anonymous, Female, 37 years old

Pregnancy 19-20 weeks, there was a detachment, but everything returned to normal. Afterwards I took all the tests, they were good! Doppler is good, the first screening was not very good, so they prescribed a second one. During the first pregnancy, there was also a detachment and the screening was not very good, but a wonderful boy was born, who is already 4 years old!!! So, I came for the second screening, they tormented me for two hours, my whole stomach was shaken... They said everything was fine, no pathologies... I just saw some kind of spot on the placenta and the doctor couldn’t understand what it was... They offered me three days later still to come... But by the evening bleeding began and by morning the water flowed out. They couldn’t save the child... The question is, could driving the device over the abdomen for two hours and frequently squeezing the abdomen have caused the water to break?

Unlikely, but not excluded. It should be borne in mind that pregnancy or spontaneous miscarriage (up to 22 weeks) is due to many reasons: genetic factors; sexually transmitted infections; endocrine disorders; immune factors; uterine fibroids; adenomyosis; abnormalities of the uterus, chronic endometritis, etc. To identify the cause of miscarriage or spontaneous abortion, it is advisable to conduct a number of studies at the stage of preparation for pregnancy: Determination of the hormonal profile - FSH (follicle-stimulating hormone), LH (luteinizing hormone), Prolactin, Estradiol, 17-OH- progesterone, Androstenedione, Androstenediol glucuronide, DHEA sulfate (dehydroepiandrosterone sulfate), Total Testosterone, Free Testosterone, Dihydrotestosterone, SHBG (sex hormone binding globulin) Determination of thyroid hormones - TSH (thyroid-stimulating hormone), T4 (thyroxine), T3 ( triiodothyronine), Anti-TG (antibodies to thyroglobulin), Anti-TPO (antibodies to microsomal thyroid peroxidase), Thyroglobulin Study on the biocenosis of the vagina and culture of the flora of discharge from the genital organs with determination of sensitivity to the main spectrum of antibiotics and bacteriophages Sexually transmitted infections ( chlamydia, mycoplasmosis, trichomoniasis, gonorrhea, herpes, etc.) Hemostasis indicators Fibrinogen, Prothrombin, Thrombin time, APTT, Antithrombin III, Lupus, D-dimer, Protein-C TORCH complex study Identification antiphospholipid syndrome– APS- (determination of IgM and IgG class antibodies to phospholipids: cardiolipin, phosphatidylserine, phosphatidylinositol, phosphatidylic acid).

HLA class II gene typing - DRB1, DQA1, DQB1 genes - study for a couple Genetic risk factors for thrombosis and folate cycle disorders, increased homocysteine ​​levels - F2, F5, MTHFR, MTRR, MTR Violation of most of these parameters can contribute to impaired sensitivity of the uterine mucosa to implantation of the embryo and, accordingly, subsequently lead to miscarriage. The exact range of necessary studies is determined depending on the specific clinical situation.

anonymously

It is important to note that ultrasound of the pelvic organs is a subjective method, the information content and accuracy of which depends both on the class of the ultrasound device and on the qualifications of the researcher; in particular, it is more effective to conduct an ultrasound by a gynecologist, also certified in the specialty of an ultrasound diagnostic doctor. To determine an accurate diagnosis and correct interpretation of ultrasound data, it is necessary to compare the information obtained from ultrasound examination with clinical and laboratory data, as well as the results of other research methods.

The second pregnancy of 20-year-old Englishwoman Laura Hills was in great danger: at 16 weeks of pregnancy her waters broke... Doctors categorically insisted on an abortion. After all, according to medical statistics, Laura’s child had only a 1 in 100 chance of survival. At the same time, the health of the unborn baby would still be in danger.
But Laura refused an abortion, despite all the doctors’ persuasion - after all, she felt her son moving.

