Amniotic Fluid: What It Is and Why It's Crucial For a Healthy Pregnancy

What is amniotic fluid? What does amniotic fluid do for baby? How much of it is normal and how can you tell if you're leaking amniotic fluid?

Do you know about the substance that puts your baby in a safe bubble until the time that they can go out into the world? Well, that's amniotic fluid for you! Learn more about this water-like fluid and why it's important to keep it at a certain level during pregnancy.

What is Amniotic Fluid?

Amniotic fluid, also known as "water" or "waters," is the protective liquid that surrounds a developing fetus within the amniotic sac of a gravid amniote. This fluid serves as a cushion, safeguarding the growing baby from external blows to the mother's abdomen and promoting muscular and skeletal development.

Moreover, amniotic fluid plays a crucial role in facilitating the exchange of nutrients, water, and biochemical products between the mother and fetus. Initially composed mainly of water with electrolytes, it gradually contains proteins, carbohydrates, lipids, phospholipids, and urea, all essential for the fetus's growth.

What does amniotic fluid do for baby?

There are several functions of if that is very important in supporting the development of the fetus in the womb. Among them are: 

• Protective and lubricating

 One of the main functions of it is to protect the fetus from external pressure and possible effects on the pregnant woman's stomach.

It acts as a shock-absorbing cushion and helps protect the fetus from possible injury. In addition, it is also a lubricant that allows the free movement of the fetus in the womb.

• Fetal development

It is very important for the physical development and function of the fetus. The fetus spends most of its time in the womb, which allows it to move freely.

In addition, the space provided by the AF allows the fetus to develop its cognitive and sensory qualities.

• Circulation and nutrition

It also plays a role in providing proper circulation and nutrition to the fetus. AF contains nutrients such as glucose, protein, electrolytes, and oxygen that are essential for fetal development and growth. The fetus absorbs these nutrients through the skin and digestive tract.

• Infection protection

It helps protect the fetus from infection and forms a protective layer that separates the fetus from any bacteria and viruses that may be present in the womb. Additionally, it also contains antibodies that can provide additional protection against infection.

• Temperature Control

Lastly, one of the main functions of this is to maintain an optimal temperature for the fetus. It has good heat capacity and helps maintain a stable temperature of the uterus. This is important because the fetus is not yet able to regulate its own body temperature effectively.

How to Read Amniotic Fluid Index

In the early stages of pregnancy, the amount of amniotic fluid may be around 10 to 50 cc only, but it will continue to increase as the gestational age increases.

The amount and reading can reach around 600cc to 1,200cc when the gestational age enters 34 to 38 weeks.

However, the amount will start to decrease as the gestational age approaches the baby's birth period.

According to Consultant Obstetrics, Gynecology, and Fertility, KPJ Tawakkal Specialist Hospital Kuala Lumpur (KL) Dr. Ahmad Murad Zainuddin said, usually, doctors will calculate the amount of it using an ultrasound machine by calculating the amount of 'amniotic fluid index' (AFI).

Healthcare providers typically use AFI readings when the gestational age exceeds 24 weeks.

"Amniotic fluid is produced through the baby's urine when it is in the tank and a normal baby will always drink the amniotic fluid back. A normal AFI reading is between 8 and 20," he said.

In addition, Dr. Ahmad Murad stated that, if the AFI is less than 8, the condition is called 'oligohydramnios.' This condition can restrict the movement of limbs and the growth of the baby's body in the womb, including organs such as the baby's respiratory system.

How is Amniotic Fluid Produced

The fetus in the womb forms amniotic fluid through a complex process. The following is an explanation of how this substance is produced:

• Early formation

In the early stages of pregnancy, around the eighth to 10th week, the newly formed embryo produces an amniotic sac.

The amniotic sac is the sac that covers the fetus and will be the place where the amniotic fluid forms. At this stage, amniotic fluid is formed from the body fluids of the pregnant woman through diffusion through the placental membrane.

• Fetal Contribution

At this stage of fetal development, organs such as the fetal kidneys begin to function and produce urine. The urine produced by the fetus gets into the amniotic fluid around it.

In the early stages of pregnancy, urine is the main contributor to the formation of amniotic fluid.

• Contribution of the pregnant mother

In addition to the contribution of the fetus, pregnant women also play a role in the production of it. Through the placental membrane, substances dissolved in the mother's blood. Such as water, nutrients, electrolytes, and oxygen, can pass through and enter the amniotic sac.

Diffusion and filtration processes allow these substances to move in and out of the amniotic fluid, thereby renewing and maintaining the AF volume.

This process creates a cycle that ensures a constant supply of amniotic fluid, facilitating the fetal movements, lung development, and protecting the fetus from external shocks or pressure during its development in the womb.

What is Amniotic Fluid Made Of

Amniotic fluid contains various important substances for the growth and development of the fetus during pregnancy.

