During pregnancy in the mother's womb, the fetus is surrounded by amniotic fluid, which is commonly called amniotic fluid. They are important in relation to the development of the fetus, so their outflow during the normal course of pregnancy occurs only during a certain period of labor.
If the waters begin to recede prematurely, this threatens with premature resolution and becomes a serious risk factor. It is necessary to understand how dangerous such situations are for a woman and a baby. The question of how to understand that the waters have broken should be studied by every expectant mother.
Symptoms of amniotic fluid loss
Many women, even at the beginning of their term, are interested in how to understand that the waters have broken. The physiology of a woman is designed in such a way that during the third trimester of pregnancy, the discharge is more abundant, and this is the absolute norm. It is necessary to identify the nature of such manifestations, which should be done by the gynecologist leading the pregnancy. But the expectant mother for her own purposesThe safety and he alth of the baby should herself be able to determine that the premature discharge of fluid has begun. It is important to know and understand what is happening in the body: leakage of amniotic fluid or discharge.
The main symptoms that can make you wary lie in the following factors:
- Fluid outflow increases with position change and movement.
- If there was a significant rupture of the fetal bladder, the fluid begins to flow down the legs. A woman, even with the effort of her genital muscles, cannot stop the flow.
- If the damage to the bladder is microscopic, the leakage is determined solely by a swab in the antenatal clinic or special tests.
External differences
You can distinguish two conditions - leakage of amniotic fluid or discharge - by the appearance of formations on underwear or hygiene products. The waters have a transparent color (sometimes with a pinkish, greenish, brownish tint) and are a bit cloudy. The discharge may have a thicker consistency and a white, yellowish-white, brownish tint. Amniotic fluid, the color of which is far from transparent, should also alert the expectant mother.
Special tests for home testing
Understand what is really happening (leakage of amniotic fluid or discharge), will help tests that are specifically designed to test women at home. Two research methods are considered the most effective, the essence of which is as follows:
- Beforecheck it is necessary to go to the toilet, wash the intimate area, pat it dry with a towel. After that, it is recommended to lie down on a clean, dry sheet or diaper. If stains appear on the surface of the fabric after twenty minutes, there is a high probability of premature effusion. The reliability of this technique is about 80%.
- Possibility of loss allow you to identify special accessories. Gaskets for the discharge of amniotic fluid can be purchased at a pharmacy for an average of 300 rubles.
Special testing tools
Some pharmaceutical companies produce special pads for amniotic fluid leakage. According to external characteristics, this is a completely standard hygienic package. The main difference is that each product contains special reagents. They help to reliably determine even the smallest fraction of the outpouring.
The test is quite simple: the product is attached to underwear and left for 12 hours. The reagents react exclusively with amniotic fluid and stain the pad aquamarine. The study allows you to distinguish urinary incontinence, the presence of discharge from the main problem. The hygiene bag just won't change color.
At the first signs of effusion, you should immediately contact a gynecologist, because such a condition can threaten the he alth of the fetus and mother. It is also better to consult a doctor if a woman is concerned about any suspicions. Only a specialist will help remove unnecessary fears and reliably establish whether a woman has amniotic fluid leakage or discharge, which area sign of he althy functioning of the body. In any case, you need to carefully listen to your condition.
How to recognize amniotic fluid leakage with a high level of confidence?
Professional survey methods give high performance. During a medical examination, a more detailed diagnosis is carried out. By manipulating a special tool - a gynecological mirror - the obstetrician examines the cervix. It is likely that the woman will have to specifically push. If a copious discharge of fluid begins at this point, the fetal bladder may be damaged, and the doctor determines how the amniotic fluid is leaking. Depending on the results of the study, further tactics are being built.
Additional manipulations
The medical test for amniotic fluid leakage is to determine the pH level of the vagina. If the environment is normal, high acidity will be detected. With the loss of amniotic fluid, it becomes slightly alkaline or neutral. This method also allows you to determine the presence of various infectious diseases.
Often an obstetrician conducts a cytological examination - this is a special test for amniotic fluid. The substance to be separated is applied to the glass. After drying, it is determined what it is: water or physiological secretions. At the 40th week of the term, the technique is not used
If the doctors justified their suspicions, at the end an ultrasound examination is performed to determine the exact amount of amniotic fluid. If theythe volume is less than normal, oligohydramnios is diagnosed.
