What is the source of amniotic fluid

Pregnancy: what if the amniotic sac bursts?

As a rule, the amniotic sac ruptures during or shortly before the birth and starts labor. Sometimes this happens weeks before the expected delivery date. An expert explains what you should know about the amniotic sac.

The amniotic sac is a perfect construction of nature. It protects the baby in the womb from bumps, injuries and infections like a tight balloon. The amniotic fluid it contains is usually light and clear, but sometimes also flaky. It is produced by the cells of the fruit cavity at the beginning of pregnancy.

"It doesn't stop during pregnancy, but the amount of amniotic fluid that is created in this way is very small," explains Christian Albring, gynecologist and president of the professional association of gynecologists, to t-online.

The baby's urine is also in the amniotic sac

"In the second half of pregnancy, the amniotic fluid mainly consists of the baby's pee. The child drinks amniotic fluid, but also receives fluid through the umbilical cord. This fluid is constantly filtered through the baby's kidney and excreted back into the fruit cavity."

If the birth is imminent after about 40 weeks, the amniotic sac can burst after the mucus plug, which until then had kept the cervix closed and thus protected the uterus, has passed. Then the content of around 800 milliliters either empties like a surge, which is absolutely painless, or the odorless amniotic fluid gradually comes off drop by drop.

Labor usually begins before the rupture of the bladder

This is the case when the crack is quite high and the liquid can therefore only escape in small amounts, so that some pregnant women initially mistake the wet for their own urine. Usually contractions have started at this point. In around twenty percent of women, however, the urine ruptures prematurely - before the contractions begin.

This is what happened to Simone when she was expecting her daughter almost five years ago. "It happened one evening when my husband and I were invited to dinner with neighbors just a few days before the expected due date," the young mother recalls. "I was actually still fine at the time. But just before we wanted to leave the house, I suddenly felt a gush of warm liquid running down between my legs. Then it wasn't long before the contractions started. We drove straight to the hospital. Six hours later our little mouse was there. "

Umbilical cord prolapse and infection are the greatest risks

Simone knew from her midwife, who had informed her beforehand about the possibility of such a scenario, that she should lie best when she was transported to the clinic. "It was clear to me: I had to be as flat as possible in the car. This reduced the risk of our daughter having an umbilical cord incident and breaking the life-sustaining connection between her and me."

However, time is also an elementary factor after a rupture of the bladder, because the baby is no longer surrounded and protected by amniotic fluid. "This makes it much easier for bacteria and germs to rise into the fruit cavity, so that there is a high risk of infection - for the child, but also for the mother," said Albring. In an emergency, this can be read off, adds the expert: the rise in temperature, an increased heart rate and an increased feeling of illness and weakness in the pregnant woman.

A lot of blood in the otherwise clear amniotic fluid is a warning sign

Fortunately, Simone was spared such a bad turnout. After the sudden rupture of her bladder, she only worried that the amniotic fluid that had drained off no longer had a clear consistency, but was somewhat discolored - as if it had mixed with blood. "A little blood in the amniotic fluid is not a cause for concern. It can come from small blood vessels that lie around the cervix and burst when it opens," says the gynecologist.

"If the discharge is clearly bloody, the woman should go to the hospital immediately, because that is an important sign that the cervical opening is already advanced or the placenta is detaching prematurely. The latter would be a life-threatening situation. Ideally, one should be in one In such a case, call the hospital beforehand and let them know so that the maternity hospital team is prepared for a possible emergency. "

Premature birth due to premature rupture of the bladder

The situation also becomes problematic if the rupture of the bladder does not occur on the calculated due date, but at a much earlier stage of the pregnancy. According to Albring, the causes for this are mostly inflammatory processes in addition to the premature opening of the cervix.

"Women should therefore definitely try to avoid infections of the vagina during pregnancy and to resolve existing vaginal infections before the beginning of a pregnancy," says the gynecologist. As a precaution, the embarrassing observation of vaginal hygiene is essential. "Only water should be used for cleaning, not soaps or intimate lotions." Because a change in the acidity in the vagina could result in a colonization with bacteria. You can then treat locally with antibiotics or antimycotics to contain the infection.

Avoid premature birth

If, despite preventive measures, the bladder ruptures prematurely, premature labor is inevitable, so that the birth can hardly be stopped. After all, a third of all premature births are triggered in this way. "In some cases, the onset of labor can still be prevented with beds, immediate antibiotic treatment of the infection and contractions," adds Albring.

"And the tear in the bladder can eventually close up again, especially if it is a high rupture of the bladder, i.e. not in front of the inner cervix." However, if the rupture of the bladder did not occur until after the 37th week of pregnancy, no more attempts would be made to delay the delivery. Then all that is left to do is to ensure that no germs can penetrate the fruit cavity and thus lead to a threatening inflammation.

Prepare for life "outside"

However, medicine does not always succeed in stopping the course of events after the amniotic sac has ruptured prematurely. Then it is important to concentrate on the baby and create the best possible conditions for life outside the protective womb. This is elementary, especially for those premature babies who are announced before the 35th week of pregnancy, explains the expert. "In this case, the mother receives a drug that accelerates the maturation of the baby's lungs so that the child can breathe independently as directly as possible, even when the baby is premature."