Here are some of the contents of it: 

1. Water: The main content of amniotic fluid is water. It plays a role in maintaining moisture and fluid balance in the uterus and provides a suitable environment for the fetus.
2. Electrolytes: It contains electrolytes such as sodium, potassium, calcium, and magnesium. These electrolytes play a role in maintaining fluid balance and normal cell function in the fetal body.
3. Nutrients: It also contains various nutrients needed by the fetus, such as glucose (sugar), amino acids, fats, and vitamins. These nutrients are important for optimal fetal growth and development.
4. Hormones: Some hormones produced by the fetus and placenta can be found in the amniotic fluid. This hormone plays a role in controlling the body functions of the fetus and affects the growth of its organs and systems.
5. Cells: It also contains sloughed-off fetal skin cells, fetal blood cells, and debris such as fetal hair and vernix caseosa (the white protective coating that covers fetal skin). This component is usually present in small quantities and is a normal part of the fetal development process.
6. Antibodies: The content of amniotic fluid also consists of antibodies produced by the mother and fetus. These antibodies provide additional protection against infection and help keep the fetus healthy in the womb.

What is Normal Amniotic Fluid

How will you know if the amount and quality of amniotic fluid is within a healthy range and is sufficient for the developing fetus?

Some of the characteristics of it are the following: 

• Sufficient amount of amniotic fluid: The normal amount of it varies during each trimester of pregnancy. In mid-pregnancy, around weeks 20 to 24, the amount of amniotic fluid reaches its peak.
• Normal colour and consistency: It is usually clear or slightly yellow. The consistency is similar to water, not too thick and not too runny. Keep in mind that the colour or clarity of the amniotic fluid can change if there is a problem, such as the presence of meconium (fetal faeces) in the amniotic fluid.
• Balanced pH: The normal pH of amniotic fluid is between 7 and 7.5. A balanced pH level is important to maintain acid-base balance and fetal health.
• Infection free: It does not contain bacteria or other infections. If there are signs of infection, such as an unusual smell, a suspicious color, or a fever in the mother, it can be an indication of an infection in the amniotic fluid.

Amniotic Fluid Colour

The normal colour of amniotic fluid is clear or slightly yellow. However, there are some situations where the colour of the AF can be different and indicate a special condition.

Here are some changes in the colour that may occur:

• Yellow

If a pregnant woman is physically active or does sports before giving birth, the amniotic fluid can appear more yellow. This is usually caused by the presence of meconium, which is fetal faeces, in the amniotic sac.

If meconium is detected, further monitoring is necessary to ensure the health of the fetus.

• Green or brown

If it is green or brown in colour, this may indicate the presence of very concentrated or oxidized meconium. Fetal meconium is usually dark green or brown.

This colour may indicate a fetal disorder or a problem with the placenta. In a situation like this, medical personnel need to be evaluated immediately and medical action may be necessary.

• Red or Bloody

If the fluid appears red or bloody, this could indicate bleeding in the uterus. Bleeding can be caused by placental abruption, placenta previa, or other problems. Significant bleeding during pregnancy should be treated immediately by medical personnel.

How to keep amniotic fluid normal? 

To maintain normal amniotic fluid during pregnancy, there are steps you can take. Although there is no guarantee that your AF will remain normal, the following steps can help maintain the balance and quality of it:

1. Drink enough water Make sure you drink enough water and other fluids every day. Maintaining good hydration helps maintain an adequate amount of amniotic fluid. Drink at least 8-10 glasses of water daily or as recommended by your doctor.
2. Balanced nutrition: Take a healthy and balanced diet during pregnancy. Make sure your nutritional intake includes protein, vitamins, minerals, and omega-3 fatty acids that are important for fetal growth. Consult a doctor or nutritionist for proper dietary guidelines.
3. Avoid dehydration: Apart from ensuring adequate fluid intake, avoid factors that can cause dehydration. Avoid strenuous physical activity, especially in hot weather, and avoid prolonged exposure to dry environments. If you feel thirsty, drink water to meet your body's fluid needs.
4. Watch for signs of infection: Infection can affect the quality of amniotic fluid. Watch for signs of infection such as fever, unusual odours in your amniotic fluid, or foul-smelling discharge. If you suspect an infection, seek medical advice immediately.

Amniotic Fluid Embolism

Amniotic fluid embolism (AFE) is a rare but serious condition that occurs during childbirth. It happens when amniotic fluid, which surrounds the baby in the womb, enters the mother's bloodstream, leading to an allergic-like reaction. Here are the key subtopics related to AFE:

The exact cause of AFE is not entirely clear, but it often happens during labour or delivery when there's a breach in the placenta or uterine wall, allowing amniotic fluid and fetal debris to enter the mother's bloodstream.

