Amniotic fluid not only protects the baby from injury, but is important for its development. When there is something wrong with them, it could mean problems. Fortunately, medicine can measure the amniotic fluid, examine it, and even… replenish the amniotic fluid deficiency!

How areamniotic waters ? Approx. On the 38th day after fertilization, the fetal bladder is closed around the embryo - a tight bag made of two membranes - the chorion (outer) and the amniotic (inner). It is the cells of the amniotic epithelium, thanks to their secretory properties, that produce the fluid that accumulates in the amniotic sac. In partamniotic fluidis also produced by the mother and the fetus.

What does amniotic water consist of?

It's not always exactly the same, as it changes depending on the stage of pregnancy and the condition of the fetus. However, it can be said that the amniotic fluid contains albumin (proteins present in the blood plasma), fats, organic and inorganic s alts, hormones, enzymes and vitamins. There are also numerous cells of the fetal epithelium, and in the late stage of pregnancy, fragments of the nap and fluid that cover the baby's skin. The composition of the fluid says a lot about the conditions in the uterus, as well as about the he alth of the baby.

Amniotic fluid: meaning and functions

The amniotic fluid is - together with the fetal bladder - a protective barrier, protecting the fetus against mechanical injuries, drying out, temperature fluctuations and other unfavorable external stimuli (e.g. noise). It also protects against vaginal microbes to some extent. But that's not all - it is also involved in the metabolism of the fetus, enabling the transport and exchange of nutrients between the fetus and the mother's body, so it is an important condition for the proper development of the baby. Thanks to the presence of amniotic fluid, the baby can test the functioning of the urinary and respiratory systems. As long as there is no access to air, it is the amniotic fluid that is drawn into the bronchi and lungs, and then released back. Thanks to this, he practices the activities that he will perform after birth (e.g. chest movements), thus preparing the lungs for work.

Amniotic fluid exchange

The amniotic fluid is always fresh - it is constantly being changed. Complete fluid exchange between mother and fetus occurs in just three hours! How is this done? On the one hand, liquidit undergoes constant resorption (absorption), on the other - constant reproduction. In the first trimester, the amniotic membranes (amniotic epithelium) absorb fluid into the mother's circulation and at the same time produce a new one. After the 20th week of pregnancy, fluid increases and decreases also because the fetus itself swallows the fluid, which is absorbed in the gastrointestinal tract and - excreted in the urine - returns to the amniotic sac.

Amniotic fluid volume

It systematically increases with the development of pregnancy: at the end of the first trimester, the amniotic fluid is about 100 ml, and in the third trimester from 1 to 1.5 liters. Both too little and too much water is bad for the baby. A lack of fluid (oligohydramnios) could be either the mother (gestosis, blood vessel or kidney disease) or the baby (kidney disease). Babies from this pregnancy are born low birth weight, are at greater risk of hypoxia in labor, and may have immature lungs. Conversely, excess amniotic fluid (polyhydramnios) may mean that your baby has defects in the central nervous system, digestive tract or kidneys. In cases of a large deficiency or excess of fluid, doctors may perform amnio-infusion or amnioreduction, respectively. The former involves injecting the fluid into the amniotic sac, and the latter extracting its excess.

Breakage of amniotic fluid - how to recognize?

Problem

Not enough fluid

By inhaling the amniotic fluid into the lungs, the baby prepares to breathe. Therefore, too little fluid can impair lung development.

What will the ultrasound tell you?

During the examination, the doctor calculates the amniotic fluid index (AFI), which is the indicator of its volume.

Appearance of the amniotic fluid

Any fluid leakage requires immediate medical attention, so it is important to be able to identify it. Normal, normal waters are transparent initially. They become slightly opalescent as pregnancy progresses, and more cloudy before birth. Then they look like soapy water. They may have a specific, fishy and fishy smell or not at all. A change in color or smell may indicate an emergency. When the waters are greenish, yellowish or brownish - you need to go to the hospital quickly, because you need a quick medical consultation. Green may indicate hypoxia, yellow may indicate a serological conflict, and brownish may indicate intrauterine death of the fetus. But it doesn't always have to be this way. Greenish water is the result of your baby giving up meconium (the first poop), which happens when your baby feels stressed for some reason, but this does not always mean that he or she is hypoxic. In many cases, the green color of the waters is not related to anythe threat and childbirth takes place at a normal pace.

Water runoff

Amniotic fluid can leak out in several ways. When they come out in a strong stream at one time, it means that the fetal bladder has ruptured and labor begins. Sometimes the bladder does not rupture spontaneously, despite the commencement of contractions - then the doctor may perform a bladder perforation procedure in order to speed up the delivery. Sometimes the amniotic fluid leaks prematurely, oozes in small rivulets, although there are, for example, several weeks until the delivery date. It is important to be able to recognize this (distinguish from discharge and leakage of urine). If there is even the slightest suspicion that the fluid leaking from the vagina may be amniotic fluid, see your doctor immediately. The discharge of fluid indicates that the fetal bladder has ruptured, and since it is not sealed, it no longer protects the fetus. Vaginal bacteria can travel to the uterus and infect your baby. Therefore, hospitalization is essential for close observation. If there is no risk of infection, the birth may not be quick at all - the obstetrician will decide whether or not to induce it. And the time gained in this way can be used to administer the preparation accelerating the maturation of the child's lungs.

Amniotic fluid testing

The amount, appearance and composition of the amniotic fluid is of great diagnostic importance, therefore their measurements and tests are performed. The volume is measured during an ultrasound performed around the 20th week of pregnancy. The doctor measures the depth of the fluid in four so-called fluid pockets, and the sum of these measurements (in centimeters) is the so-called amniotic fluid index (AFI). The correct value of the AIF is in the range 5-20. AIF of less than 5 is low water and more than 20 is polyhydramnios. Some pregnant women undergo amnioscopy - this test involves visual inspection of the amniotic fluid by a doctor. A special speculum (amnioscope) is inserted into the cervical canal through which the doctor examines the fluid, assessing its color and quantity. Amniocentesis is an invasive test, performed only in justified situations. It consists in piercing the abdominal wall and the fetal bladder with a needle and taking a sample of the amniotic fluid (15-20 ml). The withdrawn fluid can be subjected to various tests. Most often, amniocentesis is performed to detect genetic diseases (e.g. Down's syndrome, Edwards' syndrome). However, thanks to the examination of the amniotic fluid, it is also possible to detect infections of the fetus (e.g. with rubella viruses, cytomegalovirus, syphilis spirochete) or check the maturity of the lungs.

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Pregnancy