Many pregnant women have concerns about the fact that they have a very poor idea of ​​​​how the water leaves, and what should be done in this case.

Let's start a little further.

Quantity amniotic fluid depends on the duration of pregnancy, usually with a normal pregnancy, by the time of delivery, a woman has about one and a half liters of amniotic fluid.

If speak about normal pregnancy and physiologically flowing birth act, amniotic fluid plays an important role in its development. During childbirth, the head or other presenting part of the fetus is pressed against the bones of the woman's pelvis, dividing the amniotic sac into two parts, and this front part (anterior waters), with each contraction, presses on the cervix like a wedge, helping it to open faster. Thus, if the waters break early, this is already bad, the birth will not go quite right.

Unfortunately, this complication accompanies every tenth pregnancy.

How does water flow in pregnant women?

The fact is that it will not necessarily be a whole waterfall, a very small hole may form in the shells, from which they will leak little by little, almost in drops, but this is also dangerous for the child. Given the increased discharge at the end of pregnancy, and in some especially unhappy ladies, urinary incontinence, which can be mistaken for water, many begin to think about it all the time, sometimes simply worrying themselves in vain with unnecessary fears.

Water leaves when the integrity of the membranes of the fetus is violated. This can happen in different ways, and it’s simply impossible to say how much water flows in time, for someone it will be a waterfall in a few seconds, for someone they will leak for weeks. In any case, if the water has broken, the question of what to do is not even worth it, immediately consult a doctor. If they go away little by little and there are doubts, in any case, you need to go to the antenatal clinic.

Today, special tests are carried out to determine the leakage of amniotic fluid. You will have to buy the test yourself, and it will be carried out by a gynecologist who, using a tampon, will take a little secret from your vagina.

Women are often later dates they are afraid to even take a shower, afraid not to catch that the amniotic fluid has departed. You don't have to be afraid of it. When you leave the shower, if the water has broken, it will continue to leak. A reliable way to tell if your water is breaking is to wear a white cloth pad. It will provide an opportunity to objectively evaluate any discharge. With abundant discharge, it will get wet all at once, clothes will get wet, with a slight leak you will see wet spots that normally have no smell, unlike urine.

After the waters have broken, the question of when to give birth is decided individually. In case of premature pregnancy and the absence of the child's suffering according to CTG and ultrasound, the pregnancy is prolonged. You will have to lie still, take drugs that relax the uterus and an antibiotic to prevent complications. You can’t stay at home if you and your child are not protected by modern medicine, infection of the fetus can cost both lives. And do not be afraid that childbirth will be caused, they try to keep the pregnancy, even if the waters have departed at 20 weeks. If you can lie down for a few weeks, the child will be saved. If the waters broke early, it will still end in a miscarriage anyway ...

What can you feel when the water breaks:

If the fetus is hypoxic, the presence of meconium in the amniotic fluid can give them green color if the waters are brown or pink, it is very dangerous. Normally, the water leaves light, not painted in any color.

If your water breaks at home, call immediately. ambulance and go to the hospital. It doesn't matter how old you are, you need qualified help.

With the outflow of amniotic fluid at an early stage of pregnancy, when the baby is premature, the sooner you apply, the more likely it is to prolong the pregnancy. If the waters break on time, and the birth is due to take place the other day, what happened means that you will give birth in the next 6, maximum 12 hours, at least the doctors will try to make it so, because it will be better for you and the baby.

The discharge of water is one of the signs of the onset of labor. But many pregnant women are afraid of this moment and do not know how to behave correctly. Therefore, we want to tell you what they are, how they look and how the waters of pregnant women leave before childbirth, and also how to behave in such a situation so as not to harm yourself and your baby. In addition, an informative video about this topic will be presented, which will answer frequently asked questions of expectant mothers.

Amniotic fluid is a colorless transparent liquid that consists of water, enzymes, glucose, carbohydrates, proteins and hormones.

Temperature amniotic fluid corresponds to the body temperature of a pregnant woman - 37 ° C.

Normally, amniotic fluid is colorless or with a pinkish tinge.

Before childbirth, particles of the epidermis and fetal hairs may be present in the waters, which form flakes white color, due to which their transparency is somewhat reduced.

If the departed amniotic fluid before childbirth is green, then this indicates the presence of original feces (meconium) in them and is a sign of fetal hypoxia. Appearance of red amniotic fluid at least dangerous symptom that speaks of bleeding. Both conditions are urgent, so the pregnant woman should urgently call an ambulance.

The normal volume of amniotic fluid at the end of pregnancy is 800 ml.

The main functions of amniotic fluid are the creation of optimal conditions for the normal intrauterine development of the fetus, namely:

• amniotic fluid performs a protective function in relation to the fetus, as it protects it from mechanical damage;
• participation in metabolic processes, since the amniotic fluid contains substances that are necessary for the development and growth of the fetus;
• all the waste products of the child are excreted in the amniotic fluid.

