There is a risk of water leakage. Normal and pathological amniotic fluid. Leakage of amniotic fluid

Often you have to meet with the anxiety of expectant mothers that they will miss the leakage of amniotic fluid, the symptoms are unknown to them. Often, an increase in the vaginal secretion is taken for amniotic fluid, or vice versa - leakage of amniotic fluid is regarded as normal discharge.
Amniotic fluid is the baby's habitat for 9 months. The reservoir for amniotic fluid is the fetal bladder, which is formed in parallel with the development of the child. Amniotic fluid is formed by perspiration of maternal blood components through the vessels of the placenta. The amount of water increases during pregnancy and only before childbirth can a decrease in their volume occur. On average, the amount of amniotic fluid is 1.0-1.5 liters by childbirth. The role of amniotic fluid is difficult to overestimate: they contribute to the normal development of a growing organism, protecting the child from compression by the walls of the uterus, from external physical influences. The child can move freely in the uterine cavity, which contributes to its harmonious development. In addition, the fetal membranes and amniotic fluid are a fairly reliable barrier to penetration from outside pathogenic microorganisms.
Normally, the rupture of the membranes and the outflow of amniotic fluid occurs in the first stage of labor, at a gestational age of at least 38 weeks. Usually, the recognition of this process is not difficult: a sufficiently large amount (about 0.5 liters) of amniotic fluid is poured out at once, they have a slight specific smell, their outflow is accompanied by growing contractions.
Premature rupture of amniotic fluid occurs, most often, during pregnancy, which occurs with inflammatory processes in the vagina and cervix. Under the influence of microorganisms, the fetal membranes become thinner, lose their elasticity and cannot fully perform their functions.
As a result, amniotic fluid leaks, the symptoms of which are very difficult to determine on their own. Amniotic fluid can be released in drops for a sufficiently long period of time and not cause any suspicion in a pregnant woman.
Even with a gynecological examination, it is not always possible to determine the leakage of amniotic fluid: the symptoms are very poor. To obtain a reliable answer, a number of laboratory studies are carried out. The simplest is to conduct a cytological examination of a smear from the posterior fornix of pregnancy. When amniotic fluid leaks in the smear, in addition to the usual vaginal contents, there are elements of amniotic fluid.
In addition, rapid tests for the qualitative determination of amniotic fluid have recently become widespread. Such a test can also be carried out at home, which protects a pregnant woman from unnecessary worries, or allows you not to miss the time for a timely visit to the doctor.
Currently, the approach to premature rupture of amniotic fluid is unambiguous - only delivery in a short time. Attempts to maintain pregnancy with impaired integrity of the fetal bladder did not justify themselves due to frequent septic complications in mother and child.

Often, the leakage of amniotic fluid becomes a cause for concern for the expectant mother. However, not all pregnant women understand what it is and how to distinguish amniotic fluid from vaginal discharge. Let us consider the situation in more detail, name the causes, ways to eliminate the violation.

Amniotic fluid - what is it?

Amniotic fluid is a vital environment for the fetus. Filling the fetal bladder, it prevents trauma to the fetus, creating favorable conditions for it. So directly thanks to her, the baby's body temperature is maintained at the same level. Equally important is the protection that the amniotic fluid provides to the unborn baby.

Its volume is unstable, increases with the growth of the gestational age. This process is noted throughout the entire gestation period, however, water is produced unevenly. The volume is increasing every week. The maximum is reached around gestation. At this time, the volume of amniotic fluid is 1000-1500 ml. At the same time, immediately before the process of childbirth, its quantity decreases.

What is dangerous leakage of amniotic fluid?

Amniotic fluid during pregnancy is vital for the unborn baby. Reducing its volume can lead to irreversible consequences. Among these, physicians distinguish:

infection of the baby inside the womb;
development of complications of an infectious nature in a future mother: chorioamniotonitis (inflammation of the membranes of the fetus),;
premature delivery;
weak labor activity.

Causes of amniotic fluid leakage

When amniotic fluid leaks during pregnancy, a woman needs to see a doctor. The main task for physicians is to determine and eliminate the cause of the violation. At the same time, a comprehensive assessment of the situation is carried out. Possible reasons include:

Inflammatory and infectious diseases in the reproductive system. As a result of such pathogenic processes, the membranes of the bladder in which the fetus is located become thinner. Due to the loss of elasticity, integrity is violated. This is possible with colpitis, endocervicitis.
Isthmicocervical insufficiency. With this type of violation, incomplete closure of the cervix is noted. Due to excess pressure, which is caused by an increase in the size of the fetus, the fetal bladder protrudes into the cervical canal. This leads to a violation of its integrity.
Multiple pregnancy. This phenomenon is considered as a contributing factor to the development of the disorder. Due to the increased load on the walls of the fetal bladder, they do not withstand and are damaged, causing leakage of amniotic fluid.
Developmental anomalies, benign or malignant tumors in the uterus. Incorrect sizes of the reproductive organ, the presence of cysts and tumors in it interfere with the normal growth of the baby, amniotic membranes. As a result, injury to the walls may occur.

