Dr Shivani Sachdev Gour Shares Her Views on What Happens When a Pregnant Woman’s Water Bursts

by Shivani Sachdev Founder & Director

Dr Shivani Sachdev Gour, Gynaecologist and Infertility Specialist, SCI Healthcare shares her views on what happens when a pregnant woman’s water bursts. During pregnancy, the baby is surrounded by water in the womb which is known as amniotic fluid.

It is enclosed in a membranous layer known as amniotic membrane which acts as a barrier. This fluid is very important for the protection of the baby as it acts as a shock absorber and maintains aneven temperature. The amount is around 600 ml at term pregnancy.

1. “Water bursts” means breaking of this membrane and leaking of the fluid which happens priorto or at the onset of labour. It may also occur early in pregnancy which is abnormal and medicalattention should be immediately sought. The membranes can rupture spontaneously at term by themselves or can be ruptured artificially by the doctor.

2. It is colorless during early pregnancy but towards term it becomes pale straw colored. It is odourless and the feel is just like water. The colour may be green due to meconium (baby’s faeces) which implies that the baby is in distress which is an alarming sign. At times, one is confusedwhether the leaking fluid is amniotic fluid or vaginal discharge for which pads are available that change colour to show the nature of fluid.

3. If water bursts at the onset of labour, one will feel abdominal cramps but if there is leaking inearly pregnancy or prior to labour one may just complain of leakage of watery fluid leading to soakage of clothes. This leaking may be either in the form of a trickle or less commonly in the formof gush of fluid coming out. Few may not even be able to differentiate between leaking of water andurine.

4. Whenever a woman experiences burst of her water bag, she should not panic.She should applya sanitary pad and check the color of the fluid. The woman should avoid too much movement toprevent loss of fluid.She should sit and contact her doctor. The woman should take plenty of fluids orally. She should immediately be taken to the hospital and the treating obstetrician should attend toher. An examination is done and accordingly further management is carried out.

5. The time of delivery is not fixed after membranes break as it depends on many factors such aswhat month of pregnancy is going on, whether the patient is having labour pains or not, whetherlabour augmentation with medicines is done or not. In 80-90% of women, labour pains start withinthe first 24 hours. Labour pains may even be induced by giving medicines after waiting for a fewhours so as to prevent complications.

6. The complications are less when the water breaks at term and the woman delivers within thefirst 24 hour but when it occurs prematurely or there the delivery interval is prolonged. The risksare infection as the protective barrier is lost, premature separation of the placenta especially if theamount of liquor is excessive, cord prolapsed and decreased amount of liquor (oligohydramnios).

One has to take care and be vigilant when water bag breaks. Immediate medical attention shouldbe sought. One can follow general principles of infection prevention that is maintaining hygiene and using clean pads. One should take plenty of fluids orally.

7. The water bag does not break spontaneously in all women. Artificial rupture of membranes isdone at term pregnancy or whenever indicated earlier in pregnancy to induce labour. It releasesprostaglandins that cause uterine contractions and hence induce/augment labour pains. If the waterbag breaks prematurely conservative management may be done to extend pregnancy for some timebut keeping in mind the risks of infection and decreased liquor leading to complications in the baby.

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