How to understand that amniotic fluid leaves before childbirth?

Normally, the outflow of amniotic fluid should occur in parallel with the onset of contractions and the beginning of the opening of the cervix. Also, early discharge of amniotic fluid is isolated, when the cervix has not yet opened, but contractions are present, which is also considered the norm. But it is best for both the child and the mother when the water breaks when the cervix is ​​more than 4 cm dilated.

In every tenth pregnant woman, the amniotic fluid departs prematurely, even before the onset of labor.

Very often there is a situation when the cervix is ​​​​completely opened, and the outflow of amniotic fluid has not occurred, so the amniotic bladder is pierced, which is called amniotomy.

Normally, with the onset of contractions, the water is not completely poured out, since only that part of the fluid that is in the uterine cavity in front of the head leaves.

It happens that the water leaves completely when the amniotic bladder breaks from below. Most often, this situation is observed when lifting weights or changing the position of the body.

In cases where the amniotic bladder ruptures in the upper and lateral parts, labor activity will be accompanied by partial and sometimes drip discharge of water. In such situations, it is difficult for a woman to determine whether the amniotic fluid has passed or whether the amount of vaginal discharge has simply increased.

In addition, a woman needs to pay attention to the smell of amniotic fluid, since they are normally odorless. The fetid odor of the amniotic fluid is a sign of an intrauterine infection that threatens the life of both the fetus and the woman herself.

Before and during the outflow of amniotic fluid, pregnant women do not have any painful sensations. The woman only feels the moisture in the perineum, as if she were a little described. In rare situations, pregnant women have reported hearing the sound of the amniotic sac bursting, which resembled a crack, click, or pop.

Sometimes, after the outpouring of water, pregnant women may feel cramping pain and heaviness in the lower abdomen, which spreads to the lower back.

If you notice the release of amniotic fluid before the onset of contractions, you should immediately inform the obstetrician-gynecologist in whom you are seeing. It is also important to indicate what color and smell the water was, in what quantity, and describe in detail your feelings.

How to behave during the discharge of amniotic fluid?

In a situation where water leaves in small quantities, a woman should warn her obstetrician-gynecologist about this. If the outflow of water occurred before 38 weeks, then it will be necessary to undergo a study that will allow you to determine or exclude water leakage.

Normally, amniotic fluid will be, as we have already said, colorless or slightly pinkish, transparent, odorless and pathological impurities. Also, a sign of water leakage will be that it cannot be delayed or stopped, unlike urine.

• A woman should immediately inform the attending doctor about the discharge of amniotic fluid.
• Take pre-assembled things, call an ambulance or go to the maternity ward on your own. Most women give birth 6-12 hours after the water breaks.

The rupture of the amniotic bladder creates favorable conditions for the penetration of infection into the environment where the fetus is located. The maximum allowable anhydrous period for the fetus is 12 hours. A longer anhydrous period threatens the development of intrauterine infection and fetal hypoxia, so doctors resort to artificial induction of labor or even operative delivery, and antibiotic therapy is prescribed to the child after birth.

In the event that water flows into early dates, all possible measures are taken to preserve the pregnancy.

Why can water break early in pregnancy?

The causes of water leakage in the early stages may be the following:

• exacerbation of chronic gynecological diseases;
• infection of amniotic fluid;
• failure of the closing function of the cervix;
• conducting vaginal instrumental studies during pregnancy;
• chronic diseases of internal organs;
• drinking alcohol, drug addiction and smoking during pregnancy;
• congenital defects of the genital organs, in particular the uterus and its cervix;
• multiple pregnancy;
• abdominal and pelvic injuries.

An early rupture of the amniotic sac threatens with such complications as chorioamnionitis, which is characterized by an increase in body temperature to high numbers, abdominal pain, and discharge of pus from the uterus.

How is premature leakage of amniotic fluid treated?

Therapeutic tactics in this case depends on the degree of rupture of the amniotic sac, the duration of pregnancy, the presence of labor and the general condition of the woman and the fetus.

• With the outpouring of water up to 22 weeks, an artificial birth is indicated.
• With the outflow of water in the period from 22 to 24 weeks, therapeutic measures aimed at maintaining pregnancy are prescribed, which do not always bring success.
• When water is poured out up to 34 weeks, a woman is hospitalized in the gynecological department for the "preservation" of pregnancy, which consists in strict bed rest, condition control future mother and fetus. If during this period the lungs of the fetus are functionally capable, then delivery can be performed.

Indications for emergency delivery are a fetal weight of more than 2500 grams, fetal hypoxia, signs of intrauterine infection of the fetus, and a gestational age of more than 37 weeks.

