If you are a term of pregnancy I'm sure you have a lot of questions about breaking water. Dear mom, in this article I will tell you what you need to know about rupture of the amniotic sac, what to do when the water breaks, how to notice it, when to go to the hospital and what to do if the membranes rupture without contractions or when the baby is breech. So let's get started right away!
Amnio chorionic membranes
Amniotic membranes serve to protect, guard and keep the fetus warm during the nine months of pregnancy. Inside the amniotic sac, which is made up of two membranes, Amnios and Chorion, the baby swims inside submerged by a liquid called amniotic fluid. The liquid is transparent, the fetus enjoys tasting and swallowing it and sometimes even pees in it. Inside the amniotic sac, the fetus is kept warm with a constant temperature of 37 ° C, is protected from accidental impacts to the mother's abdomen and its every movement is cushioned. At the end of pregnancy, the maternal body prepares for the birth of the baby by implementing changes that trigger labor.
Water breaking
The rupture of the membranes at the end of pregnancy in most cases occurs during labor, in fact under the stresses of the contractions there is the loss of the water that pours out of the vagina. In other cases, however, the rupture of the amniotic sac occurs before labor begins, but in any case this represents a symptom that something is changing and shortly after birth contractions will begin. In both cases, spontaneous rupture of the membranes is defined as spontaneous amnioresis About 8% of pregnant women experience rupture of the amniotic membranes before the onset of labor Usually after rupture of the membranes about 50% of women go into labor within the next 24 hours.
How does the rupture of the water and the loss of amniotic fluid occur
On this topic it really says everything, for example, that the break occurs with a noise, or that it occurs in sleep wetting the bed having a bad dream. Let's clarify: when the membranes rupture there is no noise and no bad dreams or maternal movement that led to the rupture. The waters just break, to date there is no scientific data that explains why. The fear of breaking the membranes and not noticing it is a cause of great concern for the pregnant woman. Do not worry, to recognize the rupture of the membranes it is necessary to know what the amniotic fluid is like. Amniotic fluid has
consistency of the water;
transparent white color;
does not give off a bad smell.
The rupture of the membranes can be of different types and the amniotic fluid can be expelled in large quantities by wetting underwear and clothing or in scarce and prolonged losses. The first type of break is called a low break while the second type is called a high break The low rupture of the membranes is easy to recognize because there is an abundant leakage of amniotic fluid that wets panties, clothes and even the floor.
The high rupture of the membranes is more difficult to recognize because there is not a large loss of liquid but a continuous dripping.
In practice, the rupture is not near the cervix but laterally, so the liquid will flow out slowly and can be confused with urine leaks.
At the end of pregnancy, it is always recommended to purchase hygienic pads called Amniocheck indicators of membrane rupture.
You wear the pad which, in contact with vaginal discharge, will be colored if it is amniotic fluid.
For any doubts about the rupture, if it is not possible to have an amniocheck, wear a clean diaper and check the nature of the vaginal discharge after half an hour.
If they are colorless and odorless it is certainly amniotic fluid, if instead they have the characteristic smell and color it is urine.
For any doubts it is always better to have an obstetric check-up.
Quando avviene la rottura delle acque
The loss of water should normally occur spontaneously during labor, in this case we speak of timely rupture of the amniochorial membranes, if instead the waters rupture before labor, it is an untimely rupture of the membranes, known by the acronym PROM (Prelabour Rupture of the Membranes) In reference to the gestational period in which the rupture of the membranes occurs we speak of:
full-term rupture if it occurs after the 37th week of pregnancy
preterm rupture if it occurs before the 37th week of pregnancy
The medical treatment will have a different conduct in relation to the gestational period, in the preterm rupture of the membranes we will try to maintain the pregnancy as much as possible by adopting a close monitoring of mother and child by continuously evaluating the well-being and signs of fetal suffering and the indexes of inflammation otherwise in the term rupture a certain number of hours is waited for labor to start spontaneously and then, if not, to induce the birth with pharmacological methods.
What to do when the waters break
At the end of pregnancy, the rupture of the membranes is completely normal so do not get anxious, wash thoroughly, wear an absorbent hygienic diaper like the ones below, take the delivery bag and go to the hospital. Once you arrive at the hospital, the actual rupture of the water, the color of the amniotic fluid, the well-being of the baby, the dilation of the cervix and any contractions will be assessed.
