Intrauterine period: what contributes to the normal course of pregnancy. How amniotic fluid is renewed during pregnancy At what time does amniotic fluid appear?

Until the moment of birth, the baby developing in the mother's womb is surrounded by amniotic fluid. It is important for every pregnant woman expecting the birth of her baby to know how her waters break before giving birth. This will allow you to remain calm and take the necessary measures in a timely manner.

Amniotic fluid is necessary for the full development of the baby.

It performs the following functions:

Thermoregulation. The mother's womb maintains a temperature of 37 °C, which is optimal for embryo growth.
Protection against pathogens. The sterile liquid surrounding the baby protects it from infections.
Metabolism. Vital elements penetrate the growing body through the amniotic sac. Waste products entering the amniotic fluid are removed from the woman’s body through the excretory system.
Reduced risk of bleeding.
Protection from external influences, softening shocks.
Stimulation of uterine dilatation, wetting and disinfection of the birth canal.

How does a pregnant woman feel when her water breaks?

The release of amniotic fluid and contractions are two signs that indicate the onset of labor. In most cases, both processes occur simultaneously. When the cervix opens more than 4 cm, and contractions intensify, the membrane containing the fetus bursts and the waters appear outside.

If the pregnancy continues beyond the prescribed period, a doctor's intervention is required. Using medical instruments, the specialist opens the amniotic sac. How pregnant women's water breaks before childbirth is a process that does not affect the woman's sensations and does not cause discomfort.

If at the same time the uterus begins to contract, cramping pain may be felt.

The baby is expected to be born in the next 12 hours. Staying a baby longer in the mother's womb is dangerous– the risk of infection and hypoxia increases. If labor is delayed, specialists stimulate muscle contraction or produce C-section.

How to distinguish amniotic fluid from a mucus plug

A plug is a clot of mucus that fills the cervix during pregnancy. protecting the fetus from the bacterial environment of the vagina. After 38 weeks have passed since conception, the concentration of progesterone in the blood, which ensures the maintenance of pregnancy, sharply decreases.

The cervix begins to soften, the birth canal opens slightly and the plug comes out. During this period, a woman may find thick mucus streaked with blood on her underwear. There is no need to worry that labor will begin immediately after the discharge - plug particles may continue to come off for up to 14 days.

A video explaining what a mucus plug is in a pregnant woman, and how to understand that it has come off:

You can distinguish the release of a plug from the rupture of amniotic fluid by the following criteria:

Sign	Amniotic fluid	Mucus plug
Hue	Transparent, pink, light green.	Beige, brown, sometimes with red streaks.
Consistency	Watery	Mucous
Selection duration	Continuous leakage, worse when coughing.	1-2 tbsp. l. per day for several days.
Period	Shortly before the baby is born	3-5 days before the start of the birth process.

Even if the passage of the mucus plug is not accompanied by signs of the onset of labor, it is necessary to remember that there is very little time left before the baby is born. Care should be taken to avoid traveling public transport and be prepared to go to the maternity hospital if necessary.

Timely discharge of amniotic fluid - signs

How the waters break in pregnant women before childbirth is a question raised by many women due to heavy discharge at the end of gestation, which is difficult to distinguish from amniotic fluid.

How water breaks in pregnant women before childbirth, a woman needs to find out in advance in order to be aware of the consequences

The leakage of amniotic fluid can be detected by the following signs:

With sudden movements and walking, the discharge intensifies.
When the tissues holding water are severely torn, liquid pours out in a stream that cannot be stopped even by strong compression of the genital muscles.
In order not to confuse the discharge of amniotic fluid with manifestations of cystitis, you need to wear a light-colored fabric pad. Unlike urine, the water flowing from the amniotic sac is clear and odorless.
Products for diagnosing water leaks are sold at pharmacies and resemble regular sanitary pads that are attached to underwear. The surface of the products is impregnated with reagents. If amniotic fluid leaks, the pad will change color. The duration of the study is 12 hours.
During a medical examination, a specialist examines the condition of the cervix using a mirror. The doctor may ask the patient to push slightly. If at this moment the fluid separation increases, there is a possibility of damage to the amniotic sac.
To clarify the fact of water leakage, the pH of the vaginal environment is studied. In its normal state it is acidic, but before childbirth it is neutralized or becomes slightly alkaline.

How the waters break in pregnant women before childbirth is clearly demonstrated by a cytological study, which is carried out at less than 40 weeks. A specialist transfers a drop of secretions to a glass surface and determines the origin of the liquid from the stains formed after drying.

Previous leakage of amniotic fluid

The discharge of amniotic fluid before the 37th week of pregnancy is considered untimely. This phenomenon is dangerous for the baby's life.

You should immediately seek help if you experience the following alarming symptoms:

discharge of a large volume of fluid from the vagina;
the urge to urinate every 5 minutes;
bloody spots on linen;
increased body temperature;
the stomach has become smaller and lowered;
fetal movement has ceased to be felt;
there was pain in the lower abdomen.

The discharge of amniotic fluid in pregnant women before the birth process can happen for several reasons:

Polyhydramnios or large embryo. The uterus cannot cope with the load placed on it and begins the process of preparing for childbirth.
When there are three or more babies in the womb, premature rupture of water is considered normal.
The uterus has an irregular shape, preventing the free flow of nutrients into the placenta.
Previously suffered infectious disease. Pathogenic bacteria can get on the walls of the fetal bladder and cause its damage.
Abdominal injury, physical stress on the back and abdominal muscles.
Physician negligence during a medical examination.
Severe stress.
Unhealthy Lifestyle.
Neglect of hygiene rules.

After determining the cause of the pathology, specialists select the best way out of this situation:

If only a small part of the water has left the expectant mother's body, doctors try to delay the onset of labor until at least 37 weeks so that the embryo can continue to develop. In this case, the patient’s condition is constantly monitored and she is prescribed necessary medications.
Induction of labor if delay threatens the life of the woman or fetus. A premature newborn is placed in a pressure chamber where he continues to develop. In this case, the risk to the woman’s health is minimized.

If a woman does not seek medical help after a ruptured bladder, the consequences may be unfavorable:

fetal hypoxia caused by lack of oxygen;
death of an embryo in the womb of a woman;
inflammation of the uterine tissue;
difficult labor lasting 8 hours or more;
death of the patient.

Delayed release of water in pregnant women

Late effusion occurs some time after the uterus has opened. This may be due to weak muscle contraction or thickened walls of the amniotic sac. When contractions intensify, rupture occurs naturally in most cases and the baby is born within 12 hours.

Lack of water breaking during labor

Preservation of the integrity of the amniotic sac after the onset of uterine contractions may be due to the following reasons:

weak labor with absence of regular contractions;
prolonged pregnancy;
polyhydramnios;
increased density of the walls of the fetal bladder, in which the membranes cannot rupture naturally;
decreased placentation;
toxicosis in the last trimester;
flat shape of the fetal sac.

If the bubble cannot burst on its own, specialists perform an artificial autopsy. to avoid placental abruption, which negatively affects the condition of the child. The procedure is painless because the incised membrane has no nerve endings.

Amniotic fluid volume

The optimal volume of amniotic fluid provides comfortable conditions for the development of the child. The average amount of fluid at 37-38 weeks is 600-1500 ml. With a prolonged pregnancy, the volume of water begins to decrease, threatening the health of the embryo.

If the volume of fluid filling the amniotic sac is less than 500 ml, oligohydramnios is diagnosed.

Pathology can be caused by several reasons:

fetoplacental insufficiency;
metabolic disorders, obesity;
diseases of the cardiovascular system of women;
leakage of amniotic fluid;
late toxicosis;
violation of the structure of the membrane of the fetal bladder;
previous viral diseases;
disruption of the functioning of the embryo's excretory system;
diabetes.

Signs of oligohydramnios include:

the embryo moves less than ten times per day;
Abdominal circumference is less than normal.

If the presence of pathology is suspected, the patient is sent for an ultrasound scan. To establish an accurate diagnosis, it is necessary to conduct several examinations at intervals of two weeks. With oligohydramnios, caused by a violation of the structure of the membranes, there is an increased risk of bacteria entering the uterine cavity and infecting the embryo.

Severe oligohydramnios, in which the fluid volume is reduced to 200 ml, slows down the intrauterine development of a child experiencing a lack of oxygen. Due to pressure from the walls of the uterus, the baby may develop deformation of the neck and legs.

If a deviation from the norm is recorded at an early stage, a drug treatment:

Actovegin, Curantil - normalize the composition of the placenta and its blood supply.
Trental - stimulates blood circulation.

If oligohydramnios is detected in the third trimester of pregnancy, the amniotic sac becomes flat and labor may be weakened. In this case, a caesarean section is planned. Moderate oligohydramnios does not prevent natural childbirth.

The fetus can turn over in the womb, but even with a breech presentation caused by insufficient water, the process ends safely. Polyhydramnios can be chronic, when the volume of fluid increases gradually, and acute, in which the size of the abdomen increases over several days or even hours.

A mild degree of pathology is characterized by a fluid volume of 3 liters, and a severe degree is 5 or more liters.

Polyhydramnios can manifest itself as follows:

feeling of heaviness in the abdomen;
lethargy;
tachycardia, shortness of breath;
blue discoloration of the labia, abdomen;
the stomach is more than 100 cm in girth;
numerous stretch marks;
decrease in daily urine volume;
the size of the uterus exceeds normal values;
it is difficult to hear the heartbeat of the embryo;
The child kicks often.

Severe polyhydramnios can have serious consequences:

miscarriage;
entanglement of the fetus with the umbilical cord;
attacks of vomiting in a pregnant woman;
embryo hypoxia;
child developmental defects;
fetoplacental insufficiency and fetal death.

If it is possible to maintain the pregnancy, the factor that provoked polyhydramnios is determined and the necessary therapy is prescribed. On early stage Polyhydramnios can be treated with antibacterial drugs, agents that promote the release of excess fluid from the body, B vitamins and medications that improve blood circulation.