As a result, we can conclude that when amniotic fluid is released, regardless of the gestational age, you should urgently inform the gynecologist you are seeing about this. The doctor will clarify with you the nature, color and volume of the departed waters and decide what to do next. In any case, you need to remain calm and listen to the recommendations of a specialist.

Watch a video about amniotic fluid.

Amniotic fluid is a substance that normally has no color and no pungent odor. 97% is water, which includes a variety of nutrients: proteins, mineral salts. Also in the amniotic fluid, upon closer examination, skin cells, hair and alkaloids can be found. In addition, the smell of the liquid, according to scientists, resembles the smell of mother's milk. That is why, immediately after childbirth, it reaches for the mother's breast.

The discharge of amniotic fluid is one of the surest signs that labor has already begun. However, it is not uncommon for the waters to break even earlier. And it is very important not to miss this moment, because the fetus can only live 12 hours without them.

If there are any problems with the fetus, the waters may turn green or even Brown color. If the expectant mother sees the leakage of dark waters, you should immediately call an ambulance.

What does waste water look like?

Normally, if everything is in order with the woman in labor and the child, the waters look like ordinary water. Very often, women at the initial stage of childbirth go to the shower to make it easier, so they may not notice that their water has broken, because. against the general background, they will be completely invisible. In some cases, after the water breaks, a woman may feel uterine contractions, which signal that labor has entered a new phase.

However, it often happens that the water begins to leak long before the onset of childbirth - sometimes even 2-. In this case, you need to carefully monitor the amount that comes out. So, for example, it is believed that normally it can be a natural discharge of liquid with a volume of about one tablespoon. Sometimes pregnant women even confuse it with urinary incontinence. Such a loss of amniotic fluid is quite natural and does not cause any harm to the child, especially since the water is being restored.

On average, the amount of amniotic fluid for childbirth is 1.0-1.5 liters. It is difficult to overestimate their role: they contribute to the normal development of the fetus, protecting it from being squeezed by the walls of the uterus and from external physical influences.

If there are more than three months before the birth, and the amount of leaking amniotic fluid exceeds the norm, then you need to urgently consult a doctor. The ideal option is to call an ambulance. Exceeding the norm may indicate the onset premature birth.

How to calm yourself

If you are worried that your water is leaking, do not sit at home and be afraid. You have two options. The first is to go to the doctor for a consultation. The gynecologist will carry out all the necessary manipulations and understand whether it is water. If you are suspicious, and it seems to you that your water is constantly leaking, naturally, you don’t run to the doctor. In order not to torment yourself once again, it is enough to go to the pharmacy and buy a special test. Outwardly, it is quite similar to what is done at the very beginning of pregnancy. This test quite accurately determines the leakage of water and allows the expectant mother to gain peace and confidence that everything is going well and nothing threatens her baby's health.

Toward the end of pregnancy, most women, especially those expecting their first child, begin to worry about the upcoming birth, including the discharge of amniotic fluid. There are many doubts: what to do in such a situation, how not to miss the moment when the waters break, how not to confuse them with ordinary ones, and many others.

The moment of discharge of amniotic fluid

remember You should know that the discharge of amniotic fluid can occur at any stage of pregnancy, but optimally, of course, if this happens no earlier than at 38 weeks, because at that time the child is already fully ripe for birth.

Depending on the presence of labor and the degree of cervical dilatation rupture of amniotic fluid occurs:

1. Premature effusion: occurs before the onset of labor, i.e. The water has broken, but there are no contractions. This option is the most undesirable, but it occurs in approximately one in ten pregnant women;
2. Early outpouring. With this option, the water leaves when regular labor is already present, but is less than 4 cm;
3. Timely outpouring: occurs in the first stage of labor with regular contractions and cervical dilatation of more than 4 cm;
4. belated outpouring: rupture of the fetal bladder occurs for some time after the full disclosure of the cervix.

Premature and early discharge of amniotic fluid is considered a complication, because. in the absence of a fetal bladder, the child is not protected from the effects of various infectious agents. As a result, with a long anhydrous period, infection of the fetus and internal genital organs is possible, especially if a woman suffered inflammatory diseases of the vagina, cervix, and external genital organs during pregnancy. For this reason, in order to prevent infectious complications, 6-8 hours after the rupture of the fetal bladder, a woman begins to administer antibacterial drugs that do not have a negative effect on the child (ampicillin, oxacillin).

How amniotic fluid drains

How to understand that the waters have broken? This question is asked by many women, afraid to miss this moment. To accurately recognize the situation, it is necessary to know the symptoms of an outpouring of amniotic fluid well.

Amount of amniotic fluid

The question of the volume of liquid is quite complicated, because water breaks in pregnant women in different ways.

