

Leakage of amniotic fluid at a period of 20 (22) to 35 weeks of pregnancy.

The mother-to-be takes antibiotics to rule out infection. In the case of timely treatment to a specialist, the pregnancy is preserved. For this, tocolytic therapy is used, the woman is prescribed bed rest. After elimination of the pathology, an ultrasound scan is recommended twice a month, treatment with glucocorticosteroids is possible. Preservation of pregnancy is carried out at least until the 35th week.

Leakage of amniotic fluid for more than 35 weeks of pregnancy.

At this time, the baby is ready for birth. In the case of an independent onset of contractions after leakage of amniotic fluid, doctors perform childbirth. If this does not happen, expectant tactics are used, in which the task of the doctor is to find the most safe way delivery. Antibiotics are required to prevent infection.

FAQ

How to determine the leakage of amniotic fluid at home? The best choice to determine the leakage of amniotic fluid at home, there will be an Amnishur test system (AmniSure), consisting of a test strip, a polyester swab and a test tube with a solvent. What color is amniotic fluid when it leaks? Normally, the color of amniotic fluid during leakage should be light yellow. How much does an amniotic fluid leak test cost? average price for the AmniSure test is 1000 rubles. The cost of the Frautest test pad for determining the leakage of amniotic fluid is 400 rubles.
Leakage of amniotic fluid is a complication that can lead to the death of the fetus. However, timely prevention minimizes the chance of its occurrence, therefore, when planning to conceive a child, a woman should cure everything possible diseases genital organs, and during pregnancy, carefully monitor your condition and health. But even if the expectant mother has a leak of amniotic fluid, the main thing is to contact a specialist in a timely manner, then, using modern methods treatment, it becomes possible to maintain pregnancy.

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 ingredients 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 as pathological changes 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 gap 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:

Questioning a pregnant woman about a watery discharge or an increase in its amount. It should not be forgotten that by 38-39 weeks the number physiological secretions increases. Some have more, some have less. Moreover, the enlarged uterus puts pressure on bladder and any minimal exercise can provoke the release of urine.
Examination of a pregnant woman on a gynecological chair.
The amount of fluid in the uterus can be assessed using ultrasound diagnostics.
If it is possible to collect the discharge, then tests are carried out for the presence of hairs and epithelial scales in them.
In doubtful cases, amnioscopy is used - examination of the presenting part of the fetus. It's informative, but difficult method research conducted 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:

The life of the fetus is impossible without amniotic fluid.
Normal amniotic fluid is a colorless and clear liquid. Their color changes in case of infection - they become cloudy, greenish or yellow.
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.
The same experiment can help to conduct sanitary pads.
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 in without fail it is necessary, without wasting time, to appear to the 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 contact 2 months before the expected due date. 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 the home first aid kit it is better to have a special pharmacy test, which allows you to know at any time what fluid is excreted from the body - urine or water.

Pregnancy is a hectic time full of worries and anxiety 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 vaginal discharge. natural character. 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 to independently distinguish between pathological and normal discharge. The course of further actions already depends on this. If there really is a leakage of amniotic fluid - you need to act immediately - call ambulance, see 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. She 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. 85 women have water poured into deadlines, in 15% it occurs 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 a leak is quite complex and laborious 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. This question is still being researched by scientists from different countries 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 are inclined 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 end heavy 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, large fetal size, 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 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 birth defects uterus and cervical insufficiency require heightened attention as the cervix loses its ability to resist the pressure of the growing baby. With polyhydramnios and multiple pregnancy, part of the fluid may leak.

Pathogenesis

The basis of pathogenesis is pathological condition 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 incapable of full implementation 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. For more later dates During pregnancy, leakage can occur as a result of the pelvic floor muscles relaxing and fluid outflow becomes uncontrollable.

Symptoms of amniotic fluid leakage

It is quite difficult to detect leakage if the woman is on early dates. 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 light specific smell accompanied by contractions. This is a sign of an approaching birth, which usually occurs within the next 3 hours.

First signs

If the underwear appeared wet spots, these are the first signs. On early 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 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. Are formed optimal conditions 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 wait early delivery. 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 contractions long time No.

If a fluid leak occurs, you need to quickly go to maternity hospital, where it is necessary to tell the doctor the exact time when the release of fluid began.

