Congratulations! If you’re reading this as a mother-to-be, you are undergoing one of the most incredible experiences as a woman – you’ll be bringing a new life into this world soon. Whether this is your first pregnancy or not, it is understandable that you have many questions about the changes your body is going through. That’s because every pregnancy is as unique as the child it brings into the world. And it’s quite possible that the things you’re experiencing this time are quite different from what you may have experienced earlier. So, it’s completely alright if you are caught off-guard by unusual vaginal leaks that may be embarrassing and sometimes even worrisome. These leaks are called ‘pregnancy discharges’, often caused due to the leaking of the amniotic fluid.
What Is Amniotic Fluid?
Amniotic fluid is the liquid that surrounds your baby inside your womb. The fluid acts as a protectorate and offers your child the much-needed cushion and buoyancy for movement inside your uterus. It also helps in the development of your child’s body functions, especially the lungs and the digestive system and protects the fetus from the attack of infections. It ensures that during the development of your baby, the uterus does not contract too tightly.
The fluid is saturated with essential nutrients like carbohydrates, proteins, lipids, phospholipids, electrolytes and urea and has an imperative role in your baby’s development. When you’re about 12 days into the pregnancy, your amniotic sacs are formed. Your body starts producing the fluid approximately two weeks after fertilization and it grows slowly with the womb, held inside by the amniotic sac wall.
Initially, the amniotic fluid is composed mainly of water (about 98%), which it takes from your body (now you know why you feel so thirsty all the time in your first trimester). The remaining 2% is cells and salt for the baby. After 20 weeks, the baby starts growing body parts like the kidneys. Now, your baby can urinate! So, it swallows the fluid, digests it and discards it as urine. This is how the baby’s body learns the digestive function. Eventually, most of your amniotic fluid will become urine (yes, that’s actually good for your baby). But it is not just urine that’s there in the fluid. It also has several other elements that are good for your baby like hormones, antibodies and essential nutrients.
The amniotic sac and the amniotic fluid have several roles to play in your baby’s development.
- Your baby will move in your belly. If you’re in your third trimester, chances are you’ve already experienced that. The fluid actually makes sure that your womb is not too tightly wrapped around your baby and it can move around. This is important for healthy bone and muscle development of the baby.
- Along with taking in the amniotic fluid, the baby also breathes it in and out, which helps the baby practice breathing and develop the lung function.
- Another important role of the amniotic fluid is to maintain the temperature of the womb and keep the baby warm and cozy. It is important for the baby’s healthy development that the temperature of the uterus remains constant throughout pregnancy.
- The amniotic sac also protects the baby, in case the mother suffers an impact on her belly because of a fall or a push.
- It also supports the umbilical cord and prevents it from getting squeezed. If the cord’s functions are disrupted in any way, it may prevent proper nutrition from reaching the baby.
- The amniotic fluid is also a lubricant, which safeguards the tender limbs of the fetus and also prevents them from growing together. The growing body parts of the baby are too fragile to tolerate any friction or may develop into joined-parts as in the case of webbed feet or fingers if the amniotic fluid doesn’t function properly.
The amniotic fluid is your baby’s lifeline inside your womb. Which is why when you’re ready to deliver, the fluid is the first thing that escapes your body, preparing your baby to be born in the new world. The term ‘water-breaking’ is actually the breaking of the amniotic sac wall, which allows the fluid to gush out when you’re ready to deliver.
Sometimes, certain conditions may cause the amniotic fluid to leak prematurely. That is when you need to be alarmed, depending on the seriousness of the condition. But first, you need to know if it is an amniotic leak or something else.
Signs of a Leak
When you’re pregnant and your fetus is growing, there are various types of discharges that your body may experience including cervical discharge and in some cases, even amniotic fluid discharge in a very small quantity. Here’s how you can identify amniotic fluid from other types of discharges:
- Amniotic Fluid is usually colorless and odorless.
- Sometimes it may be spotted with white mucous or a bit of blood.
- It flows steadily and you cannot control its flow as in the case of urine.
- It is thin and seeps through your undergarment.
- Sometimes, it is accompanied by cramps or slight discomfort.
When It Isn’t Amniotic Fluid
To be doubly sure, take a look at some of the other common types of discharges that occur during pregnancy. In either case, it is advisable that you see a doctor.
- If you only leak occasionally, like when you cough or laugh too hard, it’s most likely urine.
- If it’s odorless, white and looks like cottage cheese and if it is accompanied by itching and soreness, or if you experience burning while urinating, they are symptoms of a yeast infection.
- If it smells “fishy” and is accompanied by itching or burning then it is most likely an infection called bacterial vaginosis.
- If it is slightly odorous, yellowish and accompanied by itching, then it may actually be an STD.
If you are unable to figure out the color and texture of the discharge, use a sanitary pad to verify. Please make sure that tampons are never used during pregnancy. Please call your doctor immediately if you experience any of the following:
- If you’re unsure of what you see and cannot determine the type of discharge.
