The Premature Departure

Facts

  1. Premature departure is the departure of amniotic water before 37 full pregnancy weeks. The pregnant will experience the departure of aqueous secretions from the abdomen in varying quantity and it can in some cases be difficult to distinguish from urine or discharge from the vagina
  2. The woman should contact the birthplace in order to be examined
  3. Treatment will usually be antibiotics and/or redemption depending on an overall assessment

The Premature Departure

What is premature water departure?
The uterus is the fetus in amniotic fluid, protected by the amniotic membranes. Amniotic membrane closes in on the fetus and amniotic fluid as a closed bag or balloon. Amniotic fluid protects the child and allows it to move freely in the uterus. Fetal membranes prevents the amniotic fluid to leak out. At birth goes there hole on this “balloon”, and amniotic fluid runs out through the vagina. Early water output is when the amniotic fluid leaking, no there are other signs that the birth has started. 6-12% of all women in labor are without contractions until an hour after the amniotic fluid is gone.

For early departure means that water “water goes” three weeks or more before the due date.

How frequent is the premature departure of water?
Premature departure complicates water approximately 2% of all pregnancies and is the cause of about 1/3 of all premature births.

Why do you get premature water departure?
Often one finds no direct cause of that water goes too early, but a number of conditions can trigger the condition, as for example:

  1. Local inflammation of the fetal membranes
  2. Failure of the cervix
  3. Inflammation of the vagina or cervix
  4. Very large uterus by twin pregnancy
  5. Too much amniotic fluid
  6. Abnormal function of the amniotic membranes

Who gets the premature departure of water?
Premature water output is a rare complication, and we do not know the cause. If the pregnant smoker, have had a sexually transmitted disease or have had premature water output in the past, the risk increased for that she gets premature water take-off for the next pregnancy. If she has had repeated bleeding in pregnancy, she has an increased risk. The risk is also greater in twin pregnancies, because the uterus will be particularly great. The same applies if there is too much amniotic fluid.

Certain procedures can lead to premature water again. It can happen as a complication when the pregnant must have taken an amniocentesis, or in connection with that sews the cervix together (cerclage) for preventing premature birth. Read more…

What is the problem for early water departure?
When the water is gone, there is a risk that bacteria can be pushed into the uterus and cause an infection in the woman and/or child. The premature departure of water can also cause birth begins too early. If the child is born very early, there is a risk of breathing problems and brain damage. In some cases, premature water departure lead to umbilical cord pinched, which can affect the blood supply to the baby.

What are the symptoms of premature water departure?
Experience of that leaking fluid from the vagina.

What symptoms you should pay particular attention to?
If you are unsure whether you have water departure, should contact the birthplace for the purpose of assessment.

How to make the diagnosis?
When the water goes, is it pregnant frequently even fully aware of what has happened. There comes relatively abundant ready to light yellow fluid from the vagina, and pants/trousers will often be soaked in a short space of time. Some think they have urinated in his pants, but the brands that they can’t stop fluid flow by going to the toilet.

If the pregnant woman has marked contractions in the abdomen (contractions), bleeding from the vagina, or have a fever, it is important to inform the midwife and/or doctor. Suspected water departure, the woman referred to food Department, so it can be clarified, whether we are talking about water boarding. It may be necessary to do a gynecological examination, which with sterile instruments in the vagina during checks for siven of amniotic fluid, if the cervix is open, and if a birth is under development.

If there are certain water departure, should the pregnant hospitalized at food Department. At the hospital, she and the fetus will be watched closely too early to be able to detect if an infection is under development. Signs of infection is increase in temperature, soreness of womb or affected infection counts (CRP) with the pregnant and a change of fetal heart activity.

The condition is stable after a few days of observation, choose some departments to send pregnant women continue to close mobile home under control.

What treatment is there?
Treatment depends on how far it is pregnant in pregnancy.

The aim of the treatment is to prolong the pregnancy if there is a chance that the fetus can survive. It is also important to avoid infections, which both can affect the fetus and the pregnant.

By the water’s departure after 34 weeks we recommend that birth is initiated within a few hours. The child is at this point in the pregnancy right developed, and assessing that risk being born at this point is less than the risk for infection if we wait. If the fetus is in the lead position, will we put birth in time with medication, and if the child is in the the body presentation, carry out the caesarean section.

If the water goes before 34 weeks, and there are no signs of infection, treat you with adrenocortical hormones in order to promote the maturation of the baby’s lungs. It also provides antibiotics in 7-10 days to prevent infection. Vehæmmende funds will be rarely used, when there is water departure, and then only until the adrenal hormone has reached to operate on the baby’s lungs.

If the birth is still going 18 hours after the water is gone, will, as a rule, regardless of age, pregnancy give preventative treatment with penicillin in high doses during delivery in order to avoid that the child will become infected with bacteria of type beta hemolytic Streptococcus in the vagina.

How is long-term prospects?
Long-term prospects for the mother is good by appropriate antibiotic treatment. For the fetus will primarily depend on the length of the forecast by the water’s departure, as well as the effect of the antibiotic treatment.

How do I avoid getting or aggravating premature water departure?
Please be aware of uterine activity or heaviness sensation in early pregnancy. If a woman previously had premature water outlet or born prematurely in early pregnancy, she should be referred to an OB for the purpose of consultation and study.

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