Leakage of amniotic fluid in the early stages

Leakage of amniotic fluid during pregnancy, at its short terms, is fraught with interruption of the process of carrying a baby. If the violation develops for up to 20 weeks, then the baby cannot be saved. In this case, infection of the fetal membranes occurs, vital processes are disrupted, as a result of which the baby dies. The woman is cleaned of the uterine cavity to prevent infection and life-threatening complications.

Leakage of amniotic fluid in the second trimester

Leakage of amniotic fluid is often fixed for a long time. It is provoked by increased pressure on the membranes of the fetus, the mass of which increases several times. When a complication of this kind developed in the first half of the 2nd trimester (up to 22 weeks), doctors are forced to interrupt the gestational process. This helps to avoid complications that adversely affect a woman's health.

If the leakage of amniotic fluid begins after, then in most cases it has a favorable outcome. The pregnant woman is sent to the hospital, where she is monitored. Doctors conduct dynamic monitoring, by conducting ultrasound, examining the condition of the bladder shell in the gynecological chair. There is no specific treatment for this. The efforts of doctors are aimed at improving the condition of the pregnant woman. It all depends on how much time has passed since the start of leakage caused by a violation of the shell.

How to determine the leakage of amniotic fluid?

To protect herself and the unborn baby, a pregnant woman should be aware of the signs of this violation. Leakage of amniotic fluid, the symptoms of which may be mild, has an increasing character - as it progresses, the volume of fluid increases. If the membranes are broken in a place located high from the neck, the water flows poorly. In such cases, pregnant women may not pay attention to this phenomenon, taking it for vaginal discharge. Among the obvious symptoms of leakage, it is worth highlighting:

sudden, profuse discharge from the vagina;
change in the nature of the discharge - they became watery, increased in volume;
reduction in the volume of the abdomen;
appearance .

How to distinguish discharge from leakage of amniotic fluid?

In order to be able to distinguish a violation from the norm, each pregnant woman must clearly understand what the leakage of amniotic fluid looks like. Among the main manifestations:

an increase in the amount of fluid released during physical activity, movement, change of position;
tension of the pelvic muscles does not lead to the cessation of discharge (unlike spontaneous urination).

When the bladder rupture is very small, pathology can only be determined using a special test or a smear. Women can diagnose larger tears on their own, at home. For this:

Go to the toilet and empty your bladder completely.
Rinse thoroughly and wipe everything dry.
Lay a sheet on the sofa, dry and clean, and lie down on it without underwear.
If after 15-20 minutes wet spots appear on the sheet, there is a high probability of leakage. The efficiency of such a simple test exceeds 80%.

What color is amniotic fluid when it leaks?

The color of amniotic fluid during leakage may be different. This makes it difficult to diagnose the disorder. In most cases, the waters are clear and colorless, so it is difficult to identify them by the marks on the sanitary napkin. Occasionally, the amniotic fluid acquires a pinkish tint. When the amniotic fluid becomes infected, it can become greenish, yellow, cloudy. However, in such cases, another clinic is also noted, which helps to diagnose pathology.

Amniotic fluid leak test

A pregnant woman can diagnose a pathological condition with the help of special tools. There are pads to determine the leakage of amniotic fluid. Their action is based on a change in the color of the indicator, depending on the medium with which contact has occurred. Initially, it has a yellow color (corresponding to a vaginal pH of 4.5). Other liquids give it a greenish-blue color. Amniotic fluid has the highest pH. This allows you to diagnose the leakage of meager amniotic fluid.

Tests for amniotic fluid leakage

Talking about how to recognize the leakage of amniotic fluid, doctors note that it is difficult to do this with a small volume. In such cases, a violation is diagnosed by laboratory methods, including:

a smear of vaginal discharge - the “fern effect” (drying liquid on a glass slide forms a pattern similar to the named plant);
a smear from the posterior fornix of the vagina is a reliable method of diagnosis;
amniotest - is based on the intramuscular injection of a dye into the abdomen, which stains the amniotic fluid released to the outside (it is rarely used due to the high risks and cost of the reagent).