“I was told that, most likely, I would give birth to this child in the next two weeks, that there was only one chance in a hundred that he would be born alive, that he would need to rule out brain damage and deformation of the lungs. And I replied that although this is only one percent, it is there, and I am not going to give up my child. I will protect him to the last,” she said.

Over the next weeks, Laura underwent ultrasounds and blood tests twice a week. She was ready for the irreparable... But a miracle happened: at the 21st week, at the next ultrasound, the doctors were convinced that the gap around the child had completely closed. At 24 weeks, the amniotic sac was already sufficiently filled with fluid.

"The baby, whom his parents named Charlie, was born in March 2011, completely healthy, weighing 3200 g.

« He screamed so weakly that I immediately began to panic, but the midwife calmed me down. She said that I have an absolutely healthy boy!"says Laura. Charlie's birthday coincided with his mother's birthday.

“When I first saw him, I thought - finally our boy is with us, and now he is safe,” says Laura’s husband, who was present at the birth.

Obstetrician-gynecologist who observed expectant mother, considers this case amazing: despite a very harsh forecast, nature itself, without any help, completely corrected the situation.

Photo from dailymail.co.uk

A similar wonderful story happened a few years later, in 2016, with 24-year-old Sheila Baty.

Sheila's water broke gradually over several days, and the woman thought she had become incontinent or leaking. However, doctors reported a disappointing diagnosis - prenatal rupture of membranes. Sheila's pregnancy at that time was also 16 weeks.

“Sheila had so little amniotic fluid left that it was impossible to determine the sex of the child using an ultrasound. Using an ultrasound, the fetal heartbeat could be heard, but doctors could not see it on the screen.

The woman was put in “conservation”; doctors checked her blood pressure every three hours, and also checked her blood weekly for infections. Sheila was given steroid injections to help the baby's lungs develop.

faster.

“At 28 weeks, when the baby was already quite viable, Sheila was discharged home, and after another week and a half she began having contractions.

During premature birth new complications arose - the cervix did not dilate, so I had to C-section. Little Ryan spent several weeks in the incubator, and only a week later his mother was allowed to take the boy in her arms. He had to have blood transfusions several times, and at 4 months his hernia was removed, but now Ryan is completely healthy!

Photo from the site medikforum.ru

I read everything, it gives me chills! My husband and I went through this. The first pregnancy - the baby froze at 12 weeks, no symptoms: no bleeding, no pain. They said the heart was not beating and that’s all. After that, my husband and I went to the doctors, tightened up everything maybe not so (besides, I have severe diabetes mellitus, and you can’t cure it!). After 2 years we decided to try again, I got pregnant right away. I registered with the antenatal clinic, took tests, there was a problem with the hormone (I forgot the name), all I took Duphaston during pregnancy. Everything was more or less until the 11th week. I came out of the toilet, red water started pouring out, and realized that my water had broken. They called an ambulance and took me to the hospital. There they injected me with a noshpa, increased the amount of Duphaston, and I bled until the 15th week. .ran around hospitals, drank hemostatic. At week 17 they did an ultrasound, they said there was no water at all, but there were no leaks. And then it began: - We need to have an abortion!!! ;- Who gave you permission to give birth?!!!- Your baby will die anyway!!! They do an ultrasound, but my heart is beating! For 3 weeks they pressured me to have an abortion, they did an ultrasound every 3 days, every time they said - HE’S probably already dead ;- Why are you tormenting a child, they can’t live without water!!! They do an ultrasound, BUT THE HEART IS BEATING!!! They did all sorts of express tests for water with an incomprehensible result. In general, they tormented as they wanted, I didn’t give up, I said, as long as the heart beats I won't do anything! I wrote a waiver from the hospital, there was a lot more at home (it would take a long time to describe), in general I struggled until 29 weeks (although I didn’t know the exact date, each ultrasound showed a different one), my waters started flowing from 20 weeks. , I sat on the forums and read how bad everything would be, but I didn’t give up! At 29 weeks. women's cons. I still got sick of it, they forced me to take tests, then the hospital, intensive care unit, caesarean section, a boy was born, 33 cm. I was even afraid to go to kindergarten for a while. intensive care! He’s in intensive care, I’m in intensive care, MY POOR HUSBAND!!! A bunch of diagnoses, a bunch of prognoses and everything is understandably terrible: he won’t survive; will not eat himself; disabled for life; he wouldn’t gain weight. But a month passed and he started breathing on his own (a hellish month!!!), the weight was 1,300, I was admitted to the hospital with him, where again, according to the doctors, he was one of the heaviest. One day when they told me about another “NO”, I said that I had already heard a bunch that did not come true, to which they told me, “Well, what do you want, medicine is not an exact science!! I understood this is my motto, and for all diagnoses about I repeated it to myself. For another 2 months, we give up food, we go home!!! (The story is very much abbreviated) My son is 10 months old, weight 7,800, we are at the clinic almost every day, being the mother of a premature baby is hard work, but it’s worth it. Of course, he does not develop like full-term children, but I hope by the age of 2-3 years we will catch up with our peers, I believe in this. My story is long, but I wanted there to be at least one review with a positive outcome. Not everyone succeeds, like in the lottery , but I got the jackpot. Condolences to those who didn’t succeed, good luck to those who still hope! Even 500 grams born at 26 weeks survive, I’ve seen such people. Only mom and dad can decide whether to give their child a chance or not, the choice is very difficult and you have to be prepared for the consequences. I took a risk and don’t regret it!!!

