Definition
If the amniotic sac bursts (or colloquially expressed “bursts”) during or at the end of pregnancy, this is called a rupture of the amniotic sac. This is when the amniotic sac surrounding the unborn child opens and contains the amniotic fluid, which then flows out through the vagina. A rupture is one of the signs of a beginning birth and usually occurs spontaneously after the onset of labour. If the cervix is fully opened, this is called a timely rupture of the bladder. Very rarely a child is born with an intact amniotic sac.
Cause for the rupture of the bladder
In most cases the rupture of the bladder is caused by the fact that the child is pushed further and further down during labour. The resulting pressure ruptures the amniotic sac and the amniotic fluid escapes. The second most common cause is infections of the vagina during pregnancy.
When these rise up to the amniotic sac, they can cause the amniotic sac to become more sensitive and rupture more quickly. Other causes include weakness of the cervix and increased strain on the amniotic sac, e.g. multiple pregnancies, increased amniotic fluid (polyhydramnios) or deviations from the normal birth position (e.g. pelvic end position). Medical interventions from outside, such as an amniocentesis, can also cause a rupture of the bladder.
Diagnosis
The amniotic fluid may be droplet-like or gushy. If this happens during the normal birth process, no further clarification is required. If a rupture of the membranes occurs before the 37th week of pregnancy, a smear is taken of the vagina and the cervix and a measurement of the pH value and a specific test is carried out to determine whether the fluid that has been drained off is amniotic fluid.
The doctor also uses ultrasound to assess the amount of amniotic fluid remaining in the amniotic sac. However, the ultrasound assessment is not sufficient to diagnose a rupture of the amniotic sac. If there is an increased (polyhydramnion) or reduced (oligohydramnion) production of amniotic fluid, this can lead to an incorrect interpretation of the values. For this reason, a detailed conversation (anamnesis) with the pregnant woman, including previous diagnoses and abnormalities, is very important. To exclude an infection, further laboratory and temperature checks are carried out and the unborn child is monitored by a CTG.
Can we see harbingers of the impending rupture of the bubbles?
In 9 out of 10 cases the rupture of the bladder occurs at the beginning of birth. Before that, in most cases contractions occur which announce the coming birth and lead to severe lower abdominal pain. A rupture of the bladder that occurs before the contractions can hardly be detected in advance. If the rupture of the bladder is caused by an infection, signs of infection such as fever, an increased heart rate, both of the mother and the child, and abdominal pain may be observed in advance. But even these are unspecific and do not indicate a rupture of the bladder with certainty.
