Leaking Amniotic Fluid: Signs, Causes, and Symptoms

When you're pregnant, it may seem like everything leaks. Your bladder, breasts, and vaginal canal can all discharge fluid. And while most leakages are not cause for concern, leaking amniotic fluid—or the fluid which cushions your baby—can be worrisome. You may be wondering if something is wrong, or if your baby is on the way. So what is really happening when you leak amniotic fluid, and is this discharge safe? Here's everything you need to know about amniotic fluid leaks during pregnancy.

What Does Leaking Amniotic Fluid Look Like?

Clear and odorless, amniotic fluid is a colorless, thin liquid. In general, it looks like water, but there are exceptions. Sometimes amniotic fluid is green or brown when meconium (stool passed by the baby) is present. It can also appear white-flecked as a result of mucus. And when blood is present, amniotic fluid may appear red-tinged.

What Are Common Leaking Amniotic Fluid Symptoms?

How do you know if you're leaking amniotic fluid, vaginal fluid, urine, or all three? The aforementioned traits are actually the biggest hint. Urine (generally) has an odor that resembles ammonia, and it's quite common to have some bladder leakage during pregnancy. Vaginal fluid is usually white or yellow in color. Amniotic fluid, however, is typically clear (or red-tinged) and will soak your underwear. It also has no scent and/or a slightly sweet smell.

If you're worried about signs of leaking amniotic fluid, the only tried and true way to diagnose the condition is contact your health care provider. They will give you an exam and may run a series of tests, which might include a pooling exam, pH test, and dye test. They may also take a fluid sample and look at it under a microscope, as amniotic fluid will have a fern-leaf pattern once dry.

What Causes Amniotic Fluid Leaks?

Amniotic fluid leaks occur when a hole or tear is present in the amniotic sac. Ruptures usually signify the start of labor. This is what's meant by your water "breaking." If your water breaks before labor begins in a full-term pregnancy, it's called premature rupture of membranes (PROM). If it occurs before 37 weeks of pregnancy, it's called preterm premature rupture of membranes (PPROM); this can lead to preterm labor and birth.

Labor isn't the only cause of amniotic fluid leakage, though. Some people will leak amniotic fluid throughout their third trimester—resulting in a condition known as oligohydramnios, or low amniotic fluid. Oligohydramnios is caused by maternal health problems, medications, birth defects, poor fetal growth, rupture of the membranes, or other reasons. It can lead to complications in the fetus, including growth restriction, the inability to tolerate labor, birth defects, and more. It happens in about 4% of pregnancies, according to March of Dimes, and your health care provider can help manage the condition.

The good news is that, in most cases, amniotic fluid leaks are not cause for concern. However, you should consult your provider immediately if you suspect you are leaking amniotic fluid, as too little fluid can cause the umbilical cord to become compressed, preventing your baby from getting enough food and oxygen.

What Should I Do If I'm Leaking Amniotic Fluid?

The treatment for an amniotic fluid leak will depend on various factors. If you're 37 weeks pregnant or beyond, delivery will often be suggested. This can be done via induction or cesarean section. If you're 34 to 37 weeks pregnant, your doctor may suggest delivery or they may recommend you continue the pregnancy in an attempt to carry the baby to term. During this time, you will be closely monitored with regular check-ups. Every attempt to stall delivery will be made for low amniotic fluid in pregnancies earlier than 34 weeks. This can be done via a combination of medication and bed rest. You may also be hospitalized, so doctors can monitor both your health and that of your baby's.

If you have oligohydramnios, your doctor may also suggest amniofusion. With amniofusion, a saline solution is injected into the uterus through your cervix. This treatment can help prevent some problems, such as the umbilical cord being squeezed.