Risk factors
- Infectious lesions of the genital tract that occurred before the start of pregnancy or in the early stages.
- Uterine malformations (mostly congenital).
- Cervical insufficiency. The cervix is poorly closed and cannot cope with the pressure from the growing fetus.
- Polyhydramnios. The diagnosis is made after an ultrasound examination.
- Chorion biopsy, cordocentesis, amniocentesis. Genetic disorders.
- Mechanical injury received while waiting for the baby.
- Insufficient pressing of the presenting part of the fetus. Most often observed in women with a narrow pelvis and in the presence of anomalies of its development.
- Multiple pregnancy.
What is the norm?
A he althy pregnancy and childbirth involves the following sequence of events: when the 38th, 39th, 40th week of pregnancy comes, labor can begin at any time. When one of the contractions proceeds, the bubble in which the amniotic fluid is enclosed breaks, and they come out in one stream. If this does not happen, the obstetrician performs a forced puncture, which is called an amniotomy.
Classification
Depending on the time when the discharge occurs, and on how the amniotic fluid leaks, the following classification has been developed:
- Timely. Begins at the end of the first birth period with full or almost full opening of the cervix.
- Premature. When it's 39, 40week of pregnancy, until the onset of stable labor.
- Early. Leakage during labor but before cervical dilatation.
- Belated. Occurs due to the high density of the fetal membranes. The outpouring begins in the second birth period.
- High rupture of shells. Occurs at a level above the cervical os.
Ideally, the outpouring should be just in time. But in terms of full-term pregnancy, the period of which exceeds 37 weeks, any option may be favorable if, as a result, normal labor activity develops. Such a condition is considered dangerous if the period is less than 37 weeks.
What is the danger of leakage?
In order to understand all the consequences that premature rupture threatens, it is necessary to understand the functions that amniotic fluid carries:
- Barrier to infection. Infection through the mother's genitals can get to the baby in a vertical way.
- Prevention of squeezing the umbilical cord. The waters help create free blood flow to the baby.
- Mechanical function. The fetus receives protection from negative external influences, such as shocks or falls. Conditions are created for the free movement of the baby.
- Biologically active medium. There is a constant exchange and secretion of chemicals between mother and baby.
In case of development of disorders, all functions suffer, but intrauterine infection becomes the most dangerous complication, becausethat the leakage is due to the loss of the integrity of the membranes. As a result, the tightness of the medium is lost, protection from external influences is lost, and sterility is violated. Viruses, bacteria, fungi can penetrate the fetus.
If an outpouring is detected…
If the effusion occurs in the second trimester, this can cause the fetus to become infected with various infections that can overcome all defenses without barriers. As soon as the obstetrician makes sure that there is leakage, the woman is sent for ultrasound diagnostics. This study helps determine the degree of maturity of the baby in the womb. If the kidneys and respiratory system of the fetus are ready for full-fledged functioning outside the uterus, labor is stimulated. This prevents the baby from getting an infection.
If the fetus is not ready for independent life, measures are being taken to prolong the pregnancy - doctors will expect the fetus to be ready for childbirth. Therapy is as follows:
- Prescription of antibacterial drugs. This will help prevent intrauterine infection.
- Strict bed rest. Rest and stability make therapy easier.
- Permanent monitoring of the he alth and condition of the child, as every day is considered important. The baby has every chance to grow to a viable state in the mother's womb. His blood flow and movement are being assessed.
- Mother undergoing lab tests, body temperature is measured.
- While there are no signs of infection, expectant management continues. The child's airways can be prepared for independent functioning, for which hormonal drugs can be prescribed. It is not dangerous, all activities are aimed at maintaining the he alth of the mother and child.
Instead of a conclusion
Premature leakage of water can be prevented if a woman, in the presence of risk factors, carries out appropriate prevention. For example, timely treatment of cervical insufficiency is implemented, when a suture can be applied to the cervix, a special obstetric pessary is introduced. In some cases, conservative therapy, sanitation of the genital tract and other potential infectious foci (pyelonephritis, caries, tonsillitis) are carried out. The most favorable prognosis is formed with effusion in full-term pregnancy. However, the expectant mother should not panic, it is advisable to remain calm and follow all the doctor's instructions.