- If you experience amniotic fluid leak anytime earlier than 37 weeks.
- If the leak is accompanied by fever.
- If the fluid has a green tinge.
- If you have any other type of unusual experience with the leak.
Causes of a Leak
Beginning of Labor
The most prominent cause of the amniotic fluid leak is the commencement of labor. When you experience the leak after 38 weeks, it’s time you call your doctor, who will prepare you for labor and delivery. This is what is known as the ‘water-break’. At full-term, it is usually not just a leak, but a full membrane rupture, or as they call it in medical terms, an SROM (Spontaneous Rupture of Membranes).
If the leak occurs prematurely, there may be a cause of alarm and a doctor should be consulted immediately. Reasons may include a bacterial infection, injury or trauma of the amniotic sac, previous cervical or uterus surgery or even bad lifestyle choices like an unbalanced diet, stress or smoking. Sometimes it is also caused by the defective structure of the amniotic sac or low levels of amniotic fluid in the sac. Premature Rupture of Membrane (PROM) usually takes place between the 37th and the 38th week of pregnancy.
Sometimes the two membranes that form the wall of the amniotic sac split or tear, resulting in a fluid leak. This is usually not a cause of worry as the membranes eventually rejoin and heal on their own. However, if you want to be sure that there are no other complications, you may want to visit your doctor once.
Even if you’re still in your first trimester, be on the lookout for the amniotic fluid leak. This is the most crucial time for your fetus’ development and any unusual leak may lead to complications during later stages of pregnancy or the development of your child.
Treatments for Untimely Leak
Leaking amniotic fluid, if not treated in time may cause problems in the baby’s development. If the leak is due to an infection it can cause complications in pregnancy in its later stages. Severe complications may even lead to miscarriages or stillbirths.
Before you’re given a treatment, your doctor may conduct various tests to determine the root cause of the leak and possible cure. These tests include:
- Taking a sample of the leaking fluid and checking PH levels.
- Testing for any infections in the uterus.
- Carrying out an ultrasound to check for source and level of the leak.
Then, depending on when the leak has occurred in your pregnancy, you will be provided the suitable treatment.
Before the 25th Week
This is too early for the amniotic fluid to leak and close monitoring of your fetus will be needed. At this time, a leak may increase the chances of a miscarriage.
Between 24th and 31st Week
It is still too early for a normal delivery. You may be admitted and given some antibiotics, if the cause is an infection. You may also be required to prepare for a premature delivery and given steroids for developing the baby’s lungs.
Between 32nd and 33rd Week
Delivery options may be discussed at this stage and you may be given steroids and antibiotics as well.
34th Week or Later
This is when you’re very close to your full term, so doctors may try to induce labor for a normal delivery. Close monitoring may still be required but steroids may not be necessary.
If the leak is slow in the early stages of pregnancy, the doctors may ask you to wait to determine if the leak seals on its own. You may be required to be on complete bed rest during this period and several tests may be performed.
If you’re being prepared for delivery, you may need to be rehydrated to compensate for the fluid loss. This means the doctor may push more fluid in your amniotic sac so that the baby stays protected and safe for delivery.
There are several conditions that may cause the amniotic fluid to leak prematurely. Depending on the cause, the following treatments may be suggested by your doctor:
Hydramnios is a condition where there is too much amniotic fluid in your sac. It is also called polyhydramnios and is often the cause for premature labor and over-distension. Sometimes it causes the umbilical cord to prolapse, squeezing it into the cervix. It may even lead to the premature detachment of the placenta from the uterine wall. All these conditions may cause defective fetal development and pose other risks as well.
It requires close monitoring of both, the mother and the baby. The excess production of amniotic fluid will need to be curbed using medication and other amnio-reduction treatments. If need be, the excess fluid may to be removed from the amniotic sac using a syringe.
Oligohydramnios is the exact opposite of hydramnios. This means in oligohydramnios the amniotic fluid levels in the womb are too low causing underdevelopment of fetus’ vital organs such as the lungs. This condition is known as pulmonary hypoplasia and often causes the umbilical cord to constrict during delivery.
This is another serious condition that calls for close monitoring of the fetus and the mother along with supplementation of the amniotic fluid. The fluid can be supplemented by amnio-infusion, that is, injecting supplementary fluid during labor via an intrauterine catheter or through the process of rehydrating.
This occurs when your amniotic fluid breaks at full-term and is a sign that your body is ready for delivery.
When it is a spontaneous rupture of membranes, you’re at full term and your doctor will prepare you for delivery. This may be done by inducing labor within 48 hours of your water break, as this increases the chances of a healthy delivery.
Not every case of amniotic fluid leak is alarming. It may just be a small membrane tear, which usually heals on its own. What’s important is that you are well aware of the changes in your body and that your doctor and your partner are informed about your experiences. This will help them take better decisions if special attention is required in a particular case. Take good care of yourself, and enjoy this beautiful experience to the fullest.