Does ultrasound detect amniotic fluid leakage?

Leakage of amniotic fluid, the signs of which are mentioned above, can also be diagnosed using ultrasound. In such cases, on the monitor screen, the doctor assesses the extent of the violation, the localization of the rupture of the amniotic membrane. With a mild violation, this technique is ineffective due to the impossible visualization and the difficulty of detecting a defect in the amniotic sac.

Amniotic fluid is not just a water shell that protects the fetus from injury and allows the baby to move freely. Without amniotic fluid (and even if it is, but its amount is less than normal), the child cannot fully develop. Therefore, a woman should know how to determine the leakage of amniotic fluid by simple symptoms and with the help of home tests.

Amniotic fluid is formed from the moment of conception. Gradually, their number increases, reaching a peak by the second trimester. By the time of delivery, amniotic fluid is not formed so intensively. Leakage of water during pregnancy can occur at any time. Up to 22 weeks, this is a sign of a miscarriage that has begun, after - the onset of childbirth.

Why amniotic fluid leaks

The reasons for the leakage of amniotic fluid in different periods are different. Depending on this, the tactics of conducting a pregnant woman are built.

At the beginning of gestation

At this time, isolated leakage of amniotic fluid is rarely observed. More often, a miscarriage begins with bloody discharge and only then, as the uterus contracts and the ovum is expelled, amniotic fluid is released. It mixes with blood and is difficult to isolate separately.

In the middle and end of gestation

Even the slightest leakage of amniotic fluid before 22 weeks is considered the beginning of a miscarriage. After this period and up to 37 weeks, the release of amniotic fluid is a signal of the imminent onset of preterm labor. However, even at this time, the prognosis in many cases is not entirely favorable. After 37 weeks, the appearance of amniotic fluid is considered the norm and indicates the onset of labor.

Leakage of amniotic fluid occurs for various reasons, which can not always be established even after a thorough examination. The main ones include the following:

Infectious diseases. Sexual infections and TORCH-complex (recently transferred rubella, cytomegalovirus, herpes) are in 95% of cases the cause of premature leakage of amniotic fluid in the first and second trimesters. When the focus of inflammation is localized in the vagina and cervix, pathogens penetrate further into the cervical canal, uterine cavity, and fetal membranes. Infection of the membranes is the cause of premature rupture of amniotic fluid.
Chronic processes. Serious chronic diseases, such as pyelonephritis, autoimmune pathologies, can also indirectly cause water outflow.
Rhesus conflict. With the incompatibility of blood groups of the fetus and mother according to the Rh factor, Rh sensitization occurs. In such a situation, the body tries to "get rid" of an unwanted pregnancy, which is the cause of water leakage.
Multiple pregnancy. When carrying two or more fetuses, a woman has an increased risk of developing premature birth due to excessive stress on the body. Often, multiple pregnancy is accompanied by isthmic-cervical insufficiency of the cervix (ICN, premature opening of the cervix). With monochorionic twins, triplets (one placenta for all), a “steal syndrome” may occur. As a result, one baby develops polyhydramnios, the other - oligohydramnios. All this is often accompanied by leakage of amniotic fluid.
Pathology of the cervix. ICI leads to premature outflow of water. At the same time, as the gestational age increases, the cervix cannot withstand the load and begins to open. The result - the fetal bladder prolapses (falls) into the cervical canal and its rupture occurs.
Manipulations on the neck. When applying an obstetric suture in case of insolvency of the cervix, an accidental puncture of the fetal bladder may occur, followed by outpouring of water.
diagnostic procedures. Amniocentesis (puncture of the uterus through the anterior abdominal wall and sampling of a small amount of amniotic fluid), cordocentesis (puncture of the umbilical cord for blood sampling or transfusion), chorionic villus biopsy (the procedure is similar to amniocentesis, but chorionic cells are harvested) due to their invasiveness are always accompanied by risk water leaks.
Myoma of the uterus. In the presence of several myoma nodes or even one large one, the extensibility of the myometrium decreases. And after 12-16 weeks, intensive growth of the uterus begins. If the nodes "interfere" with this, the integrity of the fetal membranes is violated under pressure and water leaks.
Anomalies in the structure of the uterus. In this case, a similar picture develops, as with nodes. A uterine septum, one horn, or a saddle shape can lead to the outpouring of water.
Fetal pathology. If the baby has some kind of malformation, the likelihood of outflow of water before the onset of a full-term pregnancy is also higher.
Injuries. Injuries in the abdomen (blunt, sharp) can lead to compression of the amniotic sac and rupture of the membranes.
Thrombophilia. A change in the properties of connective tissue and blood leads to destructive transformations of the cervix and membranes, which provoke rupture of the fetal bladder.
Diabetes . Changes in metabolism, especially with sugar decompensation, increase the risk of preterm birth and amniotic fluid leakage.

