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The crack of the water pocket
During pregnancy, any loss of clear, odorless fluid requires medical advice as it can mean that the water bag is cracked and the fetus is no longer protected from infections.
What is the water pocket crack?
Like all mammals, the human fetus develops in an amniotic sac made up of a double membrane (the chorion and amnion) that is translucent and filled with fluid. Clear and sterile, the latter has several roles. It keeps the fetus at a constant temperature of 37 ° C. It is also used to absorb noise from the outside and possible shocks to the mother’s stomach. Conversely, it protects the organs of the latter from the movements of the fetus. This sterile medium is also a valuable barrier against certain infections.
The double membrane which constitutes the water bag is resistant, elastic and perfectly hermetic. In the great majority of cases, it does not rupture spontaneously and frankly that during labor, when the pregnancy has come to an end: this is the famous “water loss”. But it can happen that it cracks prematurely, usually in the upper part of the water bag, and then lets small amounts of amniotic fluid flow continuously.
Causes and risk factors of crack
It is not always possible to identify the origin of a partial rupture of the pocket of the skins. Many factors can indeed be at the origin of cracking. The membranes may have been weakened by a urinary or gynecological infection, by a distension of their walls (twins, macrosomia, unusual presentation, placenta previa), by a trauma related to a fall or a shock in the abdomen, by a medical examination (cord puncture, amniocentesis)… We also know that smoking, because it interferes with the good production of collagen essential for the elasticity of membranes, is a risk factor.
Symptoms of the water bag crack
The crack in the water bag can be recognized by light continuous losses of liquid. Pregnant women often worry that they cannot tell them apart from urine leakage and vaginal discharge, which tend to be more common during pregnancy. But in the case of loss of amniotic fluid, the flow is continuous, transparent and odorless.
Management of the water pocket crack
If you have the slightest doubt, do not hesitate to go to the maternity ward. A gynecological examination, if necessary supplemented by an analysis of the liquid which flows (test with nitrazine) will make it possible to know if the water bag is cracked. An ultrasound can also show a possible decrease in the amount of amniotic fluid (oligo-amnion).
If the diagnosis is confirmed, the management of the fissure depends on its size and the term of the pregnancy. However, in all cases it requires absolute rest in a lying position, most often with hospitalization in order to ensure optimal monitoring. The objective is in fact to prolong the pregnancy as close as possible to its term while ensuring the absence of infection.
Risks and possible complications for the rest of the pregnancy
In the event of a crack in the water bag, the liquid in which the fetus evolves is no longer sterile. Infection is therefore the most feared complication of the fissure and this risk explains the establishment of antibiotic therapy associated with regular monitoring.
If the crack occurs before 36 weeks of amenorrhea, it also exposes the risk of prematurity, hence the need for absolute rest and the implementation of various treatments, in particular to accelerate the maturation of the fetal lungs and to prolong pregnancy.
As for the expectant mother, the fissure increases the risk of infection and more often requires a cesarean section.