Amniotic Fluid Leak: Causes, Signs, Treatment
Leaking of amniotic fluid is one of the important sign that a mother is ready to deliver the baby. However, it can also be an indication that something is wrong with the pregnancy or the baby growing inside. The mother should consult a doctor immediately if she feels she is leaking amniotic fluid to prevent any complications with her pregnancy.
Amniotic fluid is the name of the fluid present in the uterus and it ensconces the fetus and provides nourishment to it as it grows inside the mother's womb. The fetus moves around in this fluid, which restricts the wall of the uterus, so that they do not contract tightly around the growing fetus. The function of the amniotic fluid is to act as a cushion or as a shock absorber so that it can protect the fetus from any harm. Amniotic fluid starts to form about two weeks after the fertilization takes place. There are many substances present in the amniotic fluid, such as carbohydrates, proteins, electrolytes, phospholipids, lipids etc. all of which will provide nourishment to the growing fetus.
Signs of Amniotic Fluid Leak
It can be quite difficult for the mother to determine if she is leaking amniotic fluid. In the final trimester of the pregnancy, the fetus tends to exert increasing amount of pressure on the mother's body, which will cause cervical discharge. As the pregnancy progresses, the uterus increases in its size and puts more pressure on the bladder, which results in leaking of urine. Unlike urine, the amniotic fluid does not have any odor and if it leaks copiously, then it will soak the undergarments. An amniotic fluid leak, once started, continues to go on. One way to determine an amniotic fluid leak is using a sanitary napkin, which will help in determining if the leakage is urine or amniotic fluid. If the fluid on the sanitary napkin is odorless and appears green or yellow-brown, then this is a serious condition which indicates fetal distress and requires immediate medical attention.
SROM, also known as spontaneous rupture of membranes, is the most common cause of amniotic fluid leakage. This usually happens when the pregnancy is at its end and the membranes which hold the amniotic fluid rupture resulting in an amniotic fluid leak. Often referred to as "water breaking," SROM or spontaneous rupture of membranes is an indication that the mother is going into labor.
PROM or premature rupture of membrane occurs when the pregnancy is not yet at term and the membranes holding the amniotic fluid rupture. This commonly occurs between 37-38 weeks of pregnancy. Any tear in the amniotic sac will cause PROM. The amniotic fluid will leak as a sudden gush of fluid or as a slow trickle depending on the extent of the tear. In such cases of PROM, prompt medical attention is required to determine the cause of the tear. Causes could be any defect in the uterine shape or in the development of the amniotic sac. A bacterial infection can also cause the tear in the amniotic fluid and cause it to leak
Treatment for Amniotic Fluid Leak
Immediate medical attention is required if the tear is a major one or if there is an indication that the region has developed an infection. This also increases the risk of infection developing in the fetus. In most of the cases, if the tear is small, then it will heal on its own. However, if the tear is large, then treatment is required to avoid serious complications from developing in the pregnancy.
Tests are done to determine if the liquid, which is being leaked is indeed amniotic fluid. Mother and fetus, both of their conditions are monitored. After confirmation that the mother is indeed leaking amniotic fluid, immediate treatment is started.
If the condition is SROM and the pregnancy is at term, then doctor will initiate labor within 48 hours of amniotic fluid leak. This will help in determining whether the baby needs immediate medical attention to avoid an impending infection.
Treatment for Oligohydramnios
Oligohydramnios is a condition where there is insufficient amniotic fluid in the uterus. Oligohydramnios can cause abnormal growth of the fetus, especially impeding the growth of the lungs. This condition is known as pulmonary hypoplasia. This condition can also cause umbilical cord compression during the birth and also aspiration of thick meconium, which in turn makes it difficult for the baby to pass its first bowel movement.
After confirmation of oligohydramnios, careful monitoring of the amount of amniotic fluid in the uterus is done. Multiple follow up visits with the doctor are required to ensure that everything is fine with the mother and the baby. In case the amniotic fluid decreases below the safe level, then liquid infusion is given to the mother, which will help in supplementing the natural amount of amniotic fluid remaining in the uterus. If giving infusion alone is not sufficient, then early labor will be induced in order to protect the fetus from any potential harm.
Treatment for Hydramnios
Hydramnios, also known as polyhydramnios, is a condition where there is excessive amount of amniotic fluid present in the uterus surrounding the fetus. This results in over-distension of the uterus leading to PROM or early rupture of the membranes. This condition often leads to preterm labor. Hydramnios is very often linked to defects in the fetus. This condition can cause an early placental detachment from the uterine wall or umbilical cord prolapse, which causes it to drop through the cervix and become compressed, which can prove to be quite fatal for the baby.
The course of treatment for hydramnios is determined by keeping the health of the baby and the mother as well as her personal opinion in mind. Hydramnios is closely monitored and the mother is tested for her tolerance of certain medications, therapies or medical procedures. All these will be weighed against the overall progression of hydramnios so that the doctor will find the best course of treatment with the least amount of risk.
The mother needs follow-up appointments to monitor the levels of amniotic fluid in her body. There are certain medications, which help in decreasing the fetal urine, so as to avoid additional pressure and fluid. In severe cases, a procedure known as amnioreduction is done to remove some of the excess fluid from the uterus. Amnioreduction is done by inserting a needle into the amniotic sac to withdraw the amniotic fluid. In severe cases, the baby will be delivered early so as to cut down on the health risks to the child and the mother.