Towards the middle of pregnancy, women begin to fear leakage of amniotic fluid. Sometimes the integrity of the fetal bladder is disrupted and the amniotic fluid begins to leak. The fact is that the leakage of amniotic fluid may not manifest itself in any way, but even micro-ruptures of the membranes are the entrance gate for infection, which is dangerous by the development of fetal pathologies, intrauterine death and premature birth.
Leakage of amniotic fluid occurs in 10% of women with a normal pregnancy, almost 40% of premature births are caused precisely by leakage of water, 20% of cases of intrauterine fetal death are caused by premature rupture of the membranes. Today in obstetrics, rather effective methods of preserving pregnancy are used, even in women with leakage of amniotic fluid, and there are therapeutic methods that allow preserving the health of a child during premature birth. But for this, it is necessary to timely identify the leakage of amniotic fluid.
Why does premature rupture of the membranes occur?
Normally, rupture of the membranes occurs before childbirth. The mechanism of childbirth is still not well understood, it is believed that this occurs under the influence of several reasons, which trigger the process of childbirth. Premature rupture of the membranes most often occurs due to infectious diseases of the mother - these are infections of internal organs, foci of chronic infection, infectious blood diseases, venereal diseases. For this reason, doctors always insist on treating thrush, even if the treatment has a short-term effect. Toxins released by microorganisms thin the membranes, which leads to microcracks and subsequent ruptures.
With a clinical narrow pelvis, transverse or breech presentation of the child, the contact belt is not formed, there is no clear division of the amniotic fluid into anterior and posterior, and the entire volume of amniotic fluid presses on the lower part of the bladder. Casings often fail to withstand pressure and break.
Diseases of the cervix
In women who have undergone surgery on the cervix, or have malformations, the cervix often does not withstand the load and the fetal bladder protrudes into the canal. Often, if the cervix is insufficient, special manipulations are performed by suturing or putting on a special cap. This prevents protrusion of the fetal bladder and allows the pregnancy to be maintained. In women with pathologies and abnormalities in the development of the uterus, water leakage is diagnosed more often. The use of alcohol, drugs, smoking during pregnancy is almost always fraught with complications, including not only rupture of the membranes and premature birth, but also fetal anomalies.
Many patients refuse amniocentesis and chorionic biopsy, as this procedure increases the likelihood of rupture of the membranes. Obstetricians also believe that these procedures should be carried out strictly according to indications. However, in pregnant women who are shown such procedures, other risk factors for premature rupture of the membranes are often identified, so there is no unequivocal opinion on this.
Signs of amniotic fluid leakage
Often, the amniotic fluid leaks slightly - in a few drops. Revealing such leakage is extremely problematic. A woman should be alerted by watery discharge from the genital tract, especially when changing body position. A decrease in the abdomen and the height of the fundus of the uterus indicates serious leakage.
Today there are special tests for home use. When water leaks, the acidic environment of the vagina shifts to the neutral side. However, in about 30% of cases, the tests give a false positive result.This can happen due to an infection of the vagina, leakage of urine into it, often a false positive test result happens due to the presence of sperm in the vagina.
Obstetricians use a test based on the symptom of arbrization, and there are similar kits for home diagnostics of amniotic fluid leakage. The test is based on the characteristics of amniotic fluid - crystallizing, they form a pattern similar to a fern leaf. But impurities of urine, semen and infectious processes in the vagina can distort the result.
There are also tests that respond to the presence of placental protein, the accuracy of the tests reaches 98%. They can be used both at home and in a maternity hospital, antenatal clinics and gynecological departments.
What to do if water leaks
If a home test reveals a leak, or if you suspect that there is a rupture of the membranes, you should immediately see a doctor. If possible, visit the district obstetrician, sometimes the analysis is done on an outpatient basis, after the analysis, the woman is either hospitalized or sent home (if the test is negative).
If water leakage is detected, then a therapeutic and protective regime is prescribed. The main task is to prevent premature birth and infection of the fetus. In parallel with this, therapy is underway that accelerates the maturation of the child's lungs, since the main problem in premature birth is not the low body weight of the child, but the inability to breathe on its own.