Premature birth sometimes occurs against the background of specific circumstances, for example, infection, fetal pathology. But often there are no obvious reasons for the early onset of labor.

What does it look like

Amniotic fluid leakage can look different. It all depends on the level of stress.

Abundant and medium discharge. When the bulk of the amniotic fluid flows out, which are located in front of the presenting part of the fetus (like a “wedge”), the woman notes that it “flows down the legs”, ordinary maxi pads cannot absorb all the amniotic fluid.
Minor discharge. With a high tear of the fetal bladder or when the layers of the membranes are displaced relative to each other, the defect zone may overlap and the amniotic fluid stops leaking. In this case, the amount of water may be insignificant - up to 200 ml or less. In such a situation, it is sometimes difficult to diagnose and confirm whether it was amniotic fluid or not.
Color and presence of impurities. Amniotic fluid can be with blood (in this case, it is necessary to exclude placental abruption), with an admixture of meconium - green or yellow (a sign of fetal hypoxia). Normally, the color of amniotic fluid during leakage should approach a transparent, with a milky tint, it may contain vellus hair of the fetus and particles of its epithelium - all this provides a kind of suspension.
Smell . Amniotic fluid does not have a pungent odor, let's say a slight sour. Fetid, unpleasant - a sign of infection of the membranes and, most likely, the baby.
With or without contractions. Water can leak both with the onset of uterine contractions and contractions, and without them.

Leakage can occur both after physical activity and during well-being, for example, during sleep or after a night's rest. When the position of the body changes, the amniotic fluid may flow more abundantly.

So, the main symptoms of amniotic fluid leakage are as follows:

increased amount of vaginal discharge;
secretions are liquid;
appear periodically or leak constantly.

How to understand what kind of discharge

In preterm pregnancy, it is extremely important to distinguish true leakage from ordinary vaginal leucorrhoea. It is not always easy to do this without additional examination and dynamic observation. It is especially difficult to establish a diagnosis in the following cases.

With urinary incontinence. Even in young women, especially after repeated childbirth, the tone of the pelvic floor muscles can decrease, resulting in urinary incontinence - when straining, sneezing, coughing. This is especially characteristic in the later stages, when the uterus creates additional pressure on the bladder and pelvic floor. If the pregnant woman does not notice this, there may be an impression of water leakage.
With a pessary in place. After installing a RAP (unloading obstetric pessary) - a foreign body - the amount of vaginal discharge increases due to constant inflammation. They collect in the posterior fornix and may flow more profusely when turning the body. Sometimes it seems that it is water.
With inflammation in the vagina. The infectious process in the vagina is always associated with an increase in the amount of discharge. Depending on the nature of the inflammation, they can be transparent, white, yellow or green.
When the mucous plug comes off. When the moment of childbirth approaches and the cervix opens, mucus comes out, which during pregnancy “like a cork” closes the cervical canal from infection. Sometimes it is quite liquid in consistency and can resemble water.

By what signs it is possible to differentiate the leakage of water from other conditions, the following table shows.

Table - How to distinguish water from other secretions

Criterion	Water	Allocations with a pessary	Discharge during inflammation	Mucus plug
Quantity	Usually a lot		Enough daily panty liners for personal hygiene	Not plentiful
Color	Normally clear, but may be bloody, green or yellow	Most often white or yellowish	Depending on the cause of inflammation - from transparent (with vaginosis) to yellow, white, curdled	Transparent, but may be interspersed with streaks of blood, whiter than the vagina
Smell	Usually not, but with inflammation, an unpleasant putrefactive	Sour, often unpleasant	"Fishy" with vaginosis and purulent, putrid - with other types of inflammation	Doesn't have
Consistency	watery	Creamy	dense	Like egg white or thicker
Appearance time	Suddenly	2-3 weeks after insertion of the pessary	No pattern	Before childbirth, including premature
Do they pass	Only at high bubble burst	After removal of the pessary and sanitation	After treatment	Before childbirth, they no longer go away, but may decrease slightly

In order to recognize the leakage of amniotic fluid and distinguish it from other conditions, the following is carried out.