With severe polyhydramnios, part of the fluid is drained through an incision in the amniotic sac. If a woman's life is in danger, the pregnancy is terminated.

Color of waters before childbirth

How the waters break in pregnant women before childbirth is a diagnostic method that influences the tactics of maintaining the health of mother and child.

Therefore, it is important to pay attention to the shade of the secreted liquid:

Normally, the waters are clear, white-yellow or slightly cloudy.
A slight admixture of blood streaks may indicate dilatation of the cervix. A medical examination is necessary to rule out abnormalities.
Bloody water is a sign of internal bleeding. In this condition, you cannot move independently; you must immediately call for help.
Green tint of amniotic fluid is an alarming symptom. The reason for this coloration may be fetal hypoxia, which forced it to empty its intestines in utero. The entry of contaminated water into the lungs of the embryo threatens to disrupt the functioning of the embryo. respiratory system.

The dark brown color of the water may indicate fetal death.

How long does it take between your water breaking and giving birth?

If 24 to 28 weeks have passed since conception, a full month may remain until delivery. If the waters have not completely receded, the woman needs to be admitted to the hospital. IN otherwise specialists induce labor artificially. From 29 to 37 weeks, in half of the cases the uterus begins to contract within 24 hours. For other women, the wait can last up to 7 days or more.

If the effusion is not complete, the expectant mother is placed under the supervision of a doctor.

From the 38th week, no more than 12 hours pass between the breaking of water and contractions in half of the women. In other cases, the child is born within 72 hours. It must be remembered that when the amniotic fluid is completely discharged, the embryo can remain in the mother’s womb without a threat to health for no more than 6- 12 o'clock

By this time, doctors need to take measures to save him.

Possible problems

If the expectant mother or developing child has any pathologies, the amniotic fluid may turn an undesirable color. The deviation is detected during amnioscopy, when a specialist inserts the device into the vestibule of the uterus, or when the water breaks.

Green colored waters

The swampy tint of the liquid can be caused by the following reasons:

The baby's excretion of original feces. This happens if the baby is post-term and suffers from a lack of oxygen. Hypoxia negatively affects the development of the embryo and can cause irreparable consequences.
In rare cases, genetic diseases of the fetus.
The waters may remain normal throughout the entire period and only become colored during childbirth. As the baby moves through the birth canal, it experiences stress and produces meconium, which gives the fluid its characteristic color.
If a woman has recently had an infectious disease, a swampy tint may indicate contamination of water with pathogenic bacteria.

To prevent your child from swallowing contaminated liquids, upon detection of pathology on later a caesarean section is prescribed or stimulate labor. In the early stages, it is enough to eliminate the causes of the deviation so that the amniotic fluid is renewed as soon as possible.

Cloudy amniotic fluid

Normally, the amniotic fluid may be slightly cloudy; particles of dead epidermis, vellus hair, and vernix lubrication get into it. If unhealthy impurities appear in the fluid, this may signal infection.

If tests confirm the presence of pathogens in a woman’s body, she must undergo a course of antibacterial therapy.

Bloody discharge

An admixture of blood in the amniotic fluid indicates the presence of hidden bleeding or fetal death. In this case, you must lie down and immediately call ambulance. It is prohibited to change body position before doctors arrive.

No contractions after water breaks

If the labor process has not begun within 6 hours after the water breaks at a late stage, specialists do an ultrasound to verify the fact of rupture of the membranes. If the rupture of water is not confirmed, the woman is sent home. If amniotic fluid is partially or completely discharged, doctors decide on further actions based on the results of the examination.

Several options are possible:

stimulation of labor;
C-section;
extension of the gestation period.

What to do when amniotic fluid leaks

The outpouring of water is a harbinger of the beginning of the birth process.

If there is no bleeding, the woman needs to prepare for a meeting with a specialist:

Take a shower.
Wear clean underwear and place a urological pad in case the fluid has not completely drained.
Collect all the things necessary for your stay in the maternity hospital: a change of underwear, a robe, slippers, a bottle of still water, hygiene products, a cup with a spoon, documents. You need to try not to make sudden movements; it is best to ask one of your relatives to help with getting ready.
Call a taxi to the maternity hospital.

The breaking of water before childbirth occurs differently for each pregnant woman. The time and method of delivery depends on how the fluid is released from the amniotic sac. The specialist conducts an examination and, if any deviations exist, prescribes appropriate therapy.

Article format: E. Chaikina

Useful video about how water breaks before childbirth

A story about the first signs of imminent labor:

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

Amniotic fluid is formed from the moment of conception. Their number gradually increases, reaching a peak in the second trimester. By the time of birth, amniotic fluid is not formed as intensively. Water leakage during pregnancy can occur at any stage. Before 22 weeks this is a sign of an incipient miscarriage, after which it is a sign of the onset of labor.

Why does amniotic fluid leak?

Causes of leakage of amniotic fluid in different dates are different. Depending on this, the tactics for managing 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 fertilized egg 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 premature 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 normal and indicates the beginning of labor.

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

Infectious diseases. Sexually transmitted infections and the TORCH complex (recent rubella, cytomegalovirus, herpes) are the cause of premature leakage of amniotic fluid in the first and second trimesters in 95% of cases. When the source 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, for example, pyelonephritis, autoimmune pathologies can also indirectly cause the rupture of water.
Rhesus conflict. When the blood groups of the fetus and mother are incompatible according to the Rh factor, Rh sensitization occurs. In such a situation, the body tries to “get rid” of an unwanted pregnancy, which causes 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 pregnancies are accompanied by isthmic-cervical insufficiency of the cervix (ICI, opening of the cervix prematurely). With monochorionic twins or triplets (one placenta for all), “steal syndrome” may occur. As a result, one baby develops polyhydramnios, while another develops oligohydramnios. All this is often accompanied by leakage of amniotic fluid.
Pathology of the cervix. ICN leads to premature rupture of water. In this case, as the pregnancy period increases, the cervix cannot withstand the load and begins to open. The result is that the amniotic sac prolapses (sinks) into the cervical canal and ruptures.
Cervical manipulation. When applying an obstetric suture for cervical incompetence, accidental puncture of the amniotic sac may occur, followed by rupture of water.
Diagnostic procedures. Amniocentesis (puncture of the uterus through the anterior abdominal wall and collection of a small amount of amniotic fluid), cordocentesis (umbilical cord puncture for blood collection or transfusion), chorionic villus biopsy (the procedure is similar to amniocentesis, but chorionic cells are collected) due to their invasiveness are always accompanied by risks water leakage
Uterine fibroids. In the presence of several myomatous 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 pressure breaks the integrity of the membranes and water leaks.
Anomalies of the structure of the uterus. In this case, a similar picture develops as with nodes. A uterine septum, one horn, or saddle can lead to rupture of water.
Fetal pathology. If the baby has any developmental defects, the likelihood of water breaking before full-term pregnancy occurs is also higher.
Injuries. Injuries in the abdominal area (blunt, sharp) can lead to compression of the amniotic sac and rupture of the membranes.
Thrombophilia. Changes in the properties of connective tissue and blood lead to destructive transformations of the cervix and membranes, which provoke rupture of the membranes.
Diabetes . Changes in metabolism, especially with decompensation of sugar, increases the risk of premature birth and leakage of amniotic fluid.

Premature birth sometimes occurs due to specific circumstances, for example, infection, fetal pathology. But often obvious reasons for early onset of labor is not detected.

What does it look like

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

Heavy and medium discharge. When the bulk of the amniotic fluid flows out, which is 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. When there is a high tear in the amniotic sac or when the layers of membranes are displaced relative to each other, the defect area 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 may contain 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 when leaking should approach transparent, with a milky tint; it may contain fetal vellus hair and particles of its epithelium - all this provides a kind of suspension.
Smell . Amniotic fluid does not have a pungent odor, perhaps a slight sour odor. Fetid, unpleasant - a sign of infection of the membranes and, most likely, the baby.
With or without contractions. Water can leak with or without the onset of uterine contractions and contractions.

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

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

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

How to understand what kind of discharge it is

In a premature pregnancy, it is extremely important to distinguish true leakage from normal vaginal leucorrhoea. This is not always easy to do without additional examination and follow-up. It is especially difficult to make a diagnosis in the following cases.

For urinary incontinence. Even in young women, especially after repeated births, the tone of the pelvic floor muscles can decrease, resulting in urinary incontinence - when straining, sneezing, coughing. This is especially common in the later stages, when the uterus creates additional pressure on the bladder and pelvic floor. If the pregnant woman does not notice this, it may seem like water is leaking.
With a pessary installed. After installing the RAP (unloading obstetric pessary) - foreign body– the amount of vaginal discharge increases due to constant inflammation. They collect in the posterior fornix and can flow more abundantly when turning the body. Sometimes it seems like it's water.
For inflammation in the vagina. An infectious process in the vagina is always associated with an increase in the amount of discharge. Depending on the nature of the inflammation, they may be transparent, white, yellow or green.
When the mucus plug comes out. As the moment of birth approaches and the cervix opens, mucus comes out, which during pregnancy “like a plug” closes the cervical canal from infection. Sometimes it has a rather thin consistency and can resemble water.

The following table shows what signs can be used to differentiate water leakage from other conditions.

Table - How to distinguish water from other secretions

Criterion	Water	Discharge during pessary	Discharge due to inflammation	Mucus plug
Quantity	Usually a lot		Enough panty liner for personal hygiene	Sparse
Color	Normally transparent, 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 there may be streaks of blood, whiter than the vagina
Smell	Usually no, but with inflammation an unpleasant putrefactive	Sour, often unpleasant	“Fishy” for vaginosis and purulent, putrefactive – for other types of inflammation	Doesn't have
Consistency	Watery	Creamy	Thickish	How egg white or thicker
Appearance time	Suddenly	2-3 weeks after installation of the pessary	No pattern	Before childbirth, including premature
Do they pass	Only with high bubble rupture	After removal of the pessary and sanitation	After treatment	They no longer go away before childbirth, but may decrease somewhat.

