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Leaking Amniotic Fluid: How To Identify & What To Do

In order to identify if you are losing amniotic fluid, it is important to be aware of the presence of a transparent, odorless liquid in your panties, which makes your panties wet more than once a day. In addition, a decrease in fetal movements may also be noted.

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.

Leaking Amniotic Fluid: How To Identify & What To Do

Signs that amniotic fluid is leaking

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.

Some signs that may indicate that amniotic fluid is leaking include:

  • Wet panties with a liquid that has no smell or color;
  • Wet panties more than once a day;
  • Decreased movements of the baby in the womb, when there has already been a greater loss of fluid.

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.

What to do if you are leaking amniotic fluid

Treatment for leaking amniotic fluid varies according to gestational age:

1st and 2nd trimester

Immediate medical help is vital, but treatment is usually done with weekly consultations with the obstetrician to assess the amount of fluid throughout pregnancy. When the doctor does the ultrasound and finds that there is low amniotic fluid, it may be necessary to increase the water intake and rest so as to avoid losing more fluid and other complications for the woman.

If there are no signs of infection or bleeding associated with fluid leakage, the woman can be monitored periodically as an outpatient, with the health team checking her body temperature and doing a blood count to check for signs of infection or labor. Tests are also done to see if everything is okay with the baby, such as auscultation of the baby's heartbeat and fetal biometry. So, it is possible to check if the pregnancy is going well, despite the amniotic fluid loss.

3rd trimester

Fluid leakage at the end of pregnancy is usually not serious, but if the woman is losing a lot of fluid, the doctor may choose to induce labor. If this loss occurs after 36 weeks, it is usually a sign of rupture of the membranes, so go to the hospital as labor may have started.

What can cause amniotic fluid leakage

The causes for leaking amniotic fluid are not always known. However, it can happen due to genital infections, so go to the obstetrician whenever symptoms such as burning when urinating, genital pain, or redness appear.

Other causes that can cause amniotic fluid leakage or lead to a reduction in its amount include:

  • Partial rupture of the sac, in which the amniotic fluid begins to leak due to a small hole in the sac. This is more frequent in late pregnancy and usually the opening closes by itself with rest and good hydration;
  • Problems in the placenta, in which it may not be producing enough blood and nutrients for the baby, who doesn't produce as much urine, resulting in less amniotic fluid;
  • Medicines for high blood pressure, as they can decrease the amount of amniotic fluid and affect the baby's kidneys;
  • Fetal abnormalities: at the beginning of the second trimester of pregnancy, the baby may start to swallow the amniotic fluid and eliminate it through the urine. When amniotic fluid is lost, the baby's kidneys may not develop properly;
  • Twin-to-twin transfusion syndrome, also known as feto-fetal transfusion syndrome, which can happen in the case of identical twins, where one can receive more blood and nutrients than the other, causing one to have less amniotic fluid than the other.

Some medicines, such as ibuprofen or medicines for high blood pressure, can also decrease the production of amniotic fluid, so it is important to inform the obstetrician before any medication is started.

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  • CAMPANA, Sabrina G.; CHAVEZ, Juliana Helena; HAAS, Patrícia. Diagnóstico laboratorial do líquido amniótico. Jornal Brasileiro de Patologia e Medicina Laboratorial. Vol 39. 3 ed; 215-218, 2003
  • ZIMMERMMANN, Juliana B. et al. Oligoidrâmnio isolado em gestação a termo: qual a melhor conduta?. FEMINA. Vol 38. 4 ed; 203-209, 2010
  • HOSPITAL UNIVERSITÁRIO MARIA APARECIDA PEDROSSIAN - UNIVERSIDADE FEDERAL DO MATO GROSSO DO SUL. Protocolos de Obstetrícia HUMAP - Rotura Prematura de Membranas. 2017. Available on: <http://www2.ebserh.gov.br/documents/17082/3273530/Rotura+Prematura+de+Membranas.pdf/e03865cb-ce78-4ad8-9d87-147b8c40c748>. Access in 10 Sep 2019
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