About Amniotic Fluid
Amniotic Fluid has multiple roles during pregnancy. This clear, yellowish fluid is normally contained within the amniotic sac. Amniotic fluid helps promote pulmonary and urinary tract development and also acts as a cushion to protect the fetus from injury. Fetal urination and respiratory activity have been visualized on ultrasound at 11 weeks gestation. Unfortunately, after PPROM the amniotic fluid leaks or gushes out of tears or holes amniotic sac.
Measuring Amniotic Fluid: There are two ways of measuring Amniotic Fluid: Amniotic Fluid Index (AFI) or Single Deepest Pocket (SDP). In AFI, the ultrasonographer will divide the uterus into four quadrants, measure the visible fluid, add the amounts together and divide by four. Measurements over 5 centimeters are considered to be normal. With SDP, the single deepest pocket of fluid that is visualized on ultrasound is measured; over 2 centimeters is considered normal. Keep in mind that levels will fluctuate throughout pregnancy, and it can be difficult to correlate levels with leaking patterns. Amniotic fluid itself has bacteriostatic properties, meaning that it can help prevent bacteria from reproducing and help prevent ascending infection. Fluid will leak, and it will regenerate under most scenarios.
Ascending infection is one of the Top 3 Concerns with PPROM and it is important to ensure all measurements are done topically and NOT internally.
Journal of Perinatology- Amniotic Fluid: Not Just Fetal Urine Anymore
Role of Amniotic Fluid in the Assessment of Fetal Well Being