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

Inspection in the 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 slide resembles the leaves of this plant.
Amniotest. There are special test strips to determine the presence of amniotic fluid. They are based on changes in the pH of vaginal discharge when mixed with amniotic fluid. It is freely sold in pharmacies, and a woman can perform it herself at home.
Ultrasound of the fetus. If oligohydramnios is detected by fetal ultrasound, if rupture of amniotic fluid is suspected, this is another symptom “for”. However, a normal amniotic fluid index does not exclude leakage, especially a high tear.
Laboratory methods. Some clinics have methods for identifying certain substances in vaginal secretions, which appear only after amniotic fluid enters them. However, the method is expensive and not always informative, so it is rarely used.

In doubtful cases, wait-and-see tactics are used. The woman is being monitored in a hospital setting. Careful monitoring of discharge is carried out, ultrasound is performed in dynamics, tests and laboratory studies are performed.

Management tactics for 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. It largely depends on the period in which the waters began to flow.

1st trimester. Bloody discharge and water in this period begin together when the integrity of the amniotic sac is disrupted and the miscarriage progresses. Medical or surgical termination of pregnancy is indicated.
2nd trimester. Before 22 weeks, any leakage of amniotic fluid is considered the onset of a miscarriage. Further stimulation is carried out and subsequent curettage of the uterine cavity.
3rd trimester. Tactics are determined based on the period, condition of the mother and fetus. When the waters rupture before 37 weeks, it is possible to prolong pregnancy from several days to a month or even more with simultaneous antibiotic therapy and the administration of drugs for the maturation of the fetal lungs. There are techniques to prevent further leakage of amniotic fluid, which helps to grow the baby in utero for some more time. Since water is produced anew every four to eight hours, its volume soon increases to normal levels. If there are signs of detachment, inflammation, or according to the woman’s indications, delivery can be immediate. The rupture of water after 37 weeks is equivalent to the onset of labor.

Is it dangerous for the fetus?

The rupture of water during full-term pregnancy is most often accompanied by the onset of active contractions in the next 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 leakage of water. The most favorable prognosis is with a high tear of the bladder without concomitant inflammation. In all other cases, the rupture of water ends in premature birth.

The consequences of water leakage for a child ahead of schedule are as follows:

the risk of infectious complications increases– chorioamnionitis, congenital pneumonia;
hypoxia occurs– rupture of water affects the uteroplacental blood flow, especially if it occurs against the background of any diseases of the woman;
there is a possibility of being born prematurely– if water breaks in the early stages, it is difficult (up to 30-32 weeks) to keep a pregnant woman for more than a month;
Parts of the fetal body may fall out - with a non-cephalic presentation, along with the water, loops of the umbilical cord or parts of the fetus (usually arms, legs) may fall out through the opened cervix, which can threaten its life.

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

During pregnancy, the fetus is surrounded by amniotic fluid in the mother's womb, which is commonly called amniotic fluid. They are important in relation to the development of the fetus, so their normal discharge occurs only during a certain period of labor.

If the water begins to break prematurely, this threatens premature resolution and becomes a serious risk factor. It is necessary to understand how dangerous such situations are for a woman and baby. The question of how to understand that the water has broken should be studied by every expectant mother.

Symptoms of amniotic fluid loss

Many women, even at the beginning of their period, are interested in how to understand that their water has broken. A woman’s physiology is designed in such a way that during the third trimester of pregnancy, 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 for the sake of her own safety and the health of the baby, the expectant mother herself should be able to determine that premature fluid loss 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 may make you wary lie in the following factors:

The leakage of fluid increases with changes in position and movement.
If there is a significant rupture of the amniotic sac, fluid begins to flow down the legs. A woman cannot stop the flow even with the effort of her genital muscles.
If the damage to the bladder is microscopic, leakage is determined solely by a smear in antenatal clinic or special tests.

External differences

You can distinguish the 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 little cloudy. The discharge may have a thicker consistency and a white, yellowish-white, or brownish tint. The amniotic fluid which is far from transparent should also alert the expectant mother.

Special tests for home testing

To understand what is really happening (leakage of amniotic fluid or discharge), tests that are specially designed to test women at home will help. Two research methods are considered the most effective, the essence of which is as follows:

Before the test, you need to go to the toilet and wash intimate area, blot dry with a towel. After this, 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 shedding. The reliability of this technique is about 80%.
The possibility of loss allows you to identify special accessories. Pads for the release 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. In terms of external characteristics, this is a completely standard hygiene package. The main difference is that each product contains special reagents. They help to reliably determine even the minimum amount of overflow.

The test is quite simple: the product is attached to underwear and left for 12 hours. The reagents react exclusively to amniotic fluid and turn the pad aqua green. The study allows you to distinguish the presence of discharge from the main problem. The hygiene bag simply will not change color.

At the first signs of effusion, you should immediately contact a gynecologist, because such a condition can threaten the health of the fetus and mother. It is also better to consult a doctor if a woman is worried about any suspicions. Only a specialist will help relieve unnecessary fears and reliably determine whether a woman has leakage of amniotic fluid or discharge, which are a sign of healthy functioning of the body. In any case, you need to listen carefully to your condition.

How to recognize leakage of amniotic fluid with a high level of confidence?

Professional examination methods provide high results. During a medical examination, a more detailed diagnosis is carried out. Manipulating a special instrument - a speculum - the obstetrician examines the cervix. It is likely that the woman will have to specifically push. If at this moment copious fluid discharge begins, the amniotic sac may be damaged, and the doctor will determine how the amniotic fluid is leaking. Depending on the results of the study, further tactics of action are developed.

Additional manipulations

The medical test for amniotic fluid leakage consists of determining the pH level of the vagina. If the environment is normal, high acidity will be detected. When amniotic fluid is lost, 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 separated substance is applied to the glass. After drying, it is determined whether it is water or physiological secretions. At 40 weeks of gestation, the technique is not used

If the doctors have justified their suspicions, at the end ultrasonography to determine the exact amount of amniotic fluid. If their volume is less than normal, oligohydramnios is diagnosed.

Risk factors

Infectious lesions of the genital tract that occurred before pregnancy or in the early stages.
Malformations of the uterus (mostly congenital).
Cervical insufficiency. The cervix is poorly closed and cannot cope with the pressure from the growing fetus.
Polyhydramnios. The diagnosis is made after an ultrasound examination.
Chorionic villus biopsy, cordocentesis, amniocentesis. Genetic disorders.
Mechanical injury received while waiting for the baby.
Insufficient compression of the presenting part of the fetus. Most often observed in women with a narrow pelvis and in the presence of anomalies in its development.
Multiple pregnancy.

What is the norm?

A healthy pregnancy and childbirth imply the following sequence of events: when the 38th, 39th, 40th week of pregnancy arrives, labor can begin at any time. When one of the contractions occurs, the bladder containing the amniotic fluid ruptures, 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 rupture occurs and on how the amniotic fluid leaks, the following classification has been developed:

Timely. It begins at the end of the first labor period with complete or almost complete dilatation of the cervix.
Premature. When it is 39, before the onset of stable labor.
Early. Leakage during labor, but before dilation of the cervix.
Belated. Occurs due to the high density of the membranes. The effusion begins in the second labor period.
High shell rupture. Occurs at a level above the cervix.

Ideally, the outpouring should be timely. But in conditions of full-term pregnancy, which exceeds 37 weeks, any option may be favorable if normal labor eventually develops. This condition is considered dangerous if the period is less than 37 weeks.

Why is leakage dangerous?

In order to understand all the consequences that threaten premature rupture, it is necessary to understand the functions that amniotic fluid carries:

Barrier to infection. Infection through the maternal genitals can reach the child vertically.
Preventing umbilical cord compression. 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 baby to move freely.
Biologically active environment. There is a constant exchange and secretion of chemicals between mother and baby.

If disorders develop, all functions are affected, but the most dangerous complication is intrauterine infection, because leakage occurs due to loss of integrity of the membranes. As a result, the tightness of the environment is lost, protection from external influences is lost, and sterility is compromised. Viruses, bacteria, and fungi can penetrate the fetus.

If leakage is detected...

If an outpouring occurs, this can cause the fetus to become infected with various infections, which without barriers can overcome all protection. As soon as the obstetrician is sure that there is a leak, 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 functioning outside the uterus, this is done to prevent the child from contracting an infection.

If the fetus is not ready for independent life, measures are taken to prolong the pregnancy - doctors will wait for the fetus to be ready for childbirth. Therapy boils down to the following:

Prescribing antibacterial drugs. This will help prevent intrauterine infection.
Strict bed rest. Rest and a stable position facilitate the therapy.
Permanent monitoring of the child’s health and condition, as every day is considered important. The baby has every chance of growing to a viable state in the mother's womb. An assessment of his blood flow and movement is carried out.
The mother undergoes laboratory tests and her body temperature is measured.
If there are no signs of infection, expectant management continues. Preparation may be carried out respiratory tract child to independent functioning, for which they may be prescribed hormonal drugs. This is not dangerous, all measures are aimed at preserving the health of mother and child.

Instead of a conclusion

Premature leakage of water can be prevented if a woman, if she has risk factors, carries out appropriate prevention. For example, timely treatment of cervical insufficiency is implemented, when a suture can be placed on the cervix of the uterus, a special one is introduced. In some cases, conservation therapy, sanitation of the genital tract and other potential infectious foci (pyelonephritis, caries, tonsillitis) are carried out. The most favorable prognosis occurs when rupture occurs in full-term pregnancy. However, the expectant mother should not panic; it is advisable to remain calm and follow all the doctor’s instructions.

Every woman expecting the birth of a baby should understand the importance of amniotic fluid because it performs many useful and significant functions for life. There are pathologies that cannot be ignored.

The importance of amniotic fluid during pregnancy is justified by its necessity for the normal development of the baby. This fact has been proven by many medical studies. Pathologies can lead to serious disturbances in the development of the fetus, so each makes it possible to control the condition and volume of amniotic fluid.