If there was a complete rupture of the fetal bladder, then a sufficiently large amount of fluid leaves at the same time (most often about 150-250 ml), so this option is quite difficult to miss. Most often, the outpouring occurs at night in a dream, and the woman does not experience any sensations, just waking up in a wet bed. If the pregnant woman is awake, then she may notice a feeling of heaviness in the lower abdomen and a sensation of "popping" or "tearing inside" at the time of the discharge of water.

If the rupture of the fetal bladder occurred high and there is only a small hole, then the water can flow out in small drops for a long time. In this case, a woman can really get confused, because. such discharge can often be attributed to profuse leucorrhoea or urinary incontinence. However, even a slight leak of amniotic fluid is dangerous for the baby, so if you have any suspicions, you should consult a doctor to check the presence or absence of amniotic fluid. In addition, you can check this yourself with the help of special pharmacy tests.

Color and odor of amniotic fluid

Normally, amniotic fluid is clear with a small amount of impurities and has a slightly sweet smell. If the spilled liquid has a greenish, brown or black color, then this indicates the presence of meconium in it, which the fetus secretes during oxygen deficiency. If the water leaves with blood impurities before childbirth, this is an extremely dangerous sign and requires immediate hospitalization of the woman in the maternity ward.

What to do if the waters broke

important If a woman's water has broken, the main thing she should do is quickly pack up and go to the maternity hospital. In no case should you stay at home and wait for the start of contractions.

As mentioned above, the anhydrous gap is dangerous for the child, and labor activity may not begin immediately after the rupture of the fetal bladder. When the waters have not completely departed, but only their leakage is present, a woman may not give birth for a long time. In this case, when the patient is in the maternity hospital, doctors will begin to stimulate labor, which will help reduce the anhydrous gap.

In addition, after the discharge of the amniotic fluid, the woman must be examined on the gynecological chair.

dangerously The fact is that along with the waters, the umbilical cord can prolapse, which is extremely dangerous: when it is compressed, asphyxia and fetal death quickly occur. If the doctor fails to set the umbilical cord back, then the woman is urgently performed a caesarean section.

It is also possible for small parts of the fetus (handles, legs) to fall out, which will lead to disruption of labor and the impossibility of inserting the presenting part of the fetus into the pelvic cavity.

A pregnant woman, all the more, should be urgently hospitalized with "bad" amniotic fluid with the presence of impurities in them.

No contractions after amniotic fluid discharge

As a rule, labor activity begins within 3-4 hours after the discharge of amniotic fluid. If contractions do not start, then the question is raised about the beginning of labor stimulation.

The time issue in this situation is widely discussed and becomes a subject of dispute among various specialists. For example, in many European countries, the waiting method is chosen: artificial stimulation begins only a day after the rupture of the fetal bladder. In Russia, 12 hours of absence of labor is considered the deadline, but at the same time, many obstetrician-gynecologists try not to wait that long because of the high risk of infection of the child and begin to stimulate earlier.

Most women, of course, strive for the natural course of childbirth without the use of various medicines, however, it should be understood that in such a situation one should not argue with a specialist. Waiting can be dangerous and sometimes lead to disastrous consequences.

Premature rupture of the amniotic membrane is a serious complication of pregnancy, which is accompanied by a violation of the integrity of the bladder and is characterized by leakage or massive outflow of amniotic fluid at any stage of pregnancy.

Causes of premature discharge of water

Risk factors and causes of early discharge of water, they are not fully understood and it is impossible to answer with accuracy which of them is provoking. The following are the confirmed and most common risk factors:

• the presence in the past of one or more pregnancies ending in premature discharge of amniotic fluid. The most revealing factor, the likelihood that another pregnancy will end the same, is approximately 23%;
• inflammatory and infectious processes of the genital tract. The focus of inflammation forms a kind of “weak spot” on the wall of the bladder; over time, a rupture or crack may occur in its place;
• isthmic-cervical insufficiency. Bubble protrusion into the lumen of the dilated cervix can lead to easy infection of its walls, and as a result, rupture;
• instrumental medical interventions. Chorionic biopsy and amniocentesis. Contrary to myths, examination with a mirror, sexual intercourse and vaginal examination are not able to provoke a rupture of the amniotic sac ahead of time;
• a strong change in the volume of amniotic fluid - oligohydramnios, polyhydramnios;
• injury. This includes both a fall and a direct injury to the abdomen;
• multiple pregnancy.

Diagnosis of premature bladder rupture

There are many diagnostic techniques aimed at determining the rupture of the shell. These include a smear for amniotic fluid, and a gynecological examination, and all kinds of tests to determine the acidity of the vagina, but they are all uninformative an hour after the rupture of the bladder. Impurities of blood, urine, semen can affect their result, and they show a high percentage of errors from 20 to 40, both false negatives and false positives, which is extremely high and fraught. In the second case, this leads to unnecessary hospitalization, labor stimulation and drug therapy, and in the first case, all of the listed complications that are typical for premature release of amniotic fluid, which can lead to serious consequences.