Leaking Fluid During Pregnancy: What It Means

At 18 weeks pregnant, I showed up at my hospital's Labor and Delivery Department.

The women in the cubicles around me were hugely pregnant, moaning with contractions as they prepared to deliver and hold their new babies. I, on the other hand, was paralyzed by terror. The doctor had told me that he felt pretty sure my amniotic sac was leaking, and that my fetus and I were suffering from a preterm premature rupture of membranes (PPROM).

What Is PPROM?

Preterm premature rupture of the membranes (PPROM) is a pregnancy complication when the amniotic membrane surrounding the baby breaks before the 37th week of pregnancy. Once the sac breaks, there is an increased risk for infection and a higher chance of having your baby born early. PPROM happens in between 8 and 15 percent of pregnancies.

But a fetus at 18 weeks is nowhere near viable outside the womb, and a broken sac would mean a miscarriage. The nurse was grim-faced as she ordered the tests on the leaking fluid. "This doesn't look good," she said.

The leaking fluid had started as a gush—the day before, I'd squatted down while cleaning and suddenly my pants were soaked. As a woman who has experienced incontinence during pregnancy (what mother hasn't?), I was struck by how it didn't seem like I was peeing. It was sudden and uncontrollable. I called my doctor.

"Take it easy for the rest of the day, and call me if it continues," he said. "Even if it was amniotic fluid, sometimes the bag of waters reseals and the pregnancy continues."

Unfortunately, every time I stood up, I'd leak another teaspoon of fluid into my underpants. It was mortifying. Each time, it felt like a death knell to this pregnancy. That night, the doctor on call told me to wear dark underwear to bed and to call him if it was wet when I woke up in the morning.

My husband and I slept fitfully, terrified by the "dark underwear test."

As I tried to sleep, I could feel the baby kicking and wondered if this might be the last time I would know that feeling.

In the morning, out came another teaspoon of fluid. When I called the doctor, he offered a grave apology for the suspected miscarriage and told me to go directly to the Labor and Delivery Department.

There, the nurse performed a series of tests in order to identify the fluid. The primary test is a simple litmus strip applied to the fluid near the cervix, and we were intensely relieved when that test proved negative. Even if I did have amniotic fluid leaking before, she could find no sign of it.

Due to my 99.3° fever, the nurse also tested me for infections—whether bladder or uterine—which are a primary cause of PPROM. Both came up negative. We started to breathe a sigh of relief. Either the leaking had stopped, or it was never amniotic fluid in the first place.

Our last stop at the hospital was the ultrasound department. The nurse had ordered an ultrasound to ensure there was enough fluid surrounding the fetus. By this point, we were in better spirits, particularly after the ultrasound technician reassured us that the fluid levels looked normal.

Then she asked if she could do a full-body scan of the fetus. I whooped for joy. Not only did everything look well for the pregnancy, but now we could find out the sex of the baby too.

The Cause of the Leaking Fluid

So, what was that leaking fluid? When I saw my doctor for a follow-up visit, he checked my cervix with another pH strip to confirm there was no sign of amniotic fluid. He then explained that the amniotic sac has two layers, and I might have developed a hole in the outer layer, losing the fluid contained just between the two layers. It may then have resealed and replenished itself with fluid.

Or, I might simply have had an extended bout of wild peeing, which is not unheard of in pregnant women.

According to the National Library of Medicine, the biggest sign to watch for if you are concerned about PPROM is fluid leaking from the vagina. The fluid may leak slowly, or it may gush out. If you notice fluid leaking, use a pad to absorb some of it. Look at it and smell it. Amniotic fluid usually has no color and does not smell like urine (it has a much sweeter smell).

If you think your membranes have ruptured, call your healthcare provider right away. You will need to be checked as soon as possible.

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