Having become pregnant, a woman must understand that the first element for a child is water. During the entire 9 months of gestation, the fetus lives in amniotic fluid. The baby develops, grows there, and all its organs and systems are formed. This habitat is of great importance to the child.

Amniotic fluid satisfies the baby's needs and carries information about the baby's condition and immunity.

Amniotic fluid during pregnancy has a very large list of functions of renewal and maintenance of immunity, necessary for both mother and child. That is why you cannot ignore alarming symptoms that may indicate problems.

Functions of amniotic fluid:

The thermoregulatory function is necessary for the baby, because for the normal development of the child, the optimal temperature in the womb must be maintained - 37 degrees.
Immune protection. Amniotic fluid contains all the necessary components for the development and protection of the baby.
The mechanical function protects the baby from the influence of external factors. Thanks to it, a comfortable stay of the child in the womb is ensured.
The umbilical cord protection feature significantly softens shocks. Also, thanks to the amniotic fluid, the umbilical cord is protected from mechanical stress.
Hermetic isolation from infections. Thanks to the liquid, the baby is under reliable protection.
The amniotic fluid also contains elements that prevent the baby’s body parts from merging.
The function of ensuring optimal development is no less important. Thanks to this, the baby grows, develops and receives all the necessary elements.
Metabolism support.
Formation of the fetal circulatory system.
Prevention of bleeding.
Thanks to the structure and composition of the amniotic fluid, it is easier.

Composition of amniotic fluid

About 97% of the amniotic fluid is water, it contains elements such as proteins and salts. Skin particles, hair, and compounds called alkaloids are also present. It is believed that the smell of the liquid is similar to breast milk.

For this reason, as soon as the baby is born, he accurately understands where the mother’s breast is, at the level and by smell. When amniotic fluid appears, the baby’s kidneys begin to work, and the baby’s body’s defenses are renewed.

Amniotic fluid is renewed approximately once every 3 hours, with the baby processing a third of it.

Volume and norm of amniotic fluid

The volume of amniotic fluid is determined by the Amniotic Fluid Index (AFI), it is measured in millimeters. It is difficult to talk about the norm of amniotic fluid, since its volume directly depends on the individual characteristics of the mother, baby and the course of pregnancy. However, there are still approximate guidelines.

Norm of amniotic fluid by week of pregnancy

Gestation period, weeks	Average normal value, mm	Probable fluctuations, mm
16	121	73 – 201
17	127	77 – 211
18	133	80 – 220
19	137	83 – 225
20	141	86 – 230
21	143	88 – 233
22	145	89 – 235
23	146	90 – 237
24	147	90 – 238
25	147	89 – 240
26	147	89 – 242
27	156	85 – 245
28	146	86 – 249
29	145	84 – 254
30	145	82 – 258
31	144	79 – 263
32	144	77 – 269
33	143	74 – 274
34	142	72 – 274
35	140	70 – 279
36	138	68 – 279
37	135	66 – 275
38	132	65 – 269
39	127	64 – 255
40	123	63 – 240
41	116	63 – 216
42	110	63 – 192

There are pathologies in which the volume of amniotic fluid may be more than normal - polyhydramnios or less than normal - oligohydramnios. More about their reasons below.

Color of waters

According to known standards, the water in the womb should have a transparent light color. They should not contain any impurities. In another case, there may be a pathological process that can cause harm. If abnormal, the water may become cloudy or green.

Diagnostic value

It is not for nothing that amniotic fluid during pregnancy is considered a living environment, thanks to its presence in which the correct functioning of organs and systems is formed in babies. The kidneys begin their work due to the fact that the baby swallows water, which is excreted in the urine (amniotic fluid appears in the child’s bladder already at the age of 10).

After some time, the baby, like a fish, begins to “breathe” water, performing a significant exercise for his respiratory system, thereby preparing himself for breathing in an ordinary environment.

Also for diagnostic purposes, amniotic fluid can be used to identify genetic diseases.

Pathologies of amniotic fluid

Polyhydramnios – one of the types of pathological processes during pregnancy. This condition is characterized by the fact that the amniotic fluid begins to exceed the norm in volume. The exact quantitative indicator of the fluid is determined by the doctor using an ultrasound.

It was not possible to establish 100% reasons for these problems. But at the same time, there are certain groups whose risk of developing pathology is slightly higher than others:

Chronic diseases in a pregnant woman, for example, diabetes, heart disease.
Infections in any organs.
– a large volume of water in one fetus often comes with low water in another.
Large fruit size.
Defects in the formation of a child.

Polyhydramnios is characterized by the following symptoms: abdominal pain, shortness of breath, swelling of the limbs, too rapid pulse. A patient with such symptoms will need to go to the hospital and undergo a series of additional examinations.

The plan and duration of treatment depends on the cause of polyhydramnios. The patient may be prescribed vitamins, antibiotics, and diuretics. During treatment, the doctor monitors weight, blood pressure, and temperature. Cardiography and ultrasound are prescribed. The general condition of the child and mother is kept under control, the doctor monitors the slightest changes in the patient’s health.

There is another side to this pathology, called oligohydramnios . In this condition, the volume of amniotic fluid is less than normal. Oligohydramnios is a problem that any expectant mother may face.

Reasons that can provoke pathology:

Complex birth defects kidneys in the fetus.
Chronic diseases of the expectant mother, for example, diabetes, cardiovascular diseases.
Infections in the genitals.
The expectant mother has bad habits.
The presence of viruses and infections, past influenza.
Availability of late .
Pathological changes in the placenta.
Multiple gestations - when one embryo has little water, it often goes with polyhydramnios in the other.
The time when the baby is carried longer (the placenta becomes obsolete and the amount of water decreases).

An expectant mother who is faced with such problems may experience aching pain in the abdominal area, fetal movement becomes painful, the general condition worsens, and weakness may appear. An important symptom is high temperature.

The woman is admitted to the hospital. All manipulations will be aimed at maintaining the baby and the expectant mother in normal condition. Thanks to special medications and procedures, the health and condition of mother and child are restored to normal.

In nature, everything is thought out to the smallest detail, including the habitat of babies in the mother’s belly - amniotic fluid. During pregnancy, the state of amniotic fluid changes every week. Obstetrician-gynecologist Anna Sorokina will tell you why this depends and how the changes affect the development of the fetus.

The baby swims in amniotic fluid for the entire nine months of life before birth. This is a wonderful living environment that fully meets the baby's needs.

To understand where amniotic fluid comes from, let's remember our school anatomy lessons: an egg fertilized by a sperm attaches to the uterus and begins to divide. As a result, four components appear - the fetal membranes, the chorion (future placenta), the umbilical cord and the embryo itself ( unborn child). By the end of the second week of pregnancy, the fetal bladder already occupies the entire uterine cavity; the liquid inside is absolutely sterile. Until 14 weeks of pregnancy, amniotic fluid (amniotic fluid) seeps into the baby's body through the skin, and when it skin enriched with keratin and thickened, the baby swallows amniotic fluid and excretes it in the urine. Over time, the volume of liquid processed reaches several liters per day.

How does oligohydramnios threaten the fetus?

Oligohydramnios (or oligohydramnios) is a complication of pregnancy, sometimes even dangerous for the fetus, because it is at risk of infection, which can even lead to its death.

For example, when the integrity of the membranes is lost - this is when amniotic fluid leaks - the child becomes vulnerable to infections entering the membranes.

A woman’s reproductive tract is not sterile, pathogenic microorganisms constantly live in the vagina, “plus” the immune system is weakened due to pregnancy. All this can lead to the proliferation of harmful bacteria, which can penetrate inside the uterine cavity and infect the membranes, causing inflammation, called chorioamnionitis in gynecology. Without timely treatment, the fetus itself becomes infected.

This applies to oligohydramnios caused by a violation of the integrity of the membranes.

With severe oligohydramnios, regardless of the reasons for its occurrence, the baby suffers from hypoxia (lack of oxygen), because of this it lags behind in intrauterine development. In addition to all this, it is uncomfortable for the baby to be in such a “nest”; his neck is often curved, and the bones of the face and head are susceptible to deformation due to compression by the walls of the uterus.

Moderate oligohydramnios does not have such a critical effect on the health of the fetus: the baby is weak and lags behind in gaining body weight (so-called malnutrition is observed), his muscle tone is reduced (possible development of torticollis, clubfoot), and mild fetal hypoxia occurs.

If screening and urine/blood/smear tests are normal, the cardiotocogram (CTG) is normal and the fetus is developing well, and the pregnant woman has no complaints about her health, then the diagnosis of oligohydramnios is conditional. Obstetricians will simply prepare to induce labor, since there is a high probability of a post-term pregnancy, or for a cesarean section if the fetus is not in a standard position at the due date.

Diagnosis of oligohydramnios

During an ultrasound examination, the doctor makes some measurements and calculations to determine the amount of amniotic fluid, after which he makes a conclusion about oligohydramnios, a normal amount of water, or polyhydramnios.

Miscarriage

A gynecologist can also suggest low or polyhydramnios during the next measurement of the abdominal circumference and the height of the uterine fundus, but a more accurate diagnosis can only be made with the help of an ultrasound.

At home, you can only conduct a test for leakage of amniotic fluid. If they are often observed on underwear watery discharge, and the baby’s kicks have become painful for the pregnant woman, although such discomfort was not felt before, or the size of the abdomen is too small, although the pregnancy has already exceeded 20 weeks, then it is advisable to conduct a special test. Perhaps the reason for everything is oligohydramnios, caused by leakage of water due to a violation of the integrity of the membranes.

The test can be carried out at home by observing the discharge for some time, or by purchasing a special test for leakage of amniotic fluid at the pharmacy and using it.

The “free” test is carried out as follows: empty your bladder, take a shower (without douching and possible water getting inside the vagina), wipe yourself dry with a towel and lie down on a dry diaper. Lie motionless for 15 minutes, and then get up and see if a wet spot appears on the diaper. Normal discharge is not capable of forming and flowing out so quickly; most likely, it is amniotic fluid leaking. You can find out more accurately by contacting the LCD with a complaint about unusual discharge. There they will conduct a special test and say it is water or normal vaginal discharge.

