Is it water breaking if there is a small wet spot on my underwear?

Women in the late stages of pregnancy will be very worried about the arrival of labor. In fact, when they find that they have reached their due date, they should go to the hospital to wait for delivery. If you find that there is a small wet spot on your underwear, you should find out the specific reason. It is mostly caused by water breaking. At this time, don’t be too nervous and worried. You must stay calm and have physical strength, which will be more helpful for your childbirth.

Amniorrhea is the common name for rupture of membranes (the full name is rupture of membranes), which refers to the phenomenon of amniotic membrane rupture and amniotic fluid flowing out. Under normal circumstances, amniotic fluid ruptures naturally during the first stage of labor when the cervix is ​​almost fully dilated or fully dilated. As uterine contractions continue to intensify and the pressure in the amniotic cavity increases to a certain level, the fetal membrane ruptures naturally and the anterior amniotic fluid flows out.

Sometimes the membranes rupture before labor begins, a condition called premature rupture of membranes. Depending on the gestational age, premature rupture of membranes can be divided into full-term premature rupture of membranes (37 weeks of gestation) and preterm premature rupture of membranes (after 20 weeks of gestation but less than 37 weeks). Premature rupture of membranes may cause premature birth, umbilical cord prolapse, fetal distress and neonatal respiratory distress syndrome, maternal and fetal infection, and increase perinatal mortality. Normal rupture of membranes is a normal process of childbirth. This article introduces the more dangerous premature rupture of membranes.

Pregnant women suddenly feel a large amount of fluid flowing out of the vagina. This may happen when abdominal pressure increases due to coughing, sneezing, urinating, or holding the breath during defecation. It may also occur after sexual intercourse in the late pregnancy, or it may occur suddenly without any cause. The amount of discharge can be more or less, usually continuous, but sometimes intermittent, with a thin liquid on the underwear or perineal pad without urine odor.

1. Vaginal speculum examination

When the vagina is opened with a speculum, fluid may be seen flowing out of the cervix or a pool of fluid may form in the posterior fornix.

2. Auxiliary examination

(1) Vaginal fluid pH test: A vaginal discharge pH value ≥ 6.5 is considered positive.

(2) Vaginal fluid smear examination may reveal fern-like crystals or fetal epithelial cells.

(3) The amniotic sac disappears and the amount of amniotic fluid continues to decrease before ultrasound examination. It can also determine the size of the fetus, the maturity of the placenta, changes in the cervix, etc.

(4) Monitoring of intra-amniotic infection: Increased levels of C-reactive protein and interleukin-6 indicate intra-amniotic infection.

(5) Amnioscopic examination allows direct visualization of the fetal presenting part. If the anterior amniotic sac is not visible, premature rupture of membranes can be diagnosed.