Is That Your Water Or ...?
Late in pregnancy, it's not uncommon to feel some wetness... but is it a trickle of amniotic fluid or something else? Family Physician Jane Forester tells you how your caregiver can find out -- and if your water hasn't broken, what else it might be.
I'm 38 weeks, and notice a watery discharge. Has my water broken? - Misty in Kansas
The expert answers
Answer: I certainly appreciate your confusion regarding a watery discharge at 38 weeks -- there is so much happening around this time. Possibilities that exist to explain your symptoms are urinary incontinence (the leakage of urine), the mucous plug being passed, normal heavy vaginal discharge (leukorrhea), or as you mentioned -- amniotic fluid. It is important to contact your physician to determine what the "watery discharge" is. She will do a sterile speculum examination to confirm the diagnosis.
If the amniotic membranes are ruptured, the chances for introducing an infection through the vagina to the fetus are great if something non-sterile is placed in the vagina. The examiner will look for the pooling of amniotic fluid in the vagina, and if found, will touch a piece of yellow nitrazine paper to the fluid to determine if this is amniotic fluid. (The paper will turn blue if it's amniotic fluid.) If you are considered term, she will admit you to labor and delivery to get ready for the big event. If you are not quite far enough along in your pregnancy to be certain of a healthy outcome, other tests will be done to help the physician to determine the next logical steps to take to help increase the chances of a great outcome.
When you first notice the discharge you can actually do your own sniff test, while calling your doctor. Amniotic fluid has a sweet smell to it, whereas we know that urine smells more like ammonia. Visually, leukorrhea presents as a heavy pale white sticky discharge, while the mucous plug is usually bloodstained. While you are waiting for your physician, do not insert anything into your vagina (no intercourse, bathing or tampons). You may use a sanitary napkin to absorb the flow.
If you do experience a large gush of what appears to be amniotic fluid, and you live far from the delivering hospital, I suggest you make arrangements to get there. Another physician can examine you while you wait for your physician to arrive. This is critical, because occasionally with a great loss of amniotic fluid, the umbilical cord can be swept into the vagina and become compressed, causing a decreased oxygen flow to the fetus. Sometimes a woman even sees a loop of umbilical cord in the vagina or feels the cord in her vagina. For these reasons, a call or trip to the emergency room is never wasted.
Lastly, the good news about membranes rupturing at 38 weeks is that typically within about 12 to 24 hours, you will begin to feel contractions -- and soon enough, your little bundle of joy will arrive. Best of luck with everything ahead of you!