The pharmacy test looks like a pad, the surface of which will change color to blue or green if amniotic fluid leaks.

Coloring also occurs with bacterial/viral discharge, so if you notice blue-green spots on the surface of the pad, contact your gynecologist.

Any test for leakage of amniotic fluid is recommended to be carried out 12 hours after the last sexual intercourse, douching or use of vaginal suppositories.

Treatment of oligohydramnios

It is impossible to artificially increase the amount of amniotic fluid, so treatment of oligohydramnios comes down to determining the causes of its occurrence. Next, the root causes of oligohydramnios are treated.

To determine the causes of oligohydramnios, the pregnant woman is referred for a Doppler ultrasound or cardiotocography (CTG) in order, first of all, to refute or confirm a violation of blood flow in the placenta.

If the fetoplacental blood circulation is still impaired, then the patient is prescribed drugs to normalize it - Curantil, Actovegin.

Moreover, Curantil is often prescribed as a measure to prevent fetoplacental insufficiency.

Often, the treatment complex includes medications that help normalize metabolic processes in the pregnant woman’s body (for example, Magne + B6) and support the normal functioning of important internal organs women (for example, Hofitol).

It is also necessary to exclude the presence of infections in the pregnant woman. For this purpose, urogenital smears are taken again for STIs and from the throat + nose for cocci, and a blood test is performed for TORCH infections. If infection is present, antibiotic therapy is prescribed.

Childbirth with oligohydramnios

In case of severe oligohydramnios, a planned caesarean section is prescribed. With a small volume of amniotic fluid, the fetal bladder takes on a flat appearance. Because of this, contractions will be irregular and weak, and labor may be long and difficult.

Moderate oligohydramnios is not a contraindication for natural childbirth. Even with a breech or breech presentation of the fetus caused by oligohydramnios, the birth proceeds safely for both the mother and her child.

An insufficient amount of amniotic fluid does not allow the baby to move freely inside the womb. Therefore, the child often takes a transverse or buttock position and can no longer roll over correctly.

There are various exercises that can help turn the baby into the desired position, but their effectiveness has not been confirmed from a medical point of view. Exercise can lead to umbilical cord entanglement, so you need to weigh the pros and cons before doing it.

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During 9 months of pregnancy, the unborn child develops in a special sac, which obstetricians call the amniotic sac. This transparent and tightly closed pouch is filled with a special liquid that protects the baby throughout pregnancy. This fluid is called amniotic fluid.

When the time comes for childbirth, the bladder ruptures and all the fluid comes out. Obstetricians call this rupture of amniotic fluid, and often rupture of the membranes indicates the beginning of labor and provokes contractions.

Amniotic fluid performs a number of important functions.

Firstly, they protect the child from infections, as they contain antibacterial and antimicrobial substances.

Secondly, water is a kind of shock absorber and protects the child from various possible injuries, shocks or impacts.

And thirdly, they help the child master digestion and breathing, since with their help the baby can train the lungs and also learn to swallow.

The consistency of amniotic fluid is not similar to the water we are used to. They are transparent, but thick, sometimes yellowish or pinkish. While the baby is developing in the womb, he tastes them, and if the mother ate something sweet, the baby feels it, since the sugar enters the mother’s body. Also, the child trains the lungs by inhaling amniotic fluid and exhaling it back.

From the very beginning of pregnancy, the amount of amniotic fluid gradually increases, and towards the end of the third trimester it gradually decreases to give the growing baby more space in the uterus. Sometimes they may be too small throughout pregnancy, and then the doctor makes a diagnosis of oligohydramnios. Sometimes too much, and then we can talk about polyhydramnios.

IAI norm

The composition and quantity of the contents of the fetal bladder plays a big role in the formation of the future baby and his well-being. If their volume is normal, the doctor concludes that the child feels well and is developing normally. Too little amniotic fluid and, conversely, too high an indicator indicate that something is wrong in the expectant mother’s body, which means that the health of the fetus may be in danger.

To find out if everything is okay, you need to do an ultrasound. Using ultrasound, the doctor will be able to determine the approximate amount of water in the bladder. Your baby is constantly swallowing amniotic fluid and also urinating, so the difference in the amount of water may be noticeable throughout the day.

It must be remembered that this liquid changes in composition every 3-4 hours a day, and is completely renewed every 24 hours, which means that its composition and quantity also change constantly. Therefore, do not be alarmed if the IAF, according to the study, differs from the one shown in our table. In any case, check it out with our calculator and compare it with the values.

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The amount of amniotic fluid during pregnancy: norms and deviations

The amount of amniotic fluid during pregnancy depends on its duration. You can even find a special plate that shows the values for each week. They are determined by simple measurements during an ultrasound examination. In his report, the doctor must write the index of amniotic fluid, whether it is normal or not. Let's talk about what is a violation, what are possible reasons abnormalities and how to treat them.

There are two pathologies - polyhydramnios and oligohydramnios. When making these diagnoses, doctors rely both on examination data (length of the uterus, abdominal volume, including the rate of growth of the uterus, fetal mobility) and on the results of measurements by an ultrasound diagnostic physician.

Severe polyhydramnios, when the amniotic index is more than 240 mm (the length of the vertical pocket according to ultrasound is more than 800 mm) is a reason to suspect one of the following conditions:

diabetes mellitus (possibly gestational);
pathology of the central nervous system the fetus, for this reason it may lack a swallowing reflex, which means the amount of amniotic fluid is constantly growing;
violations heart rate(can be caused by a variety of reasons, for example, hydrops fetalis);
pathologies of the respiratory and digestive organs in a child;
chromosomal abnormalities.

The last point is excluded by ultrasound performed at strictly designated periods of pregnancy, as well as triple screening. To exclude gestational diabetes mellitus, a carbohydrate tolerance test is performed. Plus, you need to exclude cytomegalovirus, toxoplasmosis, syphilis, parvovirus, and also do a Kleihauer test (if there is a possibility of Rh conflict). Naturally, after identifying the cause, it is necessary to eliminate it or at least minimize its harmful effects.

If polyhydramnios is detected, the woman should undergo an ultrasound again after 7-10 days to see if there is a sharp increase in water. The same fact can be noticed by the sharp growth of the abdomen. If so, in this case, the woman is admitted to the hospital and treated with indomethacin and/or a reduction amniocentesis is performed - excess fluid is removed from the amniotic sac.

The causes of oligohydramnios also include possible infectious processes in the mother’s body, as well as malformations of the fetus. These reasons should be excluded in case of severe oligohydramnios. This is considered especially dangerous in the early stages. In this case, oligohydramnios is almost always combined with serious vice fetal development. Often, ultrasound examination of such children reveals polycystic kidney dysplasia, Potter's syndrome and other pathologies of the urinary system. The most difficult situation is when there is no water at all. This condition is called ahydramnios and is both a symptom of a severe disease of the fetus and a cause for the formation of additional malformations (usually skeletal deformities, especially facial bones).

If moderate oligohydramnios is recorded over a long period of time, it is less dangerous. And it can often be a variant of the norm if other ultrasound data are normal and the patient is healthy (the size of the uterus is normal, tests are in order). Knowing the norm of amniotic fluid and the woman’s medical history, the doctor can quite easily draw a conclusion about whether it is worth worrying and conducting additional examination and treatment. If there is a suspicion of amniotic fluid leakage, an amniotest should be done.

Often, oligohydramnios accompanies gestosis (late toxicosis) in pregnant women. But it is quite easy to diagnose and treat. But more often, women with oligohydramnios diagnosed by ultrasound give birth to healthy babies and after the amniotic fluid breaks, it turns out that there was no oligohydramnios (water more than 500 ml). If the oligohydramnios is true, then the woman will face a difficult, protracted labor due to the weakness of labor. The risk of birth injuries in the child and cervical rupture in the mother increases. Unlike polyhydramnios, oligohydramnios, unfortunately, cannot be corrected. In case of a serious condition of the fetus, a great risk to its health and life, the woman may undergo an emergency caesarean section.

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Amniotic fluid index

Throughout pregnancy (except for its earliest stages), the fetus is surrounded by amniotic fluid, or amniotic fluid. the environment in which the baby floats, like an astronaut in outer space, not only protects him from external influences and maintains the required temperature, but also participates in metabolism. The amount of amniotic fluid is constantly changing over the course of nine months, but for each period of pregnancy there are norms for the volume of amniotic fluid. Deviations in one direction or another may mean that not everything is in order with the fetus.

The volume of amniotic fluid can be 600-1500 ml. The amount of amniotic fluid less than 500 ml is considered oligohydramnios, more than 1.5-2 liters is considered polyhydramnios. Ultrasound examination helps to make an accurate diagnosis.

During the ultrasound procedure, a specialist visually determines the amount of fluid using transverse scanning. If there is a lot of amniotic fluid, polyhydramnios is diagnosed, if there is little, oligohydramnios is diagnosed. For any deviation from the norm, the doctor conducts a more thorough examination - calculating the amniotic fluid index. To do this, the uterine cavity is conventionally divided into 4 equal parts by two lines, one of which runs vertically, along the white line of pregnancy, and the other horizontally at the level of the navel. In each part, the maximum vertical pocket (free space between the wall of the uterus and the fetus) is measured, the results are summed up to obtain the amniotic fluid index.

Each period of pregnancy has its own norms for this indicator. For example, the normal amniotic fluid index at 22 weeks will be 14.5 cm, or 145 mm (possible fluctuations should fall within the range of 89-235 mm). And at 32 weeks, the amniotic fluid index will be 144 mm, with deviations ranging from 77-269 mm. Values for different stages of pregnancy can be found in the amniotic fluid index table.

Amniotic fluid index - deviations from the norm

Deviations from the norm are indicated if the amniotic fluid index is lower or higher than the values indicated in the table. Both polyhydramnios and oligohydramnios indicate possible pathologies in the development of the fetus or the course of pregnancy.

