Non -ruptured rupture

Non -ruptured rupture's disease overview

Normal amniotic fluid is created continuously, and after about 16 weeks of gestational age, it depends mainly on the production of the fetal urine. The rest is due to the circulation of amniotic fluid through the fetal membranes, through the skin, through the umbilical cord, as well as through the production of saliva and liquid of the fetal lung. Amniotic fluid protects against infection, fetal injury and umbilical pinch. It also allows pregnancy to move and respiratory as well as support the safety development of the lungs, chest, spine.

  • If decreased amniotic fluid or no amniotic fluid can lead to pinching of the umbilical cord and lowering the blood flow of the cake.

    • If the amniotic fluid breaks will lose the protection and development role of amniotic fluid.

    What is young amniotic fluid?

    The premature rupture of Membranes (Premature of Membranes (Prom) is the rupture of the amniotic fluid before labor. If after an hour of rupture but still not in labor, it is called young amniotic fluid.

    Non -rupture occurs about 12% of pregnancy. Non -ruptured rupture comes with about 8% of pregnancy (≥ 37 weeks of gestational age) and is followed by the onset of labor. PreterM Prom is defined as a preter rupture that occurs before 37 weeks of fetal age often causes premature birth, which is the leading cause of fetal death and fetal disease.

    What is the risk of non -rupture?

    Non -ruptured amniotic fluid leads to:

  • Premature birth accompanied by premature birth complications of newborns such as internal membrane (RDS), cerebral hemorrhage, neonatal infection, necrotic bowelitis, loss of nerve function and nerves, blood infections. Consequences increase the death rate.

    • Uterine infection: The presence of lower genital tract infections due to bacteria such as Neisseria Gonorrhea, Lien Lien, Group B, increases the risk of uterine infection associated with rupture. Young amniotic fluid.

    Other complications include umbilical cord and young each other.

    Causes of Non -ruptured rupture's disease

    Some cases do not find the cause. Besides, young rupture can occur due to:

  • Abnormal pregnancy: horizontal, buttock, high head ...

    • narrow pelvis.

    multiple pregnancy, amniotic fluid.

  • Uterine open waist.

    • Definitors

    Inflammation of the amniotic fluid: Vaginal inflammation, vagina, cervix.

  • After trauma, shock

    • Symptoms of Non -ruptured rupture's disease

    The woman saw a sudden, thin, clear vaginal water, or the pigs were chiseled by the substance, then continued to leak at least without contraction. If freezing sanitary pads will see the amniotic fluid, colorless, odorless.

    Distinguish diagnosis
  • urine: usually does not produce much water and does not leak continuously as in the rupture of amniotic fluid. In addition, urine smells and acid pH.
  • Damaged gas: Sometimes and dilute it is easy to mistake with amniotic rupture. Distinguish by asking carefully medical history and clinical examination.
  • Cervical mucus: At the end of pregnancy or the beginning of labor, the cervix part will open the mucus in the cervix: mucus, tough and often There is less pink blood.
    • Is the young amniotic fluid rupture? The risk of prolonged young amniotic fluid: Neonatal respiration, infant infection. amniotic fluid → Lung production, limb deformation, umbilical pinching.
  • Young vegetables, uterine death in the uterus

    • Transmission route of Non -ruptured rupture's diseaseNon -ruptured rupture

  • Premature biology and premature base due to young rupture
  • Vaginal infections, cervicitis, sexually transmitted diseases
  • striker, amniotic fluid, multiple pregnancy, narrow pelvis, oh, multi -pregnancy, narrow kc
  • Smoking pregnant women, using stimulants
  • Uterine open waist

    • Short cervical length on ultrasound <25mm

  • CTC tip
  • Poor nutrition

    • People at risk for Non -ruptured rupture's disease

    Preventive reinforcement of young amniotic fluid by:

  • Dotation of vaginal infections, cervicitis, sexually transmitted diseases
  • Uterine waist stitching when the uterine waist is open.
  • No smoking, drinking alcohol, using stimulants
  • Nutrition during pregnancy should focus on
  • Attention to avoid injury, psychological trauma ... during pregnancy

    • Prevention of Non -ruptured rupture's disease

    Preventive reinforcement of young amniotic fluid by:

  • Dotation of vaginal infections, cervicitis, sexually transmitted diseases
  • Uterine waist stitching when the uterine waist is open.
  • No smoking, drinking alcohol, using stimulants
  • Nutrition during pregnancy should focus on
  • Attention to avoid injury, psychological trauma ... during pregnancy

    • Diagnostic measures for Non -ruptured rupture's disease

    Diagnosis of young amniotic fluid is not always easy. The main thing is whether the amniotic fluid is broken or not to have appropriate direction. Half of the diagnosis cases are easy due to many amniotic fluids that sometimes cause substances.

    Ask the disease about the properties of amniotic fluid. In the case of typical women who produce sudden water, sometimes there are also substances. After the water continues to produce water later.

