The amniotic fluid that surrounds and protects the fetus in the amniotic sac plays a vital role during pregnancy.
Usually, this fluid comes out in a gush when you go into labor. But sometimes, it may trickle down the vagina, making you wonder if it is the amniotic fluid leak, vaginal discharge or urine leak. Knowing how to differentiate among them could help you figure out what to do next.
In this MomJunction post, we tell you the difference between amniotic fluid leakage and urine leak, what happens when amniotic fluid leaks, and what to do in such a case.
Normal Levels Of Amniotic Fluid
Usually, women have around 500ml to 1000ml of amniotic fluid, although the normal levels may vary according to the gestational age (1). The fluid serves as a cushion for the little one growing in the womb and helps in the development of various organs such as the gastrointestinal tract, kidneys, and lungs. Too little or too much of the amniotic fluid could cause problems. The doctor usually checks the levels of the amniotic fluid through an ultrasound.
The average volume of amniotic fluid around 12 weeks gestation is 60ml. It increases to 175ml by 16 weeks. The volume is the highest between 34 and 38 weeks, at around 400-1200ml. It reduces after 38 weeks gestation and comes down to 800ml by the 40th week (2).
Labor may start when the amniotic fluid levels recede and finally leak. But to assess if it is indeed amniotic fluid leak or just urine leak, you should check for the other signs as well.
Signs Of Amniotic Fluid Leak
Here are a few signs that could help you determine whether it is the amniotic fluid leakage or not.
- Amniotic fluid is clear or colorless. Urine is light yellow.
- Amniotic fluid has a peculiar smell, but urine or vaginal discharge could have an odor.
- The flow of amniotic fluid leakage doesn’t stop as quickly as urine does.
You may use a pad or panty liner to check these aspects. Another way to know this is to try holding your pelvic floor muscles for a few seconds. If it is urine, the leakage will stop. If it doesn’t stop, it is probably an amniotic fluid leak.
Usually, amniotic fluid leaks when the membranes rupture. This mostly happens at full term or during labor due to contractions or membrane weakening. Sometimes, the doctor ruptures the membranes. This is usually done during the active phase of labor when the cervix is 4cm dilated. It helps accelerate the process of labor and allows the doctor to check if the baby has passed any meconium inside the womb
[ Read: Water Break During Pregnancy ]
Causes Of Premature Rupture Of Membranes
Usually, premature rupture of membranes is unexpected. And it is not easy to figure out the cause. If the water breaks early, i.e., before the start of labor , it is called premature rupture of membranes (PROM). And if it occurs before 37 weeks, it is called preterm premature rupture of membranes (PPROM). Causes of PROM include (3) (4):
- Uterine infection
- Accidental trauma
- Polyhydramnios or too much of amniotic fluid in the sac
- Overstretching of amniotic sac and uterus
- Improper prenatal care
- Previous preterm birth
- Sexually transmitted infections
- Twin or multiple pregnancy
When the amniotic sac ruptures or water breaks after 37 weeks of pregnancy, it is considered as a sign of labor. The leakage of amniotic fluids before 37 weeks is, however, associated with certain risks.
What Happens When Amniotic Fluid Leaks?
Many women go into labor in about 24 hours of amniotic fluid rupture or leakage of amniotic fluid. If it doesn’t begin in 24 hours, labor is induced to prevent any complications (5). Preterm leakage could lead to the risks below (6):
- Infections (both mother and baby)
- Placenta separating from the uterus
- Umbilical cord problems
- C-section delivery
When To Call The Doctor?
When you find that the leaking fluid from your vagina is not discharge or urine, but is amniotic fluid, got to the doctor. You should also call the doctor (7):
- When you find the fluid is green or brown or has a foul smell
- When you have a fever or your heart rate has increased
- If there is abdominal pain
The doctor will diagnose your condition based on your gestation age, and will also give you an internal examination before going ahead with the treatment.
While you are waiting for the doctor, try to stay calm and do not insert anything, such as a tampon or cloth, into the vagina to stop the leakage. Just notice how much fluid has leaked and what the color of the fluid is to let the doctor know.
How Is Amniotic Fluid Leakage Or PROM Treated?
The treatment plan differs from one woman to another, as it is based on the gestational age. If it occurs before or at 34 weeks, antenatal corticosteroid medicines are given to speed up the maturity of the fetal lung. After observation, the next steps could be:
- Prescription of antibiotics to prevent infection
- Medication to prevent preterm labor, if it is possible
- Preparation for early delivery if the doctor thinks it is necessary
- Admission to a hospital for observation and transfer to a hospital where there are good neonatal intensive care facilities just in case the baby arrives early
Does Leaking Amniotic Fluid Mean Miscarriage?
Leaking amniotic fluid is not one of the common reasons for a miscarriage. However, if it occurs in the second trimester and is accompanied by other symptoms such as abdominal pain, then it could be a sign of miscarriage. Nevertheless, you should get it checked by the doctor before concluding that it is a miscarriage.
Can Amniotic Fluid Replenish Itself?
There is no evidence to prove that amniotic fluid could replenish after it has leaked. However, if the leak is heavy, the amniotic sac could reseal by itself to prevent the onset of preterm labor (3).
An amniotic fluid leak, at any time of the pregnancy, could make you worry. But knowing the signs and how to manage such an occurrence can help you stay careful and prevent any complications. While you do what is needed, try to remain calm and call your family member or doctor for help.
Do you have any experiences to share with us? Do tell us about them in the comments section.
2. R. L. Fischer; Amniotic Fluid: Physiology and Assessment; The Global Library of Women’s Medicine (2008)
3. Preterm Prelabor Rupture of Membranes (pPROM); C. S. Mott Children’s Hospital; Michigan Medicine
4. Premature Rupture of Membranes (PROM)/Preterm Premature Rupture of Membranes (PPROM); Stanford Children’s Health
5. Overview of Labor; Standford Children’s Health
6. Preterm Premature Rupture of Membranes (PPROM); University of Rochester Medical Center
7. Rupture of the Membranes; Michigan Medicine
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