Fracture of the water bag: how long before departure to the maternity ward?

What is the bag of water and what does it do?

The sac of water corresponds to the two adjacent ovarian membranes — called amnion and chorion — that contain the amniotic fluid that bathes the fetus in the uterine cavity. Amniotic fluid is produced during pregnancy, both by the membranes of the water bag and by the baby itself. To be the volume varies depending on the stage of pregnancy : 200 ml around 4 months, between 1 and 2 liters around 8 months and an average of 1 liter in the long term.

This fluid-filled bag is used both: to protect the fetus from possible shocks and external noises, to keep it at body temperature, to provide it with the water and mineral salts it needs, but also to protect it from possible bacterial proliferation.

The egg membranes are transparent and thin, but resistant. They become more sophisticated and vulnerable as they approach term.

Breaking water: what does it mean?

When one, the other or both ovaries rupture, the amniotic fluid flows more or less frankly, we speak of rupture of the sac containing water.
“There are two types of rupture of the water bag: if the two membranes are pierced, we speak of” clean breakif only one of the two breaks, we speak of crack‘ describes the midwife.
In the first case, the volume of fluid lost will be large, and the underwear of the future mother can literally soak. “Among 500ml and 1.5L the water flows through the cervix: it is impossible not to notice it”, reassures Aurélie Kaczmarek.
In the case of bursts, on the other hand, the fluid flows out gradually and drop by drop, which complicates the diagnosis.

There is no warning sign that the bag of water will break. If it is usually done close to the deadline, it happens that it takes place well before the deadline. The appearance of the amniotic fluid can then vary.

Amount of liquid

If the pregnant woman’s water bag contains an average of 1 liter of water over time, this volume can vary from 500 ml to almost 2 liters dependent on women.
When the break is clearthe liquid is evacuated in a significant way, which does not go away no room for doubt† On the other hand, in the case of crackhe goes flow out gradually and in small amounts. “If the mother is in doubt about the nature of her losses, we recommend that you change clothes and check regularly in the hours that follow that there are no new losses,” the midwife says. If the weather is wet, it is best for her to go to the maternity ward, where the nature of the fluid can be checked with an amniotic fluid test – which analyzes the pH of the fluid to determine if it is indeed amniotic fluid.

liquid color

“Amniotic fluid is normal” colorless, odorless and hot† However, if the pouch ruptures before the 37th week of amenorrhea, it will contain small white flakes, corresponding to the varnish which covers the baby’s skin to protect it from dehydration,” describes the midwife. In the case of preterm bursting, which makes the loss of water less obvious, these white flakes can confirm to the mother-to-be that it is indeed amniotic fluid. goes.

Finally, at the end of pregnancy, the amniotic fluid has an opaque and greenish appearance, resembling pea puree: “this is the sign of the presence of meconium, which indicates that the baby has released its sphincters,” explains Aurélie from Kaczmarek. The expectant mother must then immediately go to the maternity ward.

Amniotic fluid or urine: fluid loss or pee leakage?

When the term approaches, between the perineum softening and the uterus compressing the bladder, urine leakage is common in pregnant women this is called stress incontinence. So in the event of a leak, how do you know if it is urine or amniotic fluid. “Unlike urine which is more or less yellow and may have a specific odor, amniotic fluid is odorless and colorless‘ recalls the midwife, for whom this difference may be enough to distinguish the two fluids.
If it is not clear to the expectant mother, she should remain vigilant and check that the leaks do not return in the following hours.

Break water and bathe

How do I know if my water breaks in a tub, or even while bathing in the sea or in a pool? This is a common concern for women at the end of pregnancy. Especially since his softened perineum often tends to leak water into the cervixwater that gradually flows once the mother-to-be is out of the water, making her think it may be amniotic fluid.

Aurélie Kaczmarek, obstetrician “In case of an obvious rupture of the water bag, the woman will feel a depression in her stomach, a bit like a deflating balloon”

Even in a bath, she can realize it and feel the hot liquid pouring out of her vagina. “Just like we feel what happens when we pee in the sea,” adds the midwife. With cracks, on the other hand, it is more difficult to distinguish things from each other. The mother-to-be should therefore not hesitate to consult if she has it the slightest doubt

Can you break water while sleeping?

Does the expectant mother necessarily have to be active and/or stand for her water to break? “The rupture of the bag of water does not necessarily depend on the activity of the mother, but also on that of the baby who can do somersaults in the tummy while sleeping or resting,” the midwife recalled. So it’s all possible and frequent that the bag of water breaks overnight or during a siesta.

Is it possible to break water without contractions?

The rupture of the sac of water is not necessarily linked to the onset of labor and thus to uterine contractions! It is therefore quite possible, and even often, that it takes place before the least contractions† “And vice versa, some women will never pierce it, even during labour: it then has to be pierced by the healthcare team, with forceps to break,” describes the obstetrician.

What to do if your water breaks?

When the bag of water breaks, the biggest risk to the baby is: risk of infection, because it is no longer protected from the outside by the amniotic fluid. It is therefore important that the mother comes to the maternity ward quickly. However, the degree of urgency depends on several factors.

Aurélie Kaczmarek “In the case of a frank break, after 37 SA and with the flow of transparent liquid, the mother can take the time to get ready, take a shower and calmly go to the maternity ward within two hours of the water breaking to leave”

If the liquid is cloudy and green and therefore meconiumyou have to go faster in pregnancy† “On the one hand, the risk of infection is slightly higher, and on the other hand, the fact that baby has released his sphincters suggests that he is really ready to go outside,” explains the obstetrician.
When the fluid loss is accompanied by strong contractions, it means that labor has started: it is advisable to go to the maternity ward quickly, because the uterine contractions are more painful when the sac of water has ruptured.
Finally, in the event of a pause before the maturity, so before 37 weeks of amenorrheathe mother-to-be has to surrender straight to the maternity wardto be treated by obstetricians or obstetricians-gynaecologists in the event of a pathological pregnancy.

If the water breaks, how long does it take to give birth?

When the woman has amenorrhea for more than 37 weeks and is therefore no longer at risk of preterm birth, she will be offered a course of antibiotics to protect the fetus against a possible risk of infection, and we will wait and see 24 to 48 hours to let her give birth naturally. “If the labor doesn’t start naturally within 24 to 48 hours, it will be triggered in the maternity ward,” the midwife says.

For mothers whose water breaks before 37 SA, hospitalization is necessary. “The mother is being treated with antibiotics and given two injections of corticosteroids 24 hours apart.” accelerate the maturation of the baby’s lungs“explains the midwife. The goal is then that she comes as close as possible to the delivery term.
“Some women break very early in pregnancy, sometimes as early as 5 or 6 months of pregnancy, and manage to complete their pregnancy,” reassures Aurélie Kaczmarek, who recalls that the amniotic fluid is constantly renewedand that it is not because the mother’s water has broken that the baby is no longer oxygenated and fed, as this is done by the placenta.

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