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Preeclampsia: Symptoms, Risk Factors and Treatment. View Sources. If there is a suspicion that you are losing amniotic fluid in the first or second trimester of pregnancy, it is advisable to go immediately to the emergency room or obstetrician, as during this period the decrease in the amount of amniotic fluid can directly interfere with the development of the baby. In most cases, the leaking of amniotic fluid can be easily mistaken for the involuntary loss of urine, that happens due to the weight of the uterus on the bladder, or even increased vaginal lubrication.
A good way to tell if it is loss of amniotic fluid, urine or vaginal lubrication is to use a panty liner and observe the characteristics of the fluid. Urine is normally yellowish and smells, while amniotic fluid is transparent and odorless. Intimate lubrication is also odorless but normally has the consistency of egg white. Pregnant women with risk factors such as high blood pressure, diabetes, or lupus are more likely to have amniotic fluid leakage, but this can happen to any pregnant woman.
Immediate medical help is vital, but treatment is usually done with weekly consultations with the obstetrician to assess the amount of fluid throughout pregnancy. For example, it might be difficult to tell the difference between amniotic fluid and urine — especially if you only experience a feeling of wetness or a trickle of fluid.
If you're uncertain whether your water has broken, call your health care provider or head to your delivery facility right away. Your doctor or a member of your health care team will give you a physical exam to determine if you're leaking amniotic fluid. In some cases, an ultrasound might be done to check your amniotic fluid volume. You and your baby will be evaluated to determine the next steps. Typically, after your water breaks at term, labor soon follows — if it hasn't already begun.
Sometimes, however, labor doesn't start. If you experience prelabor rupture of membranes, your doctor might stimulate uterine contractions before labor begins on its own labor induction.
The longer it takes for labor to start after your water breaks, the greater the risk of you or your baby developing an infection. If your water breaks before the 37th week of pregnancy, it's known as preterm prelabor rupture of membranes preterm PROM.
Risk factors for water breaking too early include:. Potential complications include maternal or fetal infection, placental abruption — when the placenta peels away from the inner wall of the uterus before delivery — and umbilical cord problems.
The baby is also at risk of complications due to premature birth. If you have preterm PROM and you're at least 34 weeks pregnant, delivery might be recommended to avoid an infection.
However, if there are no signs of infection or fetal health problems, research suggests that pregnancy can safely be allowed to continue as long as it's carefully monitored. If you're between 24 and 34 weeks pregnant, your health care provider will try to delay delivery until your baby is more developed. You'll be given antibiotics to prevent an infection and an injection of potent steroids corticosteroids to speed your baby's lung maturity.
If you're less than 32 weeks pregnant and at risk of delivering in the next few days, you might be given magnesium sulfate to protect the baby's nervous system. Corticosteroids might also be recommended starting at week 23 of pregnancy, if you're at risk of delivering within 7 days. In addition, corticosteroids might be recommended if you're between weeks 34 and 36 and 6 days of pregnancy, at risk of delivering within 7 days, and you haven't previously received them.
You might be given a repeat course of corticosteroids if you're less than 34 weeks pregnant, at risk of delivering within 7 days and a prior course of corticosteroids was given to you more than 14 days previously. If you're less than 24 weeks pregnant, your health care provider will explain the risks of having a very preterm baby and the risks and benefits of trying to delay labor.
During active labor, if your cervix is dilated and thinned and the baby's head is deep in your pelvis, your health care provider might use a technique known as an amniotomy to start labor contractions or make them stronger if they have already begun. During the amniotomy, a thin plastic hook is used to make a small opening in the amniotic sac and cause your water to break. It's natural to feel anxious about labor and delivery. While you might not be able to predict when your water will break, you can take comfort in your knowledge about the next steps.
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