    Vaginal examination by hand when the cervix has opened the finger into the touch of the amniotic fluid, when pushing the head gently, the amniotic fluid can be seen. In some cases, it is very difficult if the amniotic fluid is located close to the scalp. In the case of rupture of amniotic fluid, when the vaginal examination will see the amniotic fluid in hand but see the amniotic fluid intact

    Examination of a duckling see a lot of amniotic fluid in the vagina, seeing the amniotic fluid flowing from the uterus, in the case of unclear can protect the woman coughing or pushing will see the amniotic fluid flowing out. )

    If clinically difficult to determine, it is necessary to do some tests:

  • nitrazine test
  • Doing when observing it is not clear whether the amniotic fluid flows out or not when performing the above -mentioned method.
  • Put the duckling, wipe the vagina, put the woman pushing or coughing then use a sterile cotton swab to dip into the fluid in the pocket of the same vagina and spread on the nitrazine test paper. <

    • pH of acidic vaginal fluid (pH = 4.4 - 5.5) is different from alkaline amniotic fluid pH (pH = 7 - 7.5). If there is a rupture of amniotic fluid, the amniotic fluid flows into the vagina will make the pH of the vaginal fluid become alkaline and will change the color of the test paper from yellow to blue.

  • Powerful positive in case of blood, semen, amniotic fluid has been broken for a long time, when vaginal infections, or pregnant women have used antibiotics, or in the vagina with urine. .

    • Ferning Test (Fern -shaped crystallization test)

  • Use a small stick to wip into the pocket with the back of the vagina and spread it on a glass, let it dry and observe under a microscope.

    • The presence of fern images helps to diagnose young rupture

  • Exact results if in the amniotic fluid without blood.
  • Diamin oxydase quantitative (Diamin oxydase) when secreted, this method is 90%accurate. 
  • Ultrasound
  • Measure the amount of amniotic fluid to detect amniotic or amniotic fluid
  • Estimating weight, determining the fetus, the location of the umbilical cord, each other

    • Non -ruptured rupture's disease treatments

    The doctor will consider choosing the treatment depending on:

  • Gestational age, pregnancy, pregnancy health
  • labor situation
  • CTC condition
  • Mother's infection: Blood test, vaginal implant
  • The umbilical cord abnormalities, the same cake, the striker ...
  • Mother's pathology such as pre -eclampsia, eclampsia
    • pregnancy 22 - 33 weeks: Trying to pregnancy

    Determining the health status of the fetus at the time of receiving. Monitor the fetal heart monitor at hospitalization.

    Adult lung adult drug: Betamethasone management of infections
  • Restricting manual examination → can be monitored by duckling examination
  • Cervical, vaginal, anus implantation
  • Using broad spectrum antibiotics to prevent infections for both mother and pregnancy, in addition to reducing labor rate, therefore, it is recommended to be used in case of prolonged need. Pregnancy when rupture of young amniotic fluid to stimulate adult lungs.

    • Mother monitor: Rest, freeze and clean. Monitor signs of survival 4 times/day, blood formula, white blood cell formula, CRP. Vaginal transplanting 1-3 times/week.

    Monitoring of pregnancy: obstetric monitor 3 times/day. Ultrasound evaluating pregnancy, each other, amniotic fluid

    Using 34 - 36 weeks of pregnancy medication

    Determining the health status of the fetus at the time of receiving

  • Termination of pregnancy:

    Wait for natural labor or labor onset depending on the condition of amniotic fluid, fetus and infection. The prolongation of pregnancy is at risk of uterine infection and amniotic fluid, amniotic fluid, premature peeling, fetal failure, pulmonary disabilities, limb deformation. If there is sufficient evidence to mature lungs, then stop pregnancy immediately.

  • If holding the fetus: Managing infections (similar to the above)

    • If there are signs of amniotic fluid such as fever, high blood cells, amniotic fluid changes, smells ..., or amniotic fluid continues, ultrasound ... forced to end pregnancy

    Pregnancy> 37 weeks

    recommendation of pregnancy termination for pregnancy> 37 weeks of early rupture of amniotic fluid, do not wait 12 - 24 hours to reduce complications for the mother and pregnancy. Should initiate labor in 6 - 12 hours or if favorable, you should end the pregnancy as soon as possible.

    Termination of pregnancy depends on the condition of the cervix, the fetus, the fetus, the infection or not.

  • Abnormal throne or evidence that the fetus could not stand labor → cesarean section
  • If there is evidence of clinical infections and there is no contraindication to vaginal delivery, antibiotics and labor immediately.

    • Preventive infection: antibiotics are usually ruptured in pregnancy> 37 weeks: Using antibiotics has a significant meaning

    In short, young amniotic fluid is a common disease in obstetrics that need to be treated early and right to avoid complications for mothers and fetuses. Especially for premature pregnancy, the treatment is considered and delicate, on the one hand should not be too rushed to end the pregnancy in the pregnancy of the month but also not too delayed to lead to complications quantity for mother and pregnancy.

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