What It Means to Have Leaking Amniotic Fluid

Medically reviewed by Peter Weiss, MD

Leaking amniotic fluid toward the end of pregnancy is often a sign of labor. Amniotic fluid is the fluid that surrounds a fetus during pregnancy. When the amniotic sac breaks, known as the rupture of membranes (water breaking), you may feel a gush or trickle of warm liquid from the vagina.

Leaking amniotic fluid earlier in pregnancy is a preterm complication in which the amniotic sac ruptures early. It's known as the premature rupture of membranes (PROM). This is a serious condition that requires medical attention.

This article will provide an overview of what it feels like to leak amniotic fluid, the possible causes, and what to do next.

Leaking Amniotic Fluid: What Week Can It Begin?

Most pregnant people experience leaking amniotic fluid at the end of their pregnancy when labor is starting. The amniotic sac usually ruptures within 24 hours after the start of labor.

When the amniotic sac breaks before the 37th week of pregnancy, it is considered a premature rupture of membranes. This occurs in about 2% to 3% of all pregnancies in the United States.

It is possible to leak amniotic fluid at any point during pregnancy. In most cases, the earlier the amniotic sac breaks, the more serious the condition is.

Related: What to Expect During the Third Trimester

Identifying What Amniotic Fluid Looks Like

It is natural to feel worried about leaking amniotic fluid when you notice discharge or liquid from your vagina. Fortunately, there are other possible causes for this.

Many people experience an increased amount of vaginal discharge during pregnancy. It is also common to leak urine during this time. Your uterus sits on top of your bladder, so as the fetus grows, more pressure is put on your bladder.

Amniotic fluid is usually clear and odorless. It might contain blood or mucus. Once amniotic fluid starts leaking, it does not stop.

It may be helpful to wear a sanitary pad to absorb the liquid. Then, examine the pad. If the fluid is yellow and smells like urine, it is likely urine. If the liquid looks milky and has a mild odor, it is likely normal vaginal discharge. Call your healthcare provider if you are concerned that you are leaking amniotic fluid.

Risks of Early Amniotic Fluid Leaking

Leaking amniotic fluid during pregnancy is serious and requires medical care. The amniotic sac protects the fetus from infection. Once it ruptures, the risk of infection goes up.

Other risks of leaking amniotic fluid include:

• Fetal distress: The baby does not receive enough oxygen.

• Sepsis: This is a serious infection in the blood.

• Cord prolapse: The umbilical cord slips out in front of the baby.

• Placental abruption: The placenta separates from the uterine wall.

• Birth asphyxia: The baby experiences a lack of oxygen and blood flow to the brain; this can lead to delayed motor and brain development.
  

Causes

The cause of premature rupture of membranes (PROM) and leaking amniotic fluid is often unknown. It is estimated that up to 30% of cases are related to an infection in the uterus, cervix, or vagina.

Risk factors for PROM include:

• Multiples pregnancy (twins, triplets, etc.)

• Having too much amniotic fluid (polyhydramnios)

• History of cervical surgery or biopsy

• History of PROM

• Intrauterine bleeding

• History of amniocentesis or festoscopy

• Smoking

• Undernutrition

• Low body mass index (BMI)

• Stress

• High blood pressure (hypertension) 
  

How Much Amniotic Fluid Can You Leak?

The amount of amniotic fluid in the amniotic sac changes throughout pregnancy. For most pregnant people, the amount of fluid steadily increases each week and peaks at about 800 milliliters (mL) at week 34. By week 40 of pregnancy, most people have 600 milliliters of amniotic fluid. Once the amniotic sac ruptures, the fluid will not stop leaking. 

When to Seek Emergency Care

Having the right amount of amniotic fluid is essential for a healthy pregnancy. Amniotic fluid protects the fetus from injury, allowing it to move and develop bone strength. It aids in lung development and prevents heat loss as well.

Leaking amniotic fluid is a serious condition and requires treatment right away. Call your healthcare provider if you believe that you are leaking amniotic fluid at any point in your pregnancy. Do not place anything in your vagina (such as a tampon), and refrain from sex or douching.

Seek emergency medical care if you develop:

• Leaking amniotic fluid that appears brown or green and has a foul smell

• Fever

• Rapid heart rate

• Lower abdominal pain or tenderness

When you see your healthcare provider, they may obtain a sample of the fluid and test it to determine if you are leaking amniotic fluid or another type of liquid (such as urine or vaginal discharge). They may also perform an ultrasound to check on the baby’s health.

Treatment for leaking amniotic fluid depends on how far along you are in pregnancy and may include:

• After 37 weeks: Inducing labor (using medication or natural methods to begin the process of labor)

• Between 34 and 37 weeks: Inducing labor to prevent an infection from developing

• Before 34 weeks: Treating with bed rest, steroids to help the baby’s lungs develop, or labor induction

Summary

Amniotic fluid is the fluid that surrounds a fetus during pregnancy. It is essential for healthy development. When the amniotic sac ruptures (water breaks), the amniotic fluid can gush or trickle out of your vagina.

The rupture of membranes is often a sign of labor. However, when it happens before 37 weeks of pregnancy, it can lead to serious complications for both the birthing parent and the baby.

Amniotic fluid is often clear and odorless. It is common to mistake urine or vaginal discharge for amniotic fluid. Urine is usually yellow and has a distinct odor. Normal vaginal discharge during pregnancy is often milky and has a mild odor.

If you believe that you are leaking amniotic fluid, contact your healthcare provider right away.

Read the original article on Verywell Health.