A pregnant woman faces various kinds of difficulties throughout the entire period of bearing her baby. The remarkable thing is that many people carry a child without serious problems or postpartum complications. However, there is a percentage of women who are unlucky enough to have a certain type of pregnancy pathology. An example of such a pathological condition is leakage of amniotic fluid, which is dangerous to life and health baby circumstance.

Amniotic fluid, also called amniotic fluid, are a special biological environment for the embryo. Their synthesis occurs in the amniotic membrane of the baby. Filling the cavity of the pregnant uterus, they surround the fetus and play a huge role in ensuring the normal development and growth of the child in the mother’s tummy.

In terms of its composition, amniotic fluid is a complex liquid that contains many nutrients and other substances:

• proteins;
• carbohydrates;
• lipids;
• vitamins;
• enzymatic, hormonal systems;

• mineral components;
• immunoglobulins;
• gases (oxygen, carbon dioxide);
• fetal skin lubrication;
• vellus hair.

Main functions of amniotic fluid

The main functions of amniotic fluid are:

1. Providing the child with all the necessary nutrients in addition to the main source of nutrition through the placenta and umbilical cord. All the necessary substances are absorbed by the child’s skin, and for more later periods During pregnancy, the baby himself swallows a small amount of amniotic fluid and receives some of the nutrients orally.
2. Maintaining a constant temperature(within 37 degrees), as well as constant pressure.
3. Providing a protective function in relation to the baby - reducing the force of shocks from the outside, mitigating vibrations inside the fertilized egg.
4. Protective antibacterial function mediated by the presence of antibodies in the water.
5. Ensuring free movement and the movements of the child in the womb.
6. Reducing the intensity of sound exposure from outside.

Thus, amniotic fluid is vital for the baby at any stage of intrauterine development.

How does normal rupture of amniotic fluid occur?

Normally, during any pregnancy, there comes a moment when the amniotic fluid begins to flow. This happens in the form two main options.

1. In the first option, the fetal membranes, tearing in the center, provide instant outpouring about 250 ml of amniotic fluid. The tear occurs right near the exit of the uterus. At such a moment, a pregnant woman feels a sudden wetness of her underwear and clothes.
2. In the second option, the rupture of the baby’s membranes occurs on their lateral part, that is, above the exit from the uterus. This ensures that there is no immediate expiration, as well as gradual leakage of amniotic fluid in small quantities over a period of time.

