Leaking Amniotic Fluid (Premature Rupture of Membranes) During Pregnancy

Does it seem like you’ve sprung a leak? Bladder control issues are pretty common during pregnancy, especially toward the end. You may, however, be wondering if you’re actually leaking amniotic fluid — and whether your baby is on the way.

Here’s what you need to know about leaking amniotic fluid during pregnancy, including the symptoms to watch out for and when to call your practitioner.

What is leaking of amniotic fluid or premature rupture of membranes (PROM)?

Premature rupture of membranes (PROM) is the term doctors use when the membrane sac holding your baby and your amniotic fluid breaks open after 37 weeks of pregnancy but before you're actually in labor.

What is preterm premature rupture of membranes (PPROM)?

Preterm premature rupture of membranes (PPROM) is when a membrane rupture and leaking of amniotic fluid occurs before 37 weeks of pregnancy.

Symptoms of leaking amniotic fluid

The main symptom of PROM or PPROM to watch out for is the leaking or gushing of fluid from the vagina. You can tell whether you're leaking amniotic fluid and not urine by taking the sniff test:

• If it doesn't smell like ammonia, it's more likely to be amniotic fluid. If it has an ammonia scent, it's probably urine.
• If it has a somewhat sweet smell, it's probably amniotic fluid.
• If it smells foul, it may be infected amniotic fluid.

If your water has truly broken, you’ll notice more fluids leaking when you’re lying down than when you’re standing, sitting or walking. That’s because when you’re upright, your baby’s head blocks the cervical opening and keeps most amniotic fluid trapped inside.

Got doubts about the liquid you're leaking? Call your practitioner to be on the safe side.

Causes of leaking amniotic fluid

In most cases of leaking amniotic fluid, the rupture of your amniotic sac is just a prelude to the onset of labor within the next 24 hours.

Who is at risk of premature rupture of membranes?

You may be at increased risk of preterm premature rupture of membranes if you:

• Smoke during pregnancy
• Have chronic vaginal bleeding during your pregnancy
• Had a previous early membrane rupture
• Have bacterial vaginosis (BV)
• Have certain STDs
• Have placental abruption
• Are carrying multiples

How common is leaking amniotic fluid during pregnancy?

It’s not all that common for your water to break before you go into labor. PROM, or leaking amniotic fluid after 37 weeks, occurs somewhere between 8 and 15 percent of pregnancies.

PPROM is far less common, occurring in about 3 percent of pregnancies. But it’s more serious, since it comes with the risk of premature labor and birth before 37 weeks.

Risks of leaking amniotic fluid

Possible medical issues from PROM and PPROM include:

• Premature labor and birth, which is the major risk of both PROM and PPROM
• Infection of the amniotic fluid
• Prolapse or compression of the umbilical cord if your baby's head is not yet engaged in your pelvis

What should you do if you’re leaking amniotic fluid?

If you think you’re leaking amniotic fluid at any point during your pregnancy (or even if you suspect you might be but aren’t sure), call your practitioner. He or she can help you figure out if your water really has broken and the next steps to take.

If your membranes rupture and you're at least 37 weeks along, your labor is likely to begin on its own within 24 hours. If contractions don't start on their own, your doctor will probably induce labor. Either way, you’ll likely meet your baby soon!

If you leak amniotic fluid and your membranes rupture earlier than 37 weeks, and your practitioner determines it's too soon for your baby to be safely delivered, you'll most likely receive antibiotics to ward off infection and may need to be hospitalized.

You’ll also likely get a dose of steroids to help your baby’s lungs quickly mature for an early delivery. Depending on how early you deliver, your baby may need to be in the neonatal intensive care unit (NICU) for some time before coming home.

Can you prevent premature rupture of membranes?

There’s no way to prevent PROM or PPROM. But you can lower your risk of both conditions by attending all of your prenatal appointments, eating well and not smoking.

As long as PROM and PPROM are diagnosed and treated quickly, odds are likely that you and your baby will be fine. The important thing is to know the warning signs, and if you notice any possible symptoms, to contact your doctor right away so the problem can be addressed as soon as possible.