Amniotic fluid embolism can present with sudden and severe symptoms, such as difficulty breathing, rapid heart rate, low blood pressure, and confusion. Mothers experiencing these symptoms during childbirth require immediate medical attention.

AFE is considered rare, and most pregnancies progress without it. However, certain risk factors may increase the likelihood of its occurrence. These factors include advanced maternal age, multiple pregnancies (twins, triplets), placental problems, and certain medical conditions such as preeclampsia.

Treatment for amniotic fluid embolism involves prompt and aggressive medical intervention. Emergency measures may include resuscitation, oxygen therapy, and the administration of medications to stabilise the mother's condition. Depending on the severity of the embolism, additional treatments may be necessary to address complications.

Other Issues Concerning the Amniotic Fluid

Amniotic fluid problems during pregnancy include polyhydramnios, characterised by excessive fluid accumulation, and oligohydramnios, where there is insufficient fluid surrounding the fetus.

Premature Rupture of Membranes (PROM) refers to the early breaking of the amniotic sac, which can lead to infection and premature birth if it occurs before 37 weeks.

Hydramnios is another term for polyhydramnios, causing discomfort for the mother and increasing preterm birth risk. AF(Amniotic fluid) infections pose serious risks to both mother and baby.

Regular prenatal check-ups and ultrasound monitoring are vital to detect and address these issues promptly.

How Much Amniotic Fluid is Normal

The normal amount of amniotic fluid during pregnancy varies throughout the gestational period. It typically increases as the pregnancy progresses and reaches its peak between 32 and 34 weeks of gestation.

After this point, the amniotic fluid gradually decreases until delivery. On average, the volume of amniotic fluid ranges between 800 to 1,000 millilitres (ml) at its peak. About 600 mL of amniotic fluid surrounds the baby at full term (40 weeks gestation).

Signs that the Amniotic Sac Has Ruptured

How can you tell if you're leaking amniotic fluid?

Recognising whether it has broken or not can be a difficult task. However, there are some signs and symptoms that can help you recognise that your water has broken.

Here are some ways to tell if the water has broken:

• Pay attention to vaginal discharge: Pay attention to vaginal discharge. Amniotic fluid rupture usually results in more discharge than normal discharge or mucus. It generally has a clear texture and is usually colourless. However, sometimes it can have blood spots or a slight yellow colour. If the discharge continues and does not stop, it could be a sign that the water has broken.
• Note the smell of the fluid: It usually has a distinct odour that is different from vaginal discharge or other fluids. A slightly sweet or chlorine-like odour is a common odour associated with a ruptured amniotic sac.
• Pay attention to the colour of the fluid: If it looks green, brown, or has an unusual colour, this could be a sign of a problem and you should seek medical attention immediately.
• Watch for changes in sensation: Your water breaking may cause a wet or moist sensation that is different from normal vaginal discharge. You may find that your underwear continues to be wet even after you change your pads or pantyliner.
• Watch for contractions: Amniotic fluid breaking is often followed by contractions. If you start to feel regular contractions, this may be a sign that labour has begun.

When to Call the Doctor

If you notice the following signs, seek medical help without delay:

1. Sudden Gush or Continuous Leak: If you experience a sudden gush of fluid or notice a continuous trickle, it could be your amniotic fluid leaking. Don't wait; call your doctor to rule out any complications.

2. Change in Fluid Colour or Odour: If you notice a change in the colour or smell of the fluid, such as greenish or foul-smelling, it might indicate an infection. Reach out to your doctor immediately.

3. Reduced Baby Movements: Feeling fewer baby kicks or movements than usual? Call your doctor to ensure everything's okay with your little one.

4. Abnormal Swelling: Swollen hands, face, or feet could be a sign of preeclampsia, a condition related to high blood pressure. Get medical advice promptly.

5. Severe Abdominal Pain: Sharp or intense abdominal pain should never be ignored. It could be a sign of complications that need immediate evaluation.

6. Fever or Chills: If you develop a fever or experience chills, it might indicate an infection. Call your doctor to discuss your symptoms.

7. Bleeding or Spotting: While some spotting can be normal, heavy bleeding is a cause for concern. Contact your healthcare provider right away.

8. Less Amniotic Fluid: During routine check-ups, if your doctor mentions low levels of amniotic fluid, follow their guidance and monitor it closely.

9. High Blood Pressure: If you have high blood pressure or develop it during pregnancy, it's crucial to keep your doctor informed and follow their advice.

Remember, you know your body best. If anything feels off or you have concerns, don't hesitate to reach out to your healthcare provider.

A high-risk pregnancy can still have a positive outcome with proper care and prenatal attention. Regular check-ups, a healthy lifestyle, and open communication with your doctor can make all the difference. Keep yourself and your little one safe and enjoy this special time in your life!

Republished with permission from theAsianparent Philippines. 

Updates from Camille Eusebio

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