Discharge and amniotic fluid leakage present similarly in most cases. Women feel an excessive wetness of vagina and/or fluid leakage. There are many differential diagnoses for vaginal discharge out of which spontaneous rupture of membranes is one. Therefore, it is important to understand that while amniotic fluid leakage may present as vaginal discharge in pregnancy, it is not the only cause. This article will talk about both vaginal discharge and amniotic fluid and the differences between them in detail.
The large bag in which the baby is in is made out of a thin but strong membrane called the chorioamnion. It is a hybrid membrane made by combining chorion and amnion. In this bag, there is a fluid called amniotic fluid. This fluid is a product of secretions of the baby’s skin, placenta, baby’s lungs and baby’s urine. It helps protect the baby from infection, heat, trauma, pressure, impact and certain chemicals. This is the fluid which leaks out when water breaks. Water breaking is spontaneous rupture of chorioamnion. Chorioamnion ruptures when the cervix of the uterus dilates. Uterus contracts and the baby’s head presses against the membrane stretching across the cervical region. This pressure breaks the membrane, and the amniotic fluid gushing out washes the birth canal, removing harmful bacteria.
The color of the amniotic fluid is a good indicator of the wellbeing of the fetus and progression of labor. If amniotic fluid is meconium stained, it is a sign of fetal distress. Immediate delivery by assisted methods or cesarean section may be needed. Normally water breaking is not associated with any complications. If there is polyhydramnios, low lying placenta or unstable lie, there may be problems. Cord prolapse, hand prolapse, and malpresentation are commonly encountered problems. While water breaking is spontaneous, the same method is also used by obstetricians to induce labor. Artificial rupture of membranes is a sterile procedure done at labor room when the cervix and the pelvis are favorable for vaginal delivery.
Vaginal discharge, on the other hand, can be due to many causes. Infections like candida and bacterial vaginitis present with vaginal discharge. The characteristics of the vaginal discharge often help the clinician in diagnosis. A white, creamy discharge with vulval itching is due to candida. A fishy smelling vaginal discharge is due to bacterial vaginitis. A high vaginal swab should be taken before the commencement of antibiotic treatment for definitive diagnosis.
Post-menopausal women also complain of vaginal discharge, but this is almost always due to atrophic vaginitis and atrophic cervicitis. Cervical cancers and endometrial cancers may also present with vaginal discharge. Therefore, a good clinical history, vaginal examination, and biopsy of suspicious lesions are essential. Infections require antibiotics and cancers require surgery, chemotherapy and radiotherapy.
What is the difference between Discharge and Amniotic Fluid?
• Amniotic fluid comes from the water bag while other vaginal discharges may be due to many conditions.
• Therefore, while vaginal discharge is common to all women, amniotic fluid leakage occurs only in pregnant women.
• Amniotic fluid leakage is a serious condition that needs immediate attention and sometimes immediate delivery if the fetus is mature enough. Other vaginal discharges are not medical emergencies.