Tests for determining amniotic fluid leakage

Amniotic fluid is essential for the protection and nourishment of the developing fetus during pregnancy. This fluid envelops the developing child in the womb, providing support and cushioning.

Pregnant women may occasionally experience amniotic fluid leakage, which can be dangerous. Determining if the discharge is regular, amniotic fluid, or urine is not always simple.

There are several tests that can help identify whether the fluid is amniotic. These tests, which provide peace of mind and guarantee that everything is proceeding according to plan with your pregnancy, can be performed by a medical professional or at home.

General information

The amniotic sac is a special space in which the baby spends all 9 months of the mother"s pregnancy and goes through all stages of development. It is filled with amniotic fluid – the very first habitat of the baby, optimal for him until the moment of birth on light. The bladder is a sealed structure that reliably protects the fetus from any external influences. It consists of a two-layer shell. The outer one is the chorion. The inner membrane that secretes amniotic fluid is called the amnion. Water is produced in constant mode, and every 3 hours their composition is completely updated, which allows you to achieve a sterile environment inside the uterus. Water nourishes the baby, protect it, help maintain a constant temperature in the uterine cavity, soften the blows and shocks. Timely discharge of water occurs at the peak of birth fights, when the cervix is ​​almost completely opened. In this case, water contribute to the further disclosure of the neck and the faster and more rapid biomechanism of childbirth – passing the baby along the birth canal. Less often, childbirth begins with a pour out of water, and this is already considered a pathology. However, complete discharge, if there was a rupture of the fetal membranes, is not difficult to diagnose even at home – There are a lot of liquids, it is not related to urination. Everything is more complicated with incomplete “depressurization” – side bubbling tears. In this case, the water does not completely leave, but only leaks. The problem is that an infection can get to the fetus through damaged fetal membranes, and this can be a very dangerous event for it. To minimize the risks of intrauterine infection, it is necessary to diagnose a violation of the integrity of the bladder for at least a day, after this time the probability of infection increases several times.

For this reason, specialized tests for amniotic fluid leakage have been developed, aimed at identifying partial amniotic fluid effusion and premature discharge.

During pregnancy, amniotic fluid leakage can be concerning, but there are easy tests to find out if it’s occurring. These tests, which can be performed in a medical facility or at home, detect the presence of amniotic fluid and can either provide comfort or indicate that further care is necessary. Early detection of signs is critical for the health of the mother and the unborn child.

The principle of operation of test systems

It is not always possible to guess about leakage. Usually, it can theoretically be indicated by an increase in the amount of vaginal discharge. There is more of it after a woman spends some time in a horizontal position. And it is reasonable, of course, to go to the doctor at the slightest suspicion of leakage, especially if the woman has a high risk of premature birth. However, even an experienced gynecologist can find it difficult to determine something accurately during a standard examination, especially since he himself standard examination is strongly discouraged, if a woman complains of probable amniotic fluid leakage, so as not to increase the risk of introducing infections into the genital tract. Ultrasound examination in this situation does not provide accurate answers, and doing amniocentesis with the addition of indigo contrast dye to make sure that the woman and baby are not in danger is not the best decision, associated with additional risks.

Therefore, the only fairly reliable method of determining whether or not there is a water leak is through testing.

There are two types of tests available: those that are only used in laboratories and are performed in antenatal clinics or maternity hospitals, and home express tests that are available at any pharmacy. I respond to the alkaline selection environment in at-home tests, which can be traditional stripes or gaskets that operate on the same principle as litmus paper. The naturally acidic environment of a woman’s vagina may signal that the fetal membranes are no longer hermetic when it becomes alkaline.

More complex and expensive tests, as well as laboratory systems for detecting amniotic fluid in discharge are based on the detection of special substances that cannot be found in sperm, urine, or vaginal secretions. They are inherent only in the composition of the waters surrounding the fetus. This is insulin-like growth factor and placental microglobulin-1. The systems that can determine microglobulin are considered more accurate. They are made in the maternity hospital if there is a suspicion of amniotic fluid leakage. Among the variety of tests offered to women in pharmacies, only one is capable of diagnosing microglobulin – this is Amnisure. The rest, including such well-known brands as Frautest and others, This is incapable of this and limited only to the definition of an alkaline or acidic excretion environment and the presence of an insulin -like growth factor.

As with ovulation tests and pregnancy detection systems, the results of home tests are very easy to interpret. It is crucial to adhere to the guidelines and promptly seek medical assistance upon receiving a positive test result.

