13 June 2023

Am I Leaking Amniotic fluid? Signs and what to do

Leaking Amniotic fluid
Medical Director
Cesar Diaz-Garcia
MD PhD Assoc Prof
IVI London


 A m i leaking amniotic fluid? The baby is immersed in amniotic fluid in the uterus during pregnancy. It has many functions, which is why it is important to preserve it throughout your pregnancy

When you are pregnant, a number of different fluids can be leaked. Although most of these are not a cause for concern, the loss of amniotic fluid can be worrying.

You may wonder if there is something wrong with the baby or if the baby is on the way. So, what really happens when amniotic fluid leaks? Is it safe? Today we will explain how to recognise it and what to do if it happens before you give birth.

What is amniotic fluid?

Amniotic fluid is a clear, slightly yellowish fluid that surrounds the foetus during pregnancy. While the baby is still in the uterus, it is contained within the amniotic sac. This sac is made up of two membranes: the amnion and the chorion. The foetus grows and develops inside this sac, surrounded by the amniotic fluid.

Initially, the fluid is composed of water produced by the mother. However, around the 20th week of gestation, this original composition is completely replaced by foetal urine, as the foetus ingests and excretes fluid. Amniotic fluid also contains vital components such as nutrients, hormones and antibodies, which help fight possible infections.

What are the functions of amniotic fluid?

Due to its content of nutrients and other elements, amniotic fluid is responsible for various functions.

  • Protecting the foetus from external pressures, acting as a shock absorber.
  • Temperature control. The fluid insulates the foetus, keeping it warm and at a constant temperature.
  • Controlling infections, thanks to its antibody content.
  • Facilitating lung and digestive development.
  • Enabling muscle and bone development. As the foetus floats inside the amniotic sac, it has sufficient freedom of movement to give the bones and muscles a chance to develop properly.
  • Thanks to this function, the amniotic fluid prevents certain parts of the body such as fingers and toes from growing together. If the fluid levels are low, membranes can develop between them.

In addition, amniotic fluid supports the umbilical cord. It prevents it from being compressed and thus allows the cord to transport nutrients and oxygen from the placenta to the growing foetus.

Am I leaking amniotic fluid?

If you are leaking fluid, it is normal for you to worry in case it is amniotic fluid. First of all, it is useful to distinguish what amniotic fluid is in order to recognise it. What does it look like?

Amniotic fluid is usually clear and odourless, but sometimes there are exceptions. It may be green or brown as a result of meconium or faeces excreted by the foetus. It may also appear with white flecks as a result of mucus, or tinged red if blood is present.

Symptoms of leaking amniotic fluid

Sometimes it is difficult to tell if you are leaking amniotic fluid, urine or vaginal fluids. The traits mentioned above are key clues to tell the difference.

Urine has an ammonia-like odour and it is quite common to leak urine during pregnancy. Vaginal fluid is usually white or yellowish in colour. However, amniotic fluid is often clear (or red-tinged) and ends up soaking through your underwear.

If you are concerned about possible amniotic fluid leaks, it is best to see a specialist to find out the true diagnosis of the condition.

What are the causes of leaking amniotic fluid?

Leaking amniotic fluid is mainly due to the presence of a hole or tear in the amniotic sac. The rupture usually begins when labour starts, known as your “waters breaking”.

However, labour is not the only reason for a leak. Losing amniotic fluid during the third trimester will result in a condition known as oligohydramnios, or low amniotic fluid level. This can be caused by maternal health problems, drug use or ruptured membranes. It can also lead to foetal complications such as birth defects, foetal growth retardation or the inability to complete the pregnancy with a natural delivery.

The good news is that in most cases, leaking amniotic fluid is not a cause for concern. However, you should consult your doctor immediately, because if you have too little fluid in your sac, your baby may not be getting the nutrients and oxygen it needs due to compression of the umbilical cord.

What should I do if I am leaking amniotic fluid?

Treatment for amniotic fluid loss will depend on several factors. If you are at 37 weeks’ gestation or later, the recommendation will be to go into labour.

If you are between 34 and 37 weeks of pregnancy, the specialists will decide whether you should go into labour or continue the pregnancy in an attempt to carry the baby to term. During this time, close foetal monitoring will be carried out.

Finally, every effort will be made to avoid delivery if there is fluid loss before 34 weeks’ gestation, which can be achieved through a combination of medication and bed rest.

In short, the decision on what to do if there is a loss of amniotic fluid will always be made by a doctor. Therefore, the first thing to do, and in case of any doubt, is to consult an expert to determine the treatment to be followed.

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