Looking in mirrors. In most situations, when examining the mucous membrane of the vagina and cervix in gynecological mirrors, it is possible to understand whether it is water or just discharge.
Smear. With a positive analysis, after staining the discharge, a “fern symptom” is detected - under magnification after drying, the picture on the glass slide resembles the leaves of this plant.
Amniotest. There are special test strips for determining the presence of amniotic fluid. They are based on a change in the pH of vaginal secretions when mixed with amniotic fluid. It is freely sold in a pharmacy, and a woman can perform it herself at home.
Fetal ultrasound. Identified oligohydramnios by ultrasound of the fetus is suspected of rupture of amniotic fluid is another symptom of "for". However, a normal amniotic fluid index does not exclude leakage, especially a high tear.
Laboratory methods. In some clinics, there are methods for identifying certain substances in the vaginal secretion, which appear only after the amniotic fluid enters them. However, the method is expensive and not always informative, so it is rarely used.

In doubtful cases, expectant tactics are used. The woman is being monitored in a hospital setting. The secretions are carefully monitored, ultrasound is performed in dynamics, a test and a laboratory study.

Management of pregnant women with leakage

If signs of amniotic fluid leakage are obvious or there is reliable confirmation of this process, the pregnant woman undergoes a series of examinations, after which further management tactics are established. In many ways, it depends on the period in which the water flowed.

1 trimester. Bloody discharge and water in this period begin together if the integrity of the fetal bladder is violated and the miscarriage progresses. Medical or surgical termination of pregnancy is indicated.
2 trimester. Until 22 weeks, any leakage of amniotic fluid equates to the onset of a miscarriage. Its further stimulation and subsequent curettage of the uterine cavity is carried out.
3rd trimester. Tactics is determined based on the period, condition of the mother and fetus. With the outflow of water up to 37 weeks, it is possible to prolong pregnancy from several days to a month or even more with simultaneous antibiotic therapy and the introduction of drugs for the maturation of the lungs of the fetus. There are methods to prevent further leakage of amniotic fluid, which helps to grow the baby in utero for some more time. Since the waters are re-produced every four to eight hours, their volume soon increases to normal values. With signs of detachment, inflammation, or according to the testimony of a woman, delivery can be immediate. The outpouring of water after 37 weeks is equated with the onset of childbirth.

Is it dangerous for the fetus

The outpouring of water during a full-term pregnancy is most often accompanied by the onset of active contractions on the following day. Therefore, at this time it is the least dangerous. When amniotic fluid leaks from 22 to 37 weeks, the severity of the baby's condition is determined by the cause that led to this, as well as the degree of outflow of water. The most favorable prognosis is with a high tear of the bladder without concomitant inflammation. In all other cases, the outpouring of water ends in premature birth.

The consequences of the onset of water leakage for a child ahead of time are as follows:

increased risk of infectious complications- chorioamnionitis, congenital pneumonia;
hypoxia occurs- the outflow of water affects the uteroplacental blood flow, especially if it occurs against the background of what diseases of the woman;
there is a chance of being born prematurely- with the outflow of water in the early stages, it is difficult (up to 30-32 weeks) to keep the pregnant woman for more than a month;
parts of the body of the fetus may fall out - with a headless presentation, along with the waters, loops of the umbilical cord or parts of the fetus (usually arms, legs) may fall out through the opened neck, which can threaten his life.

If a woman is able to suspect or even accurately determine the leakage of amniotic fluid at home, then the sooner she seeks medical help, the better, since the condition without amniotic fluid is dangerous for the fetus. It does not matter what the gestational age is when the water is poured out, only a specialist can determine the most appropriate tactic in each case.

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

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 the most common factors for 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

The rupture of the membranes in the last weeks of pregnancy without pathologies is characterized by the discharge of a large amount of fluid 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 abundant in nature, their number increases when 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

When the membranes rupture, treatment will vary depending on the duration of the 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. During treatment, bed rest is required. In case of a belated appeal to specialists, there is a high chance of 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 safest method of delivery. Antibiotics are required to prevent infection.

FAQ

How to determine the leakage of amniotic fluid at home? The best choice for determining amniotic fluid leakage at home is the AmniSure test system, which consists of a test strip, a polyester swab, and a vial of 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? The 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 all possible diseases of the genital organs, and carefully monitor her condition and health during pregnancy. But even if the expectant mother has a leak of amniotic fluid, the main thing is timely access to a specialist, then, using modern methods of treatment, it becomes possible to maintain pregnancy.

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 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 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 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:

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 using 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:

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 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