Doctors call amniotic fluid an amniotic fluid (from the Greek word amnion, which means fetal membrane). The reservoir for them is the fetal bladder, which forms approximately 12 days after conception. In such a specific aquatic environment, the baby spends most of its intrauterine life.
During this time, the amniotic fluid has time not only to repeatedly change its composition and volume, but also to perform several important functions at once.
In the mother’s stomach, the future baby is quiet, calm and warm, primarily because the temperature of the amniotic fluid is 37 ° C. This degree is not only ideal for the development of a small body: it reliably protects the crumbs in cases where the mother can not avoid hypothermia.
Another role of the amniotic fluid is to keep the walls of the uterus in the optimum position for the baby and to serve as a shock absorber during drops.
In the amniotic fluid also contains immunoglobulins – antibodies, thanks to which the child is protected from infections. This property is especially valuable, given that pathogenic bacteria live even in the body of an absolutely healthy woman.
Another function of the amniotic fluid is to provide training for key organs and systems of the baby. So, it is in the womb that the baby begins to exercise its lungs, “inhaling” the amniotic fluid instead of air.
If he does not do this every day, he will not be able to breathe on his own, having come into the world. In addition, swimming and tumbling (up to a certain point, of course) in the amniotic fluid, as if in a pool, the child “kneads” its muscles and bones.
Amniotic fluid is formed primarily due to the sweating of the blood plasma of the mother through the walls of blood vessels penetrating the fetal bladder. With increasing gestational period, the volume of amniotic fluid gradually increases.
By the 10th week it averages 35 ml, by the 20th – already 400, and by the 24th it reaches its maximum level, as a rule, it is 1.5 liters. However, immediately before birth, the amount of amniotic fluid can significantly decrease, decreasing to 800–1000 milliliters or less.
Despite the fact that amniotic fluid is 98% composed of sterile liquid, a variety of substances are dissolved in them: salts, proteins, enzymes, fats, carbohydrates. In addition, in the amniotic fluid can be found flakes of original lubrication and fluff hair, which covered the skin of the baby.
The composition of the amniotic fluid is updated completely every three hours. The “spent” portion returns to the systemic circulation, seeping into the umbilical artery. From a certain moment, the baby also begins to make a contribution: he swallows amniotic fluid and removes it in the standard way.
In addition, through the vessels of the umbilical cord and placenta, the mother’s blood constantly enters the kidneys of the child. After filtration, it forms sterile urine, which then also enters the amniotic fluid, contributing to “renewal”.
To determine the amount of amniotic fluid allows ultrasound, which in a planned manner arrange three times during pregnancy. Evaluation is carried out on special tables. Amnioscopy also helps to identify the color and amount of amniotic fluid to check the baby’s condition.
The study is conducted using an optical device that is inserted into the cervical canal through the vagina. The need for this procedure occurs extremely rarely, usually with suspected chromosomal abnormalities in a child or blood transfusions for hemolytic disease.
Amniocentesis – another study of amniotic fluid – is appointed in the event that prenatal screening revealed a high risk of developing chromosomal pathologies. The procedure is a painless puncture of the fetal bladder and collection of 10-15 ml of amniotic fluid to analyze baby cells.
A doctor can make an idea about the amount of amniotic fluid during palpation of the abdomen. More accurate information gives ultrasound.
This indicator is extremely important to monitor, because the well-being of the baby directly depends on it.
The diagnosis of “low water” is made if at this time of pregnancy the volume of amniotic fluid is below normal. This may indicate a congenital kidney disease of the child, intrauterine growth retardation, or the fact that the mother has gestosis, hypertension or chronic inflammatory diseases.
Indirect signs of lack of water – compacted uterus, rare movements of the baby, persistent abdominal pain, aggravated by the movements of the crumbs.
If in the third trimester ultrasound registers more than 1.5 liters of amniotic fluid, doctors talk about polyhydramnios. The causes may be different: genetic diseases, Rh-conflict, inflammation of the fetal membranes, waiting for twins or triplets. The future mother is usually concerned about the pulling sensations in the crotch zone.
The abdomen is tense and increases too quickly. There are also swelling, shortness of breath and heart palpitations.
The doctor chooses the course of treatment in case of low and high water, depending on the reason that caused the deviation from the norm. In any case, both diagnoses require careful monitoring.
During the normal course of pregnancy, the fetal bladder retains its integrity until the middle of labor and breaks only at that moment when the diameter of the cervix is 6–7 cm. If the amnion breaks ahead of its time in the upper part (doctors speak of a “high gap”), water start to leak slightly, the protection weakens and the risk of infection of the child increases.
But this does not mean that they are completely drained. According to statistics, every fifth woman gets into such a situation.
Fortunately, in most cases, a high gap occurs just before the onset of labor, so the threat to the baby is minimal.
If the fetal bladder ruptures ahead of time, but already in the lower compartment (in the immediate vicinity of the birth canal), premature discharge of water occurs. In this scenario, it is necessary to urgently call an ambulance and go to the hospital.
The fact is that the so-called “dry period” should not last longer than 12 hours, otherwise the probability of infection of the baby will become very high. Further developments will depend on the degree of risk.
So, for a period of less than 34 weeks, doctors will try to extend the pregnancy and speed up the maturation of the baby’s lungs with the help of special preparations. If the mother’s temperature has risen, and a blood test states an acute infection, it may require stimulation of labor or emergency caesarean.
As you know, closer to childbirth in most women begins a slight leakage of urine. It is caused by quite physiological reasons: the muscles of the bladder relax for a long time.
However, given that it is rather difficult for a non-professional to distinguish urine from amniotic fluid, future mothers are seriously worried about this.
Dispel doubts will help simple tests. First, you should know that the amniotic fluid is usually leaking at the moment when the woman rises abruptly, and the urine when she coughs, laughs, or makes sudden movements.
Secondly, the amniotic fluid is usually clear and smells of nothing, and the urine has a straw color and a characteristic odor. Thirdly, it is possible to conduct such an experiment: completely empty the bladder and lie down, having previously laid under it a clean, dry and certainly white diaper. If a wet spot appears on it in the next 15 minutes, you need to call an ambulance: most likely it is an amniotic fluid.
And finally, fourthly, you can use the pharmacy tools – amniotest or amnioprone. Upon receipt of a positive result, you should immediately consult a doctor.
By the color of the amniotic fluid, whenever they move away, doctors are able to judge the condition of the baby. Normally, the amniotic fluid is transparent, although by the end of pregnancy it may become slightly dull due to the content of whitish flakes (fluffy hair, as well as original lubricant, come off the baby’s skin). Sometimes red streaks can be seen in the waters.
In 99% of cases, this suggests that the cervix began to open. If the amniotic fluid is green, it means that the baby has severe hypoxia (lack of oxygen). Red shade most often occurs when bleeding.
In the latter two cases, it is necessary to urgently call an ambulance. In case of bleeding, you should not try to get to the maternity hospital by yourself: a woman should not get out of bed before the doctors arrive.