Rupture of the waters and vaginal swab
If the rupture of the amniotic sac is confirmed, hospitalization will proceed, and in the presence of a positive vaginal swab for Group B Streptococcus Haemolytic Diseases, the antibiotic will be administered to avoid infecting the fetus. Normally, if there are no particular risk factors, one waits 24 hours before proceeding with any medical intervention to stimulate delivery because within these hours 50% of women go into labor spontaneously. During this waiting period, the baby and the mother will be constantly monitored and if the conditions require it, the delivery times will be accelerated.
Water breaking without contractions
Breaking water without contractions is a sign that labor is about to begin and generally occurs in the prodromal phase This phase cannot be defined as actual labor but a path that leads to the active phase of labor. The changes generated by the prodromal phase are the loss of the mucous plug, the presence of irregular contractions and in some cases the rupture of the membranes. From rupture of the membranes to delivery, a few hours may pass before the baby is born, in fact the contractions must become frequent and close together in order to fully dilate the cervix and initiate expulsive thrusts
Breaking of water and liquid tinged with meconium
As mentioned, the color of the amniotic fluid is clear and transparent and does not give off a bad smell.
In some cases the liquid may have a different color and in these cases we speak of a liquid dyed with meconium.
The dyed liquid indicates that the water is dirty because the baby has expelled meconium, the substance contained in the baby's intestine presumably following a distress.
Based on the gradation of the amniotic fluid, we speak of tinted fluid 1, tinted fluid 2 and tinted fluid 3 in an ascending order based on the intensity of the color.
In the presence of dyed amniotic fluid, a careful assessment of fetal well-being must always be made by means of a cardiotocographic trace and other tests such as flowmetry, ultrasound, white blood cell count and maternal PCR.
Water rupture with fetus breech presentation
At term of pregnancy it can also happen to have the sac ruptured when the fetus is in breech presentation. In this case it is necessary to go to the hospital to undergo a caesarean section.
Rupture of the waters with caesarean section
One of the questions that mothers often ask themselves is how the rupture of the membranes occurs during a caesarean section. As mentioned, the bag of water envelops the newborn and during the caesarean section a small hole is made on the membranes which will then be enlarged with the fingers, the liquid pours out and the baby is extracted.
Rupture of membranes in preterm pregnancy
Unfortunately, it can also happen that you lose water at 8 months, 7 months or even worse at 6 months of pregnancy. In cases of preterm rupture, the treatment of obstetrics guidelines provides as far as possible the preservation of the pregnancy and the fetus. Hospitalization is required, which involves continuous evaluation of fetal well-being, any maternal infections, and other maternal and fetal tests that monitor pregnancy. In the presence of a rupture of the membranes in which there has been a large loss of amniotic fluid and therefore there is a considerable reduction of fluid, oligoamnio, a measurement of the fluid is constantly carried out, AFI mniotic fluid index, to estimate if it is increasing .
Rupture of the membranes and moon
According to popular tradition, the phases of the moon influence the rupture of the membranes and the beginning of labor, it is believed that the full moon exerts a sort of pressure inside the uterus, a bit like it does with the tides and face. break the amniotic sac I'm sorry to disappoint you but a Spanish midwife after a study on the correlation between rupture of membranes and the full moon found that most women lost their waters and gave birth on a waning moon. For the next waning moon, get ready
Breaking of the water to induce labor
In some cases it is necessary to artificially induce rupture of the membranes to stimulate labor which takes the name of iatrogenic amniorhexis.
Rupture of the membranes is followed by the gynecologist or midwife and only in limited cases in which labor is slow or labor is in an advanced stage and the membranes have not yet ruptured spontaneously.
The procedure is called amniotomy and is performed with a tool called an amniotome.
It is a sort of hook, like the one for cross-stitching, so to speak, with which a small hole is made in the membranes along the vaginal canal.
The breakdown of the water stimulates the production of prostaglandins which increase contractions and thus accelerate labor.
Water breaking products
Amnio check for rupture of the membranes
An innovative and useful product that serves to check if the membranes are ruptured during pregnancy. It is a sanitary napkin that contains an amniotic fluid detector test inside. The absorbent is worn and when there is a rupture of the membranes the absorbent surface is colored indicating the presence of rupture. A product that pregnant mothers can use when in doubt about the presence of amniotic fluid in their panties.
Sanitary napkins
It is a panty that contains a sanitary pad inside. This product is very useful and discreet in case of rupture of the membranes because it can be worn like a normal panty, but also in post partum because it allows the freedom of movement that a new mother needs. Product to be included inside the delivery suitcase.
Write me in the comments if you have any questions about rupture of membranes, I will be happy to answer you.
Mom. Mather
pocket obstetrics and gynecology
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