Leaking Amniotic Fluid: How To Tell & What To Do

Medical review: Dr. Sheila Sedicias
Gynecologist
January 2022

Leaking amniotic fluid is usually characterized by the presence of a transparent, odorless liquid in your underwear that results in wetness that occurs 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, you are advised 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.

Signs that amniotic fluid is leaking

In most cases, the leaking of amniotic fluid can be easily mistaken for the involuntary loss of urine, which is common during pregnancy, It happens due to the weight of the uterus on the bladder. Leaked amniotic fluid can also be mistaken for increased vaginal discharge.

A good way to tell if the wetness in your underwear is a loss of amniotic fluid, urine or vaginal discharge is to use a panty liner and observe the characteristics of the fluid. Urine is normally yellowish and has a distinct odor, while amniotic fluid is transparent and odorless. Vaginal discharge is also odorless but normally has more of an egg white consistency.

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

  • Wet underwear with an odorless and colorless liquid;
  • Wet underwear more than once a day;
  • Decreased movements of the baby in the womb, when there has already been a great 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 it 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 lost throughout pregnancy. When the ultrasound is completed and a low amount of amniotic fluid is noted, you may be advised o increase water intake and rest. This will help to prevent further fluid loss and the development of other complications.

If there are no signs of infection or bleeding associated with fluid leakage, the woman can be monitored periodically as an outpatient. Outpatient visits usually involve checking body temperature and doing a blood count to assess 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.

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, loss of amniotic fluid is usually a sign of rupture of the water sac. If you experience loss of fluid in the third trimester, proceed to the hospital to confirm whether labor has started.

What can cause amniotic fluid leakage

The causes for leaking amniotic fluid are not always known. However, it can happen as a result of a genital infection, therefore you should report any symptoms like burning when urinating, genital pain, or redness to your obstetrician if they 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. 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;
  • Medication 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 medication, such as ibuprofen, can also decrease the production of amniotic fluid, so it is important to inform the obstetrician before any medication is started.

Was this information helpful?

Atualizado por Tua Saude editing team, em January de 2022. Medical review por Dr. Sheila Sedicias - Gynecologist, em March de 2019.

References

  • 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
Show more references
  • 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
Medical review:
Dr. Sheila Sedicias
Gynecologist
Physician graduated in Mastology and Gynecology by UFPE in 2008 and member no. 17459 of CRM-PE, Brazil.