Types of tests

Pads

When we talk about test strips, women need to know that we are not referring to the tiny, narrow strips that were dipped in urine a few months ago to determine whether or not a pregnancy had occurred. Amniotests come in the simplest form: pads that must be worn for a certain amount of time in order for the reagent to identify the specific component that predominates in the discharge. These exams are thought to be the most user-friendly and reasonably priced. Their accuracy, though, could use some improvement.

Frautest Amnio

Outwardly very similar to an ordinary thin daily pad. It is simply attached to underwear in a simple, familiar way. The pad has a yellowish stripe in the center, which is a matrix with an indicator. If the vaginal acidity is normal, then the pad remains yellowish. If it is reduced due to the presence of an alkaline environment of amniotic fluid in the discharge, then the stripe changes color to bluish-greenish – this is a positive result, requiring urgent medical attention. The instructions for using such a test are very simple: take out the pad, attach it to the underwear and remove either as it fills up or within 12 hours. The disadvantages of this test are that the pad can change color even as a reaction to ammonia in the urine, and you should not conduct diagnostics immediately after a woman takes a shower, uses vaginal suppositories. Disposable pads. Their cost starts from 350 rubles.

AL-sense

This test pad functions in the same manner as the previously mentioned Frautest. However, you will have to wait for the results as the removed pad needs to be put in a special case, and the verdict won’t be determined for 30 minutes. Determining how much the vaginal environment’s acidity has decreased is another foundation of the test.

If a woman has any of the following conditions: vaginosis, colpitis, or any other vaginal disease, the test may yield false positives. The price is about 550 rubles.

"AmnioTest"

The set consists of tampons-sticks for single use. Each is impregnated with nitrazine yellow, and therefore such a test is often simply called the nitrazine test. Each tampon is packed in a separate bag, it is completely sterile, and therefore the expectant mother can safely allow it to be inserted into the vagina. It is quite difficult to do this yourself – you should insert the stick either into the posterior fornix of the vagina, or touch the external os of the cervix. Usually, such tests are used by gynecologists in antenatal clinics, although according to reviews, some expectant mothers managed to do all this on their own. After extraction, wait about half a minute, and then compare the test by color with the attached color palette, thereby decoding it. Packages of 25 tampon sticks cost from 5.5 thousand rubles. Amnicator test is considered an analogue, the use and characteristics of which are identical.

Crucial! If the rupture occurred more than 12 hours ago, simple pad tests are essentially useless. There is a noticeable decrease in efficiency.

More sophisticated equipment built on the immunochromatography technique is called a diagnostic system. Nevertheless, unlike the most basic pads, the systems do not rely on measuring the vagina’s acidity. Their job is to look for the previously mentioned unique protein substances.

AmniSure ROM Test

AmniSure is the most accurate test to date, which is quite effective. The disadvantages include the high cost – from 2 thousand rubles. However, the result of such a test should not raise doubts either for your doctor or for you. The instructions for use are somewhat more complicated than those of simple pad tests, but everything you need for the test is included in the kit. The test determines the presence of placental α1-microglobulin. After performing standard hygiene procedures, the woman should open the package with a sterile swab. It is inserted into the vagina, holding it by the middle of the handle, to a depth of up to 7 centimeters, but not less than 5 centimeters. After a minute and a half, the swab is carefully removed and placed in a bottle with a solvent – it is also included in the kit. After a minute of the swab being in the chemical liquid, it can be thrown away. From now on, you will only use the solvent. You should remove the test strip from the package and lower it into the bottle in which the swab was previously. The result is assessed within ten minutes. And it looks almost like a pregnancy test – two clear red stripes appeared – there is a leak, if one strip appeared, then there is no leakage, and the result is negative. Neither urine, nor the presence of sperm remains in the vagina, or other biological fluids can affect the result. However, despite the high cost, the test also belongs to the category of disposable. It cannot be used again.

Crucial! As with simple tests, the test’s efficacy declines and the possibility of receiving a false negative result rises if more than 12 hours have elapsed since the side of the side.

If a woman follows the directions incorrectly—bending the test strip, touching the tampon’s tip, applying vaginal candles, or douching before self-diagnosis—there is a greater chance that the result will be inaccurate. There is no reduction in accuracy when there is genital bleeding.

