Some women will notice vaginal discharge that feels similar to a small gush and it can lead to embarrassment, even if it isn't visible. Among pregnant women, leaking amniotic fluid is a common issue and if it is not treated soon enough, it can threaten the health of the mother and child.

What Is Amniotic Fluid and What Does It Do?

Throughout your pregnancy, your baby is inside of an amniotic sac which is a fluid-filled bag within your uterus that cushions him. There are two membranes that make up the amniotic sac wall: the amnion and the chorion. The membranes serve to ensure your baby is securely sealed within the amniotic sac and they will typically break open when you go into labor, at which point fluid flows out and your baby will be ready for birth. This process is commonly referred to as the waters breaking.

During your pregnancy, the amniotic fluid protects your baby from infection and from injury if your baby bump gets squashed or if you experience a blow to the stomach. It also helps your baby’s digestive system and lungs mature.

Am I Leaking Amniotic Fluid?

In many cases, it can be challenging to tell whether you are leaking amniotic fluid. During the final three months of pregnancy, your baby will put a tremendous amount of pressure on your body, leading to normal cervical discharge in small quantities. It is also possible that the leaking you are experiencing is urine; the large pressure on the bladder during pregnancy can easily lead to an accident if you make the wrong movement.

You can tell that the leaking is indeed amniotic fluid if it is odorless and significantly soaks your undergarments. It also continues to leak, repeating the saturation of your undergarments. The fluid will not usually smell, but it may be clear or have white flecks. It will sometimes also be tinged with mucus or blood.

In the case of leaky urine, you will probably notice a distinctive odor to the fluid. In the case of leaking vaginal fluid, your discharge will most likely be yellowish to white or clear in appearance. It may also be very sloppy, making you change your panty liner or underwear multiple times a day.

If you aren’t sure whether you are leaking amniotic fluid or another liquid, talk to your doctor. They may conduct an exam to determine the fluid being leaked. It is particularly important to talk to a medical professional if you think your water broke or you notice the fluid seems green. Green fluid will typically indicate your baby passed a bowel movement and requires special care at delivery.

What Causes Leaking Amniotic Fluid?

In most cases when your pregnancy goes to term, the amniotic sac membranes rupture, causing the fluid to begin leaking out. This process is known as spontaneous rupture of membranes (SROM), and most people call it the water breaking.

It is also possible for the amniotic sac to rupture or tear and cause leaking amniotic fluid before term. The phrase premature rupture of membrane, abbreviated as PROM, refers to when this happens at 37 or 38 weeks before term. In either SROM or PROM, you may notice the liquid gushing out or it may simply leak out in a trickle that is continuous.

In the case of a premature rupture, your doctor will need to determine why the fluid is leaking. This will typically be caused by a bacterial infection, but it may also be caused by a defect of the structure of the amniotic sac structure of the uterus or cervix.

If leaking occurs, this can lead to challenges for your growing fetus as it can limit its growth or cause a bacterial infection to travel to the uterus and the growing fetus.

The following are other possible causes of leaking amniotic fluid:

• Infection of the uterus, cervix, or vagina
• Low amniotic fluid levels
• An injury or trauma to the amniotic sac
• Psychological issues such as stress
• Poor lifestyle habits during pregnancy, including drugs, alcohol, or poor diet
• Previous surgeries to the cervix or uterus
• A history of the amniotic sac rupturing prematurely

Treatments for Leaking Amniotic Liquid

Most of the time, the treatment for your leaking amniotic fluid will vary based on your stage of pregnancy. If you are near full term, your doctor may suggest attempting delivery. If you are not yet at that point, they may consider one of the following medical therapies combined with close monitoring.

Before beginning a treatment plan, your doctor will determine whether the leakage is truly amniotic fluid. In the case of minor tears, they may simply monitor your progress as it will heal by itself. Major or large tears, on the other hand, will require immediate medical attention as well as management therapies aimed at preventing pregnancy complications.

For Hydramnios (Too Much Fluid)

Hydramnios is also known as polyhydramnios and occurs when there is too much fluid in the amniotic sac. This can lead to preterm labor (such as the sac rupturing) and over-distension. It may also lead to a prolapse of the umbilical cord which makes it constrict, falling into the cervix or the placenta detaching from the uterine wall early, posing a fetal risk. This condition is typically linked to defects within the fetus.

Treating hydramnios will involve constantly monitoring the mother’s health as well as that of the baby. At the same time, amniotic fluid production will be reduced using medications and amnio-reduction, which involves removing excess fluid by inserting a needle in the amniotic sac.

For Oligohydramnios

Oligohydramnios is the opposite, meaning it occurs due to reduced amniotic fluid levels in the sac. It can lead to pulmonary hypoplasia (stunted lung growth, umbilical cord constriction at delivery, and issues with the first bowel movement) or negatively affect fetal growth.

Treating oligohydramnios will require doctors to closely monitor amniotic fluid levels and supplement these levels if necessary. Supplementation can occur by using amniocentesis to inject fluids, amnio-infusion with an intrauterine catheter during labor, or rehydration of the mother with intravenous and oral fluids.

For SROM

If the membrane ruptures spontaneously at term, it is likely that your healthcare provider will perform an emergent intervention that induces labor within a period of 48 hours as this increases the chances of your baby being born healthy.