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, this phenomenon is part of natural childbirth, falls on 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 independent life, outside the uterus. If the pregnancy is premature, there may be serious consequences and complications, up to intrauterine infection fetus and infectious lesions of 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 is possible and full development fetus. 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. The bed must be laid white fabric. 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 environments, as a result of which 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 unusually simple: the pad is attached to 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 important diagnostic sign by which the doctor determines a lot. Normal amniotic fluid is clear. Turbidity and 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 in the background yellow waters a reddish tint and slight inclusions appear, the process is accompanied by contractions - we can safely say: childbirth has begun.

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

Appearance dark brown shade the situation is catastrophic. 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 the 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?

These two types of discharge can be distinguished by appearance. The waters are clear and slightly cloudy. Vaginal discharge is thicker and mucilaginous different shade, usually white or yellowish.

Amniotic fluid leakage or urinary incontinence

Amniotic fluid leaks constantly and cannot be controlled by muscle effort. Urine has 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. Also used funds aimed at relaxing muscles, uterus, restorative 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 further development of the pathology can 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 necessary measures to prevent infection, maintain pregnancy.

Medications

Any medicines should be taken strictly on the advice 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. Used when threatened 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

pregnant woman, as normal flow pregnancy, and in pathology, vitamins are required. 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 effective means, contributing to the relaxation of 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 comfortable temperature and pour in the extract of 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 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 aroma 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 with each other. 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 means.

Nutrient Blend

A mixture is prepared from an equal amount of dried apricots, raisins, prunes, figs. These substances are ground through a meat grinder, add 25 pieces of finely chopped walnut. 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 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 the impossibility of delivery through natural ways undergoing a caesarean section. 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 injected obstetric pessary. Special care, observance of the daily routine, 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.

The changes that occur during pregnancy surprise even the women themselves. For example, vaginal discharge should normally be colorless and odorless. However, in the nine months of bearing a baby, their character can change repeatedly. Under influence hormonal background and many other factors, they can be transparent or beige, thick or liquid. For the period of pregnancy, such changes are considered the norm.

However, doctors recommend controlling this process and, if alarming and uncharacteristic signs appear, immediately contact them, since vaginal discharge may indicate that they threaten the baby and require immediate medical intervention.

Why is such a process dangerous? How to make sure that the cause of the discharge is the leakage of amniotic fluid? You will find the answers in this article.

What is the risk of water leakage during pregnancy?

Traditionally, the flow of amniotic fluid marks the beginning of labor activity. When a woman experiences strong, the uterine cervix opens, the fetal membrane ruptures, as a result of which the fluid comes out of the bladder, in which the baby was all the time. It also happens that the fetal membrane bursts even before the onset of labor. In this case, it is necessary to urgently go to the maternity hospital, without waiting for the onset of contractions.

But sometimes amniotic fluid can leak long before the appointed date. Firstly, such discharge indicates a violation of the integrity of the fetal membrane, which means that sterility inside the bladder is at risk, and there is a risk of infection. With an untimely response, such a process can end in premature birth, if we are talking about late childbearing. If leakage occurs in the first or second trimester, then there is a threat of miscarriage or fetal fading. In other words, the closer to childbirth there is an outflow of amniotic fluid, the more favorable the forecasts of physicians.

How to define a pathological process?

It is not always possible to determine with accuracy that vaginal discharge indicates a violation of the integrity of the fetal membrane, since the water does not have a characteristic color or specific smell. amniotic fluid can have a very different color: from transparent to greenish.

Basically, leakage occurs in small portions, and this also creates difficulties in identifying the pathology, since a woman can confuse such discharge with the usual vaginal secretion or urinary incontinence.

But still, some symptoms of water leakage during pregnancy can be distinguished:

Constant feeling of moisture in the perineum.
Wet linen.
Increased secretions when the muscles of the vagina are tense (sneezing, laughing, lifting weights, etc.).

But such signs may not always mean water leakage. Similar Symptoms often appear with the problem of urinary incontinence, which usually occurs on recent months pregnancy. Therefore, in order to confirm or refute suspicions, you need to seek qualified help in a timely manner and go through necessary examination. Only after that the doctor can determine the nature of the vaginal discharge.

How to test for water leakage at home?

If you are experiencing vaginal discharge, and their nature is alarming, then you can test at home. You can buy a special amnitest at a pharmacy. The kit includes instructions for use and a gasket impregnated with a chemical reagent that reacts to the high pH of acids (pH level). If the cause of the discharge is water leakage, then the pad will change color during wearing. In this case, it is necessary to urgently consult a doctor, since only in clinical conditions can one confirm or refute the presence of a pathology.