With polyhydramnios, the child often takes an incorrect position in the uterus, and sometimes ends up entwined with the umbilical cord. Excess amniotic fluid can cause premature rupture and premature birth. An overstretched uterus contracts worse during childbirth and the postpartum period, which can lead to weakness of labor and the development of bleeding.

The main causes of polyhydramnios are:

developmental defects (nervous and digestive systems) and chromosomal abnormalities of the fetus;
pregnancy due to Rhesus conflict;
infectious disease of a pregnant woman;
diabetes mellitus in a pregnant woman.

If the amniotic fluid index indicates severe oligohydramnios already in the second trimester of pregnancy, then a life-threatening situation for the fetus may arise—compression of the umbilical cord. In addition, the child is trapped in the uterus, his movements are limited. After birth, such babies often have problems with the spine and hip joints.

The development of oligohydramnios can lead to:

malformations of the fetus (excretory system and kidneys);
hypoxia and fetal malnutrition;
fetoplacental insufficiency;
post-term pregnancy;
infection;
hypertension in pregnancy;
smoking.

Contrary to the beliefs of some women, the amount of fluid they drink does not affect the change in the volume of amniotic fluid in the placenta.

The protection of the baby in the mother's belly, its stable growth and proper development are ensured by amniotic fluid during pregnancy. The enlarged uterus contains a fetal bladder filled with a special liquid substance. It is a “home” for the baby for the entire long period of pregnancy, almost from the very moment of conception. Therefore, it is especially important to monitor the condition of this fluid and correct any deviations that appear in a timely manner.

Formation and functions of amniotic fluid

The Greek concept "amnion", meaning the membrane of the fetus, gave the name to amniotic fluid - a nutrient medium for intrauterine development child. Immediately after the fertilized egg enters the uterus and attaches to it from the inside, a chorion is formed at the attachment site (in the future it will become the placenta). With the help of the umbilical cord, the chorion is connected to the amnion - the fetal bladder. Real magic happens inside the amnion - a baby develops from several cells over time. Reliable protection is provided by the thin and elastic, but very strong walls of the bladder.

The fetus is located in the amnion, filled with amniotic fluid or amniotic fluid.

The amnion is filled with fluid, the sterility of which is achieved by regular renewal. How is amniotic fluid renewed during pregnancy? Until the middle of the term, they are produced by the cells of the fetal bladder, and after the 20th week they are mainly produced by the baby’s kidneys. At the end of pregnancy, the fluid is renewed 8 times a day.

Amniotic fluid provides versatile protection for the child:

Thanks to the content of immunoglobulins, the baby is reliably protected from all kinds of infections
If the mother accidentally falls, the shock is absorbed due to the presence of liquid, and no harm is caused to the child
The umbilical cord remains free and is not pinched.

The temperature inside the bubble is constant and amounts to 37 degrees Celsius. Until about the third trimester, the baby can even make swimming movements, as long as there is enough space for this.

Water characteristics

More than 95% of the composition of amniotic fluid is water. The rest consists of vitamins, microelements, even particles of fetal skin and hair. Towards the end of pregnancy, when the baby masters urination, urine also appears in the fluid. But thanks to frequent renewal, the composition of the liquid remains unchanged. There is an opinion that the liquid smells similar to breast milk, which is why a newborn baby unmistakably finds the mother’s breast.

The amount of amniotic fluid increases from week to week, reaching a maximum two weeks before the planned due date.

At 38 weeks, the volume of amniotic fluid is approximately 1-1.5 liters. Further, the amount of water decreases, and by the time of birth there is already about 800 ml of water left.

Various pregnancy pathologies can affect a decrease or increase in the amount of amniotic fluid.

Normally, amniotic fluid should be clean and transparent. If suspended matter appears in the waters, this most often indicates infection.

Diagnosis of the condition of a pregnant woman and child using amniotic fluid

The condition of the amniotic fluid is one of the main indicators of the normal or pathological course of pregnancy, as well as the condition of the unborn child. The amount and homogeneity of water can be assessed by ultrasound examination, which every woman should undergo at least three times during pregnancy.

If necessary, amniotic fluid analysis can determine the child’s gender and blood type. In addition, suspicion of genetic abnormalities in the fetus can be confirmed or refuted by analyzing the amniotic fluid.

If it is necessary to determine whether the child is ready to be born, amniotic fluid is also taken for analysis. Based on the results of the analysis, emergency delivery by cesarean section can be performed. Fluid analysis also makes it possible to find out about the readiness of the newborn’s respiratory system to work independently.

Possible problems

Unfortunately, pregnancy does not always go smoothly. There are cases when disturbances in the quantitative or qualitative composition of the amniotic fluid provoke the occurrence of various pathologies.

Polyhydramnios.

This condition is said to occur when the amount of amniotic fluid exceeds one and a half liters. This condition can be caused by kidney problems in the mother, infectious diseases, cardiovascular pathologies of the mother, or congenital diseases of the child. In case of multiple pregnancy Polyhydramnios is also quite common.

With polyhydramnios, the amount of amniotic fluid exceeds 1.5 liters

Polyhydramnios is usually detected in the second or third trimester of pregnancy. If polyhydramnios occurs suddenly against the background of the previous normal state, delivery should be carried out immediately.

Low water.

The opposite situation occurs when the amount of water does not exceed 500 ml. Oligohydramnios can be caused by hypertension in a pregnant woman, inflammatory diseases of the female genital organs, overweight of the expectant mother, or disturbances in the functioning of the fetal urinary system. The condition is dangerous due to the risk of hypoxia (oxygen starvation) of the child, therefore appropriate treatment aimed at increasing the production of amniotic fluid should be carried out immediately.

Low water can also have a negative impact on the process of childbirth - the fetal bladder will not be able to press on the cervix with sufficient force, so its slow opening will lead to weak labor.

With oligohydramnios, the risk of premature birth doubles, and babies, due to lack of space, are much more likely to take an incorrect position in the uterus, not having time to turn into a cephalic presentation in time.

Oligohydramnios often makes itself felt by abdominal pain in the expectant mother - the child does not have enough space, and his every movement is difficult and painful. A reduction in the amount of amniotic fluid can lead to compression of the umbilical cord, resulting in oxygen starvation and even fetal death.

Water leakage.

In normal condition, the amniotic sac remains intact throughout pregnancy, and the rupture of water indicates the beginning of active labor. However, there are times when the water begins to flow prematurely. Such a situation or even the slightest suspicion of it requires an urgent examination by a doctor, since a decrease in the amount of amniotic fluid can seriously harm the child’s health if assistance is not provided in a timely manner.

You can check whether water is leaking using special tests

A sign of water leakage is a sharp increase in fluid secretion when changing body position. Water leakage can be accurately determined using pharmacy tests. If the condition is confirmed, it is necessary to contact the maternity hospital as quickly as possible - perhaps this is a signal of the onset of premature labor.

The waters are of atypical color.

In a normal state, waters are transparent and free of impurities. True, towards the end of pregnancy, impurities inevitably appear - these are epidermal cells and fetal vellus hair. This state of water is quite normal and does not threaten the child’s development in any way. However, the green color and cloudiness of the waters may indicate a serious pathology - fetal hypoxia. In this case, when there is a lack of oxygen, the muscles of the anus reflexively contract, and meconium is released into the amniotic fluid.

Another reason for premature passage of meconium is the aging of the placenta as a result of postterm pregnancy. In this case, the placenta ceases to fully supply the fetus with oxygen, as a result of which the child develops oxygen starvation. The anal muscles contract again and meconium is released.

If a baby swallows amniotic fluid mixed with meconium, it negatively affects its development, so green water requires immediate medical intervention.

Is it possible to avoid problems?

Amniotic fluid is a nutrient medium that ensures the development of the child in the womb until birth. Any violations and deviations require close attention and medical supervision. Most amniotic fluid pathologies can be successfully corrected in a hospital setting with the help of medicines and vitamins. The patient must maintain complete calm, both physical and mental. ABOUT physical activity and an active lifestyle will have to be forgotten for a while.

It would also be a good idea to remind you of the need to visit a doctor who is monitoring your pregnancy. It is constant monitoring that allows you to avoid many problems that negatively affect the normal course of pregnancy.

19.01.12

While the baby is growing in the mother's belly, he is surrounded by amniotic fluid, in which he floats freely throughout the entire period of pregnancy. The rupture of amniotic fluid indicates the onset of labor. How important is the amount of this fluid for a child's life? Let's try to figure it out.

The main function of water is protective. They smooth out sudden movements from the outside that could harm the unborn child, and also protect the umbilical cord so that the fetus does not press it against the wall of the uterus and the blood flow does not stop. Amniotic fluid plays an important role in the child's metabolism. They deliver nutrients, hormones and immunoglobulins and remove metabolic products from the body - urine, hairs, skin flakes, etc. In addition, it is the amniotic fluid that is actively involved in the process of childbirth - firstly, it makes contractions less painful, as it serves as a natural buffer, and secondly, the lower waters (located under the baby’s head, if he is in the most common cephalic presentation) press from the inside onto the uterus, causing it to open faster and better.

Amniotic fluid renewal

Amniotic fluid (or amniotic fluid) is a non-static substance. They are constantly renewed, “waste”, “polluted” waters are removed from the body, and their place is taken by renewed ones. The inner surface of the placenta and the fetal membranes are involved in the formation of amniotic fluid. And even the child himself influences the amount of amniotic fluid, since it is he who swallows the fluid surrounding him and secretes urine.

The process of water exchange occurs continuously - they are completely renewed within 3 hours.

A serious complication of pregnancy is leakage of amniotic fluid. Signs of amniotic fluid leakage may go unnoticed. A woman may mistake wetness on her underwear for sweat or vaginal discharge. Do not draw conclusions on your own; describe the situation to your gynecologist in detail. If amniotic fluid leaks, there is a risk of infection for mother and child.