As mentioned above, amniotic fluid can be released only when the integrity of the amniotic membrane of the fetus is damaged. Amniotic fluid leaks are a rather dangerous phenomenon., first of all, for the child.

• Firstly, if the medical care it threatens miscarriage or even spontaneous abortion. Secondly, there is a risk from the walls of the uterus and asphyxia of the child.
• Thirdly, leakage of water can provoke disturbances in the normal labor process, that is, its reduced or increased intensity. A particularly important consequence is the formation of respiratory distress syndrome in a newborn premature baby.

Causes of amniotic fluid leakage

During the normal course of pregnancy, amniotic fluid will be released only after the end of the first labor period, that is, after the cervical canal has sufficiently opened. But in some cases, a woman observes leakage of water in an earlier period of gestation. Thus, leakage of amniotic fluid is considered to be its early expiration earlier in the course of pregnancy.

The list of etiological factors that can cause leakage of amniotic fluid includes:

• The presence of cervical insufficiency, leading to “protrusion” of the bladder in which the fetus is located, which only increases the risk of the child contracting an infectious principle.
• Infected genital organs of the mother, which leads to increased ripening of the cervix and high rates of production of specialized enzymes that can provoke detachment of the placenta and softening of the membranes of the fetus.
• Small transverse dimensions of the pelvic ring of the expectant mother.
• Incorrect position of the baby in the womb.
• The presence of development of several embryos in the uterine cavity (multiple pregnancy).
• Abnormal structure of the uterus (uterine septum, congenital shortening of the organ).
• Chronic general somatic diseases (anemic syndrome, dystrophic changes in organs and tissues in various manifestations).
• Alcohol abuse, smoking history.
• Incorrectly planned and illiterately carried out invasive diagnostic techniques in the prenatal period.

Symptoms of amniotic fluid leakage

How do amniotic fluid leak? In almost all cases, the symptoms of amniotic fluid leakage appear on later gestation of the fetus. In the early stages, the appearance of such signs is also possible, however, their determination is quite difficult due to the small amount of fluid released. There is so little of it that, mixed with normal vaginal discharge, it will go completely unnoticed by the woman.

In certain cases, a pregnant woman may mistake the minimal discharge that has occurred as a manifestation of urinary incontinence. In the later stages of pregnancy, leaks will be distinguished by their abundance, and the woman will not confuse them with anything else. Often the amount of discharge increases with tension in the pelvic muscles or active change of position.

What does amniotic fluid look like? Amniotic fluid can have a different character. In some cases it is a colorless transparent liquid, and in others it is reddish, with a brown or green tint, with a pronounced odor, which clearly indicates the presence of a pathology from pregnancy.

How to diagnose amniotic fluid leakage

Currently, there are many methods that make it possible to accurately determine the presence of excessive secretion of amniotic fluid at the first suspicion of the mother. Developed by specialized tests for amniotic fluid using indicator test strips.

One such test for amniotic fluid leakage is Frautest amnio. The essence of it is that a pregnant woman wears a special pad on her underwear, which contains a test strip. When you feel the pad getting wet, it is removed, the strip is taken out and placed in the case included in the kit for half an hour. Next, the color of the strip is assessed: if it turns yellow-green, the test can be considered positive.

The formation of such a color reaction is associated with determining the acidity of a woman’s discharge, or to be more precise, amniotic fluid has an alkaline reaction, and ordinary vaginal discharge has an acidic reaction. This allows us to distinguish them from each other. The main advantage of the Frautestamnio amniotic fluid test is its ease of implementation and highly sensitive reaction to even minimal traces of amniotic fluid in the discharge.

Another type of test "AmniSure ROM" is based on a method for determining alpha microglobulin protein, which is highly specific for the composition of amniotic fluid. The kit includes a swab, a vial of solvent and a test strip.