Amnioquick

Another system, which, in fact, is an analogue of Amnisure, but only in terms of the ability to determine protein substances. This test determines insulin-like growth factor, not microglobulin, and the accuracy of the study is slightly lower than that of the AmniSure system. Here you should understand one important nuance — it is not about the accuracy of the results, but about the sensitivity of the device. AmnioQuick is less sensitive. And therefore it may well show a negative result if the leakage is small, a little liquid is released. The principle of use is almost the same as AmniSure, and the kit is very similar in its configuration. When conducting the test, it is important for a woman to remember that all components of the diagnostic system must be at room temperature, and testing should also be carried out under normal room temperature. To do everything correctly, you need to conduct diagnostics within an hour after the package with the kit for determining water in discharge is opened. The tampon is also inserted into the vagina, and then placed in a bottle with a reagent, where after a minute a test strip is lowered to obtain a visual result.

The test costs more than simple tests (starting at a thousand rubles) but less than AmniSure. Additionally, it is throwaway, so you will need to purchase a new package if you need to repeat the test.

Accuracy and reliability

If we talk about simple test pads, their accuracy is low. There is a fairly significant chance of getting either false positive or false negative results. Test systems are more accurate, but they cannot be considered 100% reliable. If the cause of false results of simple tests is usually vaginal infections, some diseases of the genitourinary system, then more complex and expensive systems make mistakes if a woman has bloody discharge, during full-term and post-term pregnancy. There are also more accurate data on the clinical effectiveness of tests for determining water in discharge. For example, laboratory microscopy of a smear, which can be carried out by a gynecologist if a woman consults him with suspicions of amniotic fluid leakage, in every third case can give a false positive result. A special pattern on the laboratory glass appears not only in the presence of amniofluid, but also in the presence of sperm residues, and the woman is hospitalized without reason.

Naturally, the expectant mother must remain composed and peaceful, which is what her "interesting situation" demands of her!

Nitrazine “AmnioTest” can react to sperm, urine, and vaginal infections, and therefore the probability of getting a false positive result, according to the Ministry of Health, is 17%, and a false negative is obtained in about 12.9%. AmniSure is the only test that has an accuracy of almost 99% with a specificity of 91%. Such results of clinical studies allow us to call the test a non-invasive analogue of amniocentesis, since the procedure of puncturing the amniotic sac with the introduction of a dye into the water gives approximately the same results in accuracy, in order to then detect or not detect the dye in the discharge. Studies have shown that the test is equally effective at any stage of pregnancy – both at the end of the first trimester from the 11th week, and throughout the third trimester. Considering all of the above, doctors do not recommend buying many different amniotests, one more accurate one is quite sufficient. In any case, the clinical recommendations of the Ministry of Health for questionable complex cases are exactly like this. And if AmniSure shows a positive result, in 99% of cases – this is a good reason for hospitalizing a woman in a hospital.

If the result is negative, it can be argued that the amniotic sac is not damaged, even in cases where certain pregnancy-related pathologies may necessitate hospitalization.

Folk diagnostic methods

Women who are puzzled by the issue of choosing a test to determine amniotic fluid, are not recommended to resort to folk remedies. Not because these products themselves can cause harm, but because it takes precious time, which is necessary for doctors to make the only correct decision – to prolong the pregnancy and place the woman in a sterile ward for preservation and bed rest or to initiate labor, since the consequences of intrauterine infections can be horrific. But tests were not always available, and our grandmothers and great-grandmothers used other methods to find out whether the amniotic sac was intact or not. You can try to determine the leakage with a diaper. But if it is very scanty, then the diaper will not cope with the diagnostic task. A clean and ironed diaper should be folded into the shape of a pad and placed in the perineum. In this form, you need to lie down for half an hour to an hour, and then sit or stand up and walk around.

In order to receive a more precise diagnosis, you should see a doctor if there are noticeable wet spots on the diaper.

However, the so-called foam test, which women mistakenly believe to be a means of identifying amniotic leakage, is only loosely associated with the issue. If a decision about whether to induce labor or continue the pregnancy needs to be made immediately, this test is performed to assess the fetal lung’s maturity. This can be achieved by shaking the test tube after adding ethyl alcohol to the water for analysis. After three minutes, if a foam ring appears on the surface, the fetus is thought to have developed enough lung tissue to be ready for birth and to be able to breathe on its own once it is outside the mother’s womb.

It’s critical to know if amniotic fluid is leaking for a successful pregnancy. Early detection of the symptoms can help guarantee the safety of the mother and the child.

Leak detection can be quickly and easily done at home with home tests, but it’s crucial to have a doctor verify the results. It’s always safer to seek medical advice if you’re unsure about anything.

During this critical period, you can better safeguard your health and the health of your infant by being informed and taking quick action.

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