Amount of amniotic fluid: polyhydramnios and oligohydramnios

The amount of amniotic fluid is not the same throughout pregnancy. In the first 18-20 weeks, their volume is proportional to the size of the child. Towards the end of pregnancy, the normal amount of water is from 600 to 1500 ml. It is for the purpose of determining the amount of amniotic fluid that women are recommended to have an ultrasound scan at 37-38 weeks, since deviations from these parameters can have a detrimental effect on the health of the mother and child.

Polyhydramnios during pregnancy

Polyhydramnios during pregnancy is a situation when the amount of amniotic fluid in the amniotic fluid exceeds 1.5 - 2 liters. You can notice the symptoms that this is happening even externally - in women with polyhydramnios, as a rule, the abdomen grows very much, and many “stretch marks” appear on the skin. During the examination, it is necessary to resort to additional examination methods, since it is difficult for the doctor to determine the location of the organs in the fetus and hear the heartbeat. The woman finds it difficult to breathe, her pulse quickens, and her legs become very swollen.

Complications of polyhydramnios during pregnancy

Pregnancy becomes a heavy burden for the mother in the literal sense of the word, and the child is completely exposed to a mortal threat. Since too much space allows for additional movements, and at this time the umbilical cord can wrap around the cervix. Also, the presence of excess amniotic fluid can lead to incorrect presentation - breech or transverse.

An increased amount of amniotic fluid is often discharged before term, which provokes premature birth. But since the uterus itself was too swollen during pregnancy, it may contract worse, which will lead to a weakening of labor. In this case, labor may be delayed, which negatively affects both the health of the mother and the condition of the child; both may experience hypoxia (lack of oxygen in the blood).

Causes of polyhydramnios during pregnancy

There may be several reasons for the increase in the amount of amniotic fluid. Basically, polyhydramnios is caused by infections suffered at different stages, disrupting the functioning of the amnion, disturbances in the development of the fetus (most often the nervous and digestive system, when the baby either does not swallow enough or secretes too much fluid), as well as feto-placental insufficiency, when the placenta does not produces amniotic fluid in the required quantity. Polyhydramnios often occurs in women suffering from diabetes mellitus, or during pregnancy aggravated by Rh conflict.

Pregnant women whose studies have determined polyhydramnios should be constantly under the supervision of specialists.

Ultrasound during pregnancy detects polyhydramnios

If you have been diagnosed with polyhydramnios, you will need additional ultrasound diagnostics, since ultrasound is the best way to determine the amount of amniotic fluid and identify possible fetal malformations. If polyhydramnios is not pronounced, does not interfere with the woman and does not impair blood circulation, the pregnancy continues until its natural completion, and the expectant mother is offered treatment for the cause that caused the increase in the amount of water. Most often this is an infection in the body, in which case the doctor will prescribe antibiotics. If the problem is other health problems (such as diabetes, or Rhesus conflict), these are the ones that are treated.

Oligohydramnios during pregnancy

Oligohydramnios is much less common than excessive amniotic fluid. Oligohydramnios is a condition when the amount of amniotic fluid is less than 500 ml. The expectant mother herself can notice and feel it: the belly is growing poorly, prints of parts of the child’s body can even be visible on the outside, the baby’s movements cause pain. Low water also has a negative effect on the fetus itself: the wall of the uterus is too close, they compress both the child and the umbilical cord. Because of this, the baby lags behind in development, he is too small and weak, his skin becomes dry and covered with unnecessary folds. Possible defects of the musculoskeletal system - curvature of the spine, torticollis, clubfoot and others.

Causes of oligohydramnios during pregnancy

Typically, oligohydramnios during pregnancy occurs due to insufficient functioning of the amnion (fetal membrane), which, as with polyhydramnios, can be caused, for example, by an infectious process in the pregnant woman’s body. The amount of amniotic fluid may decrease if the child’s development is impaired, especially with defects of the kidneys and excretory systems, as well as in the case of fetal hypoxia, since at this time the fetus also produces little urine. Oligohydramnios can occur in one of the identical twins if the second is characterized by polyhydramnios. This happens when the blood circulating from the common placenta is distributed unevenly. The amount of water decreases during post-term pregnancy. Smoking during pregnancy also causes oligohydramnios.

Treatment of oligohydramnios during pregnancy

Treatment of oligohydramnios is carried out in almost the same way as in the case of polyhydramnios. The woman is under constant medical supervision, and in case of serious suffering for her and/or the child, early delivery is offered. If mother and child feel well, spontaneous birth on time is possible. However, with both excess and insufficient amounts of amniotic fluid, labor rarely begins spontaneously; usually the woman undergoes a puncture of the amniotic sac, since a large amount of water interferes with the contraction of the uterus, and with oligohydramnios, the flat amniotic sac does not open the uterus from the inside. In extreme cases, if the umbilical cord is entangled, the fetus is positioned incorrectly, or the condition of mother and child is extremely serious, a caesarean section will be performed. However, we wish you that your birth proceeds in accordance with the norms, and that problems do not frighten you.

Most of the time that a child spends in the mother's womb, he is protected by the placenta or, as it is also called, the amniotic sac. The amnion constantly produces amniotic fluid, in which the baby will remain until the very moment of his birth. This liquid protects the baby from bacteria and viruses, creates favorable conditions for his development, and allows him to stay warm and comfortable throughout the most important and responsible months of his life.

The temperature of the amniotic fluid is maintained by the body at a constant level and is about 37°C, provided that the woman is healthy. As for the amount of fluid, this indicator is constantly changing and directly depends on what week of pregnancy the expectant mother is at. It is also worth noting that the larger the baby becomes in the womb, the more fluid the amnion produces. The norm of amniotic fluid during pregnancy is 1-2 liters at the 36th week of pregnancy, but in the following days this figure may decrease slightly, because during preparation for childbirth the body begins to actively remove fluid.

Among the components of amniotic fluid you can find a wide variety of components, for example, proteins and carbohydrates, hormones and enzymes, fats and salts, various vitamins and glucose. Amniotic fluid also contains oxygen, carbon dioxide, immunoglobulin, waste products of the child and many other substances. The composition of the liquid is always variable and changes at least every 3 hours. In addition, the composition of the water also depends on the duration of pregnancy, because at different periods of development the baby requires different substances.

Why amniotic fluid is needed

The role of amniotic fluid in the process of growth and development of the fetus is difficult to overestimate, because thanks to the many functions that this substance performs, the child is not only under constant protection, but also has the opportunity to be born. We will tell you more about the functions of amniotic fluid below:

One of the purposes of amniotic fluid is the exchange of substances between maternal and child organisms. Those components that the baby requires for his development and maintenance of vital functions come to him through the amniotic fluid. Processed food, being excreted from the tiny body, also first enters the amniotic fluid, and only then is completely removed from the woman’s body. The waste products that enter the liquid also include the upper scales of the epidermis, particles of vernix, baby hairs and maternal blood components.
The second important function of amniotic fluid is its ability to protect the unborn baby from all sorts of harmful factors in the surrounding world. Thanks to the constant temperature of the water, the child in the womb will not be able to freeze, and besides, he is not afraid of physical influences such as blows, compressions, pressure. Amniotic fluid eliminates the risk of umbilical cord compression and gives the baby the opportunity to move freely in the mother’s belly.
The female body also made sure that the amniotic fluid was always absolutely sterile. Due to the fact that viruses, bacteria and other pathogens do not penetrate into them, the baby is reliably protected from diseases. Sterility is mainly maintained by constantly updating the composition of the liquid, which occurs at least every 3 hours.
Amniotic fluid not only helps the baby grow and develop in a safe environment, but is also directly involved in the process of childbirth. Firstly, the so-called anterior waters, by their pressure on the uterus, ensure better opening of its cervix. Secondly, while the baby is trying to be born, the amniotic fluid protects it until the very moment of birth. Thirdly, as the baby passes through the birth canal, water plays the role of a lubricant, facilitating this process.

In addition to the above useful functions, amniotic fluid also has important diagnostic value. By conducting certain water tests, the doctor can find out a lot of necessary information regarding the child’s health and the characteristics of his development. Thanks to diagnostics, it is possible not only to determine the baby’s gender and blood type, but also to obtain information about possible hereditary diseases or other abnormalities, the development of which can be prevented even during pregnancy.

Volume, composition, degree of transparency, color and consistency - all these parameters of amniotic fluid can be determined using the necessary tests. In addition, in the case of some pathologies, when emergency delivery is required, using such diagnostics it is possible to determine the degree of readiness of the child for birth. Based on the data obtained, a decision is made to use special medical equipment to support the baby’s life activity for a certain period of time.

Pathologies of amniotic fluid

Oligohydramnios during pregnancy

The condition when there is little amniotic fluid during pregnancy is called oligohydramnios. This pathology can occur if the amnion produces less fluid than is excreted from the body. It should be said that such a disease does not occur very often and accounts for no more than 1% of cases in the total number of pregnancies. Low water – serious problem, which requires attention and timely treatment. If this phenomenon is not eliminated, certain complications may arise:

Firstly, the pressure of the amniotic fluid on the uterine canal is significantly reduced, which, in turn, leads to difficulties in the process of delivery.
Secondly, oligohydramnios is fraught with complications such as premature birth. A child born prematurely will need special medical care.
Oligohydramnios is also dangerous because the baby is not able to move normally, which increases the risk of breech presentation of the fetus.
A very common companion to this pathology is hypoxia - a lack of oxygen necessary for the child. The consequence of hypoxia is growth retardation and fetal development abnormalities.

As a rule, it is not possible to notice such a pathology on your own, since oligohydramnios has almost no physically noticeable symptoms. Occasionally, a woman with a similar problem may feel minor pain in the abdominal area, but often this manifestation is simply absent. The disease can be detected using ultrasound, which is why timely testing and routine ultrasound examinations are so important for a pregnant woman.

