What is the role of amniotic fluid?

Your baby floats in this fluid while inside your uterus. Amniotic fluid is a warm, fluid cushion that protects and supports your baby as they grow in the womb. This important fluid contains:

• hormones
• immune system cells
• nutrients
• hormones
• your baby’s urine

At its highest level, the amniotic fluid in your belly is around .95 litres. After 36 weeks of pregnancy, your fluid levels start to decrease as your body prepares for your baby’s delivery.

Your doctor checks your amniotic fluid level in each ultrasound.

If too much fluid starts to leak out, this is known as oligohydramnios. The fluid can also gush out due to the rupturing of the amniotic sac. This is known as the rupturing of membranes.

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Amniotic fluid: How to Identify

Sometimes, the amniotic sac breaks or leaks before labour starts. If the amniotic sac breaks before the 37th week of pregnancy, doctors refer to it as preterm PROM. If the waters break before labour has started it’s called premature rupture of membranes or PROM. 

Don’t be alarmed by the word ‘premature’. It just means the water breakage has happened before labour has started.

Women who got pregnant less than 6 months after their last labour or are carrying more than one baby have a higher risk of PROM.

Sometimes it can be tough to tell if the fluid you are leaking is amniotic fluid. Here’s a look at the symptoms.

Amniotic fluid is odourless, amniotic fluid is a colourless, thin liquid. It looks like water. If the leakage has a smell, it is most likely urine. 

Sometimes amniotic fluid is green or brown when meconium (stool passed by the baby) is present. It can also appear white-flecked as a result of mucus. And when blood is present, amniotic fluid may appear red-tinged.

• clear, white-flecked, and/or tinged with mucus or blood.
• no odour.
• often wets your underwear quite a lot.
• Unlike urine, vaginal fluid is usually white or pale yellow in colour.

Another way you can try to determine if the fluid is amniotic fluid is to first empty your bladder. Place a sanitary pad or panty liner in your underwear and examine the fluid that is on the pad after 30 minutes to an hour. If the fluid is yellow in colour, it’s likely urine. If it isn’t, the fluid could be amniotic fluid.

Another option is to put on a pad or panty liner and concentrate on holding your pelvic floor muscles tight, as if you are trying to stop your urine stream. If you do this and don’t see any fluid on the pad, the fluid you are seeing is probably urine.

When you detect a leak in your panties, it's best to go to a doctor. They may also take a fluid sample and look at it under a microscope.

If it leaks once you are close to your due date, it may be a sign of approaching labour.

What’s considered a normal level of amniotic fluid?

The amount of amniotic fluid cushioning your baby tends to increase as your pregnancy progresses, reaching its highest point at about 36 weeks.

Fluid levels throughout your pregnancy could be around:

60 millilitres (mL) at 12 weeks gestation

175 mL at 16 weeks gestation

400 to 1,200 mL between 34 and 38 weeks gestation

Your doctor can measure your amniotic fluid levels using an ultrasound. There are two calculations on ways to measure, known as the amniotic fluid index (AFI) or the maximum vertical pocket (MPV).

Doctors consider your fluid levels to be low if your AFI is less than 5 centimetres (cm) or your MPV (Mean platelet volume) is less than 2 cm.

Where does amniotic fluid leak from?

The amniotic sac in which your baby is growing is like a water balloon. A small hole in it can cause leakage.

When you’re pregnant, you may feel like everything leaks: Your bladder becomes fuller faster, and you may leak urine. Your vaginal tissues also may produce extra fluid to help your baby pass more easily. So it can be difficult to determine if the fluid is urine, amniotic fluid, or just excessive vaginal fluid (common in pregnancy).

Risk factors for amniotic fluid leakage

It's only an issue that very few women face. But, if you are leaking amniotic fluid and you are not close to your due date, you need the doctor to intervene.

During the third trimester, low levels of amniotic fluid can cause:

• difficulties during labour, such as squeezing the umbilical cord, which can affect a baby’s ability to get oxygen
• increased risk for caesarean delivery
• slowed growth
• There are several treatments for low levels of amniotic fluid if yours has leaked too much. Your doctor can advise the best treatment option.
• What Does Leaking Amniotic Fluid Look Like?

What Should I Do If I'm Leaking Amniotic Fluid?

The treatment for an amniotic fluid leak will depend on various factors. If you're 37 weeks pregnant or beyond, delivery is the most likely plan. Depending on the case, it could be an induction of labour or a caesarean section. If you're 34 to 37 weeks pregnant, your doctor may suggest delivery or put you on close monitoring for a few weeks. 

All attempts will be made to hold delivery in pregnancies earlier than 34 weeks. This can be done via a combination of medication and bed rest. You may also be hospitalised, so doctors can monitor both your health and that of your baby's.

If you have oligohydramnios (low fluid), your doctor may also suggest amnioinfusion. With amnioinfusion, a saline solution is injected into the uterus through your cervix. This treatment can help prevent some problems, such as the umbilical cord being squeezed.

How to do an amniotic swab test at home?

There are tests available in the market. Before you buy a test, do try this:

Wear a pad or panty liner for 30 minutes. Check the leakage on it. Does it check these boxes:

• It's colourless
• It's odourless
• It’s more than just a few drops

If yes, it's most likely amniotic fluid.

There are strip tests available. You have to put a drop of fluid obtained from the vagina onto paper strips containing Nitrazine dye. The strips change colour depending on the pH of the fluid. The strips will turn blue if the pH is greater than 6.0. A blue strip means it's more likely the membranes have ruptured. See your doctor.

In summation, this is not a condition you need to worry about since leaking fluid before term happens in rare cases - only 3% of pregnancies.

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