After collecting the secretions using a swab, it is placed in a test tube for one minute. Next, the test strip is immersed in the same test tube, and the results are read on a clean, light surface from this strip. The presence of two stripes indicates the presence of amniotic fluid in the pregnant woman’s discharge.

In addition to quick tests, the following are used: research methods, How:

• Collection of a woman’s gynecological history, information about pregnancy, examination and instrumental examination.
• Taking a smear from the vagina.
• (ultrasound).
• Carrying out amniocentesis with dye injection.

All therapeutic measures are aimed at preserving the life and health of the baby. But patient management tactics with full term and premature pregnancy varies significantly.

Prevention of leakage of amniotic fluid

• Timely detection and treatment of cervical insufficiency.
• Timely conservation therapy for the fetus (prevention of spontaneous miscarriage).
• Sanitation of chronic foci of infection in a woman’s body, including in the genital tract.

A lively discussion consisting of your questions and advice to each other is welcome. Share your own experience and clarify any unclear points on this topic. Your active discussion of the problem of premature leakage of amniotic fluid during pregnancy benefits not only you, but also all readers.

If a woman becomes pregnant, then she should definitely find out what it is amniotic fluid and what they look like, when they recede and in what volume. If you don’t know this, then in some cases (for example, the contractions are very weak, but the water gradually broke) you may not even notice the beginning birth process. This can end very sadly for both the mother and her child.

What is amniotic fluid?

Amniotic fluid is a special liquid that is found in a woman’s uterus and surrounds the baby throughout pregnancy. They protect the baby from infection that can penetrate the mother’s genital tract, as well as from numerous mechanical influences from the outside. The water helps the baby feel as comfortable as possible in the uterus and not experience possible shocks or other impacts. Amniotic fluid also plays another, no less important role. They hold back the walls of the uterus and thus create space in the woman’s abdomen for the growth and development of the child. If there were no water, then the walls of the uterus would put pressure on the child and he would have no opportunity to fully develop.

The process of discharge of amniotic fluid

As a rule, the waters break before childbirth occurs at the end of pregnancy. If no pathologies or complications arise during pregnancy, then the waters break just before childbirth, and this is the period (in most cases) from the 38th week of pregnancy. When your water breaks but contractions haven't started yet, don't panic. Get ready to go to the maternity hospital, and contractions will either begin on the way or will be induced artificially already in the maternity hospital.

What if the amniotic fluid broke before the 37th week of pregnancy?

Doctors do not consider it normal for amniotic fluid to break earlier than 37 weeks of pregnancy. This situation requires immediate medical intervention. It is worth noting that if the water breaks before the 37th week of pregnancy, then there are two options for the development of events. In the first case, the child is immediately born and is placed in a pressure chamber for babies who are born ahead of schedule. The second option is when a woman goes to the hospital and for another two weeks she will not even be able to move normally, and all this time she is given special antibiotics to avoid the baby getting an infection. The earlier the water breaks during pregnancy, the more difficult it will be to save the baby. Of course, there are many practical cases when a child was born six months old and completely healthy. Although the risk of developing pathologies in such premature babies is too great.

What if the amniotic fluid broke before the 20th week of pregnancy?

If your water begins to break at 20 weeks of pregnancy or a little later, then most likely it will not be possible to save the baby and there will be a miscarriage. In this case, you must immediately call ambulance, because negative consequences can also affect a woman’s condition.

How much amniotic fluid breaks before birth?

If pregnancy proceeds normally, then on average a woman’s body will contain approximately 1.5-2 liters of fluid. Although there may be some deviations from the norm and this depends directly on individual characteristics woman's body.

It is worth noting that water can also drain in different ways. Ideal option at normal pregnancy without pathologies, there is a simultaneous discharge of the entire amount of fluid, so it is very difficult not to notice it.

If the pregnancy had complications or there are some peculiarities of the woman’s body, then the water may break in parts over several days. In this case, it will be somewhat more difficult to notice them and it will be possible to understand that they are leaving only by the nature of the discharge.