If it is possible to detect oligohydramnios before 28 weeks, an examination of the expectant mother’s body will make it possible to find out the cause of the pathology and, if possible, eliminate it. To prevent the child from suffering from a lack of oxygen, it is important to start treatment as soon as possible - this will allow gas exchange and uteroplacental blood flow to be established. During therapy, the doctor monitors the baby’s condition and sometimes, if absolutely necessary, prescribes an early cesarean section.

Let's take a closer look at the causes of oligohydramnios during pregnancy:

the expectant mother has hypertension;
significant overweight pregnant;
infections and inflammatory diseases;
developmental disorders of the placenta;
inflammation in the pelvic organs;
polycystic kidney disease of the fetus, anomalies in the development of its genitourinary system.

Polyhydramnios during pregnancy

Approximately as rarely as oligohydramnios, the opposite pathology, polyhydramnios, can also occur. This problem occurs in 1-1.5% of pregnant women and represents an excess of amniotic fluid relative to the norm.

There are two types of polyhydramnios:

Chronic polyhydramnios is characterized by the fact that the amount of amniotic fluid increases gradually. If the pregnant woman is healthy and feels normal, the doctor may prescribe her diuretics - special medications responsible for removing fluid from the body. In addition, the doctor prescribes a certain diet that involves reducing the amount of salt in the diet. It is important to follow all the doctor’s recommendations, because polyhydramnios can have unpleasant consequences. An excessively enlarged uterus puts pressure on other organs, disrupting their function. In addition, polyhydramnios sometimes causes circulatory problems in the female body, it complicates labor and can cause heavy bleeding after childbirth.
The second type of polyhydramnios is acute. It is characterized by a sudden increase in amniotic fluid that occurs over several hours. As a rule, this disease makes itself felt with the following symptoms: abdominal pain, severe swelling, and shortness of breath. With such a pathology, a woman needs hospitalization. While undergoing hospital treatment, a pregnant woman is kept in bed, which makes it possible to reduce the risk of premature birth. If acute polyhydramnios is characterized by a continuous surge of water and threatens the health of the woman and her baby, abdominal amniocentesis can be used to eliminate the problem. During this operation, the placenta is punctured and excess fluid is drained out.

Among the causes of pathology are the following:

diabetes mellitus in a pregnant woman;
conflict of rhesus blood of mother and baby;
carrying twins;
the child has genetic diseases;
infection of the fetus in utero;
disruption of the membranes, which manifests itself in excess production of amniotic fluid even in early pregnancy.

Leakage of amniotic fluid during pregnancy

Another pathology of amniotic fluid is its leakage. This condition is characterized by the appearance of copious liquid discharge from the female genital tract. Amniotic fluid is distinguished from ordinary secretions by its transparency, colorlessness, very liquid consistency, and lack of odor. Often, leakage of amniotic fluid during pregnancy does not manifest itself with any symptoms other than the above-mentioned discharge. But the expectant mother may not pay attention to such manifestations, because during pregnancy, heavy vaginal discharge is the norm.

If a woman suspects that she has a similar pathology, she should immediately see a doctor. The specialist will prescribe tests that will determine the nature and origin of the discharge, after which the leakage of water can be refuted or confirmed. By the way, in pharmacies you can find special tests with the help of which such an analysis is carried out independently. But it is recommended to use this method only if it is completely impossible to see a doctor for some reason. In addition, if the test gives a positive result, the pregnant woman will one way or another have to go to the hospital for inpatient treatment.

If such a phenomenon makes itself felt after the 36th week of pregnancy, doctors can stimulate labor, and the baby will be born premature by only 1 week. If leakage of water occurs in the early stages, the woman requires hospitalization in order to maintain pregnancy for the maximum possible period. During hospitalization, strict bed rest should be observed. In some cases, when the period is too short and it is not possible to maintain the pregnancy for a long time, the situation is fraught with abortion.

The most common causes of amniotic fluid leakage are genital tract infections. To avoid such a risk, it is very important to monitor your health, observe personal hygiene rules, practice only safe sex and periodically get tested for the presence of pathogenic flora in the vagina.

Green amniotic fluid

Transparency, colorlessness, odorlessness and liquid consistency are the characteristics of normal amniotic fluid. Slightly cloudy amniotic fluid during pregnancy can be observed at the very end of the term and is also considered normal, since their appearance is due to the presence of epidermal scales and lubricant flakes that enter the fluid from the baby’s body. But if the amniotic fluid has acquired a greenish tint, we can talk about pathology. The green color of amniotic fluid is often due to particles of original feces, which the baby secretes when he lacks oxygen. Hypoxia is considered one of the most dangerous conditions of the fetus, because it not only interferes with the normal development of a small organism, but sometimes causes irreparable consequences.

Possible reasons why amniotic fluid may take on a green tint are described below:

If the waters were normal throughout pregnancy and turned greenish during labor, this can very often be the cause of the baby’s stress. When going through childbirth, the baby sometimes secretes meconium, which is why the liquid acquires a characteristic shade.
As mentioned above, the cause of this pathology during pregnancy can be such a dangerous condition as fetal hypoxia. It can be caused by post-term pregnancy. If the baby is in the womb for too long, the amniotic sac ages and does not perform its functions properly. Because of this, the baby experiences a lack of oxygen.
Sometimes a greenish tint to the amniotic fluid indicates infection. This happens if the expectant mother has had a cold, flu, bronchitis, suffered a genitourinary tract infection or some other inflammatory disease.
Very rarely, the cause of abnormal shade of amniotic fluid can be genetic diseases of the fetus.

Green waters can be dangerous for a child if he ingests contaminated liquid. If this phenomenon was detected in late pregnancy, the woman may be prescribed a cesarean section. If such a pathology is detected in the early stages, you should first identify the causes of the condition and take measures to eliminate them. Since the amniotic fluid is often renewed, it will be enough to eliminate the causes of the pathology to correct the situation.

In the event that a pregnant woman’s green water has broken, the process of delivery should begin as soon as possible in order to eliminate the risk of oxygen starvation and associated consequences.

Tests of amniotic fluid during pregnancy

There are several ways to assess the state of amniotic fluid during pregnancy, the simplest of which is considered to be ultrasound. This procedure does not harm the health of the woman and her fetus, but is the least informative. Using ultrasound, you can only visually determine the transparency of the liquid and determine its quantity. To obtain more detailed information, other studies are carried out, which we will consider in more detail:

Amniocentesis is a complex procedure in which fluid is taken directly from the amniotic sac. To do this, the woman's stomach is pierced with a special instrument and a small amount of amniotic fluid is drawn out. The procedure is performed under local anesthesia. This material is then sent for research, where immunological, biochemical, cytological and hormonal analyzes are carried out. Depending on the location of the amniotic sac, doctors determine the puncture site, and an ultrasound diagnostic device is used during the procedure. Amniocentesis is carried out if there is a conflict between the blood rhesus of the mother and the child, as well as if there are suspicions of chromosomal pathologies, hypoxia, or genetic diseases. Such an analysis is carried out even when the age of the expectant mother exceeds 40 years, as well as in cases when it becomes necessary to determine the maturity of the child’s lungs. Amniocentesis is not used if a woman has any inflammation in her body, if the pregnant woman suffers from pathologies of uterine development or diseases of the genitourinary system. If there is a threat of miscarriage, the procedure should also be abandoned.
Amnioscopy is another method for determining the status of amniotic fluid. During the procedure, the doctor inserts an amnioscope into the cervix and examines the lower pole of the placenta and amniotic fluid. Using the procedure, you can determine the amount of amniotic fluid, examine its color and identify the presence of hypoxia in the fetus.

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Intrauterine period: what contributes to the normal course of pregnancy. How amniotic fluid is renewed during pregnancy At what time does amniotic fluid appear?

How does a pregnant woman feel when her water breaks?

How to distinguish amniotic fluid from a mucus plug

Timely discharge of amniotic fluid - signs

Previous leakage of amniotic fluid

Delayed release of water in pregnant women

Lack of water breaking during labor

Amniotic fluid volume

Color of waters before childbirth

How long does it take between your water breaking and giving birth?

Possible problems

Green colored waters

Cloudy amniotic fluid

Bloody discharge

No contractions after water breaks

What to do when amniotic fluid leaks

Useful video about how water breaks before childbirth

Why does amniotic fluid leak?

At the beginning of gestation

In the middle and end of gestation

What does it look like

How to understand what kind of discharge it is

Management tactics for pregnant women with leakage

Is it dangerous for the fetus?

Symptoms of amniotic fluid loss

External differences

Special tests for home testing

Special testing tools

How to recognize leakage of amniotic fluid with a high level of confidence?

Additional manipulations

Risk factors

What is the norm?

Classification

Why is leakage dangerous?

If leakage is detected...

Instead of a conclusion

Composition of amniotic fluid

Volume and norm of amniotic fluid

Color of waters

Diagnostic value

Pathologies of amniotic fluid

How does oligohydramnios threaten the fetus?

Diagnosis of oligohydramnios

Miscarriage

Treatment of oligohydramnios

Childbirth with oligohydramnios

IAI norm

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The amount of amniotic fluid during pregnancy: norms and deviations

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Amniotic fluid index

Amniotic fluid index - deviations from the norm

Formation and functions of amniotic fluid

Water characteristics

Diagnosis of the condition of a pregnant woman and child using amniotic fluid

Possible problems

Polyhydramnios.

Low water.

Water leakage.

The waters are of atypical color.

Is it possible to avoid problems?

Amniotic fluid renewal

Amount of amniotic fluid: polyhydramnios and oligohydramnios

Polyhydramnios during pregnancy

Complications of polyhydramnios during pregnancy

Causes of polyhydramnios during pregnancy

Ultrasound during pregnancy detects polyhydramnios

Oligohydramnios during pregnancy

Causes of oligohydramnios during pregnancy

Treatment of oligohydramnios during pregnancy

Why amniotic fluid is needed

Pathologies of amniotic fluid

Oligohydramnios during pregnancy

Polyhydramnios during pregnancy

Leakage of amniotic fluid during pregnancy

Green amniotic fluid

Tests of amniotic fluid during pregnancy