What is amniotic fluid? Functions of amniotic fluid during pregnancy

Fungsi air ketuban adalah untuk menyokong perkembangan serta memberikan perlindungan kepada janin di dalam kandungan sepanjang kehamilan

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What is amniotic fluid (AF)? It is also known as amniotic fluid, is the fluid that surrounds the fetus in the womb during pregnancy. The function of amniotic fluid is very important in the development and protection of the baby. The amount of amniotic fluid in the fetus in the womb will always change according to the gestational age. 

What is amniotic fluid?: Function 

There are several functions of if that are very important in supporting the development of the fetus in the womb. Among them are: 

  • Protective and lubricating

 One of the main functions of it is to protect the fetus from external pressure and possible effects on the pregnant woman’s stomach.

It acts as a shock-absorbing cushion and helps protect the fetus from possible injury. In addition, it is also a lubricant that allows the free movement of the fetus in the womb.

  • Fetal development

It is very important for the physical development and function of the fetus. The fetus spends most of its time in the womb, which allows it to move freely.

In addition, the space provided by the AF allows the fetus to develop its cognitive and sensory qualities.

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  • Circulation and nutrition

It also plays a role in providing proper circulation and nutrition to the fetus. AF contains nutrients such as glucose, protein, electrolytes, and oxygen that are essential for fetal development and growth. The fetus absorbs these nutrients through the skin and digestive tract.

  • Infection protection

It helps protect the fetus from infection and forms a protective layer that separates the fetus from any bacteria and viruses that may be present in the womb. Additionally, it also contains antibodies that can provide additional protection against infection.

  • Temperature Control

Lastly, one of the main functions of this is to maintain an optimal temperature for the fetus. It has good heat capacity and helps maintain a stable temperature of the uterus. This is important because the fetus is not yet able to regulate its own body temperature effectively.

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Amniotic fluid reading

In the early stages of pregnancy, the amount of amniotic fluid may be around 10 to 50 cc only, but it will continue to increase as the gestational age increases.

The amount and reading can reach around 600cc to 1,200cc when the gestational age enters 34 to 38 weeks.

However, the amount will start to decrease as the gestational age approaches the baby’s birth period.

According to Consultant Obstetrics, Gynecology, and Fertility, KPJ Tawakkal Specialist Hospital Kuala Lumpur (KL) Dr. Ahmad Murad Zainuddin said, usually, doctors will calculate the amount of it using an ultrasound machine by calculating the amount of ‘amniotic fluid index’ (AFI).

Healthcare providers typically use AFI readings when the gestational age exceeds 24 weeks.

“Amniotic fluid is produced through the baby’s urine when it is in the tank and a normal baby will always drink the amniotic fluid back. A normal AFI reading is between 8 and 20,” he said.

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In addition, Dr. Ahmad Murad stated that, if the AFI is less than 8, the condition is called ‘oligohydramnios.’ This condition can restrict the movement of limbs and the growth of the baby’s body in the womb, including organs such as the baby’s respiratory system.

How is AF produced?

The fetus in the womb forms amniotic fluid through a complex process. The following is an explanation of how  (AF) is produced:

 

  • Early formation

In the early stages of pregnancy, around the eighth to tenth week, the newly formed embryo produces an amniotic sac.

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The amniotic sac is the sac that covers the fetus and will be the place where the amniotic fluid forms. At this stage, amniotic fluid is formed from the body fluids of the pregnant woman through diffusion through the placental membrane.

  • Fetal Contribution

At this stage of fetal development, organs such as the fetal kidneys begin to function and produce urine. The urine produced by the fetus gets into the amniotic fluid around it.

In the early stages of pregnancy, urine is the main contributor to the formation of amniotic fluid.

  • Contribution of the pregnant mother

In addition to the contribution of the fetus, pregnant women also play a role in the production of it. Through the placental membrane, substances dissolved in the mother’s blood. Such as water, nutrients, electrolytes, and oxygen, can pass through and enter the AF. Diffusion and filtration processes allow these substances to move in and out of the amniotic fluid, thereby renewing and maintaining the AF volume.

Contents

Amniotic fluid contains various important substances for the growth and development of the fetus during pregnancy.

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Here are some of the contents of it: 

  1. Water: The main content of amniotic fluid is water. It plays a role in maintaining moisture and fluid balance in the uterus and provides a suitable environment for the fetus.
  2. Electrolytes: It contains electrolytes such as sodium, potassium, calcium, and magnesium. These electrolytes play a role in maintaining fluid balance and normal cell function in the fetal body.
  3. Nutrition: It also contains various nutrients needed by the fetus, such as glucose (sugar), amino acids, fats, and vitamins. These nutrients are important for optimal fetal growth and development.
  4. Hormones: Some hormones produced by the fetus and placenta can be found in the amniotic fluid. This hormone plays a role in controlling the body functions of the fetus and affects the growth of its organs and systems.
  5. Cells: It also contains sloughed-off fetal skin cells, fetal blood cells, and debris such as fetal hair and vernix caseosa (the white protective coating that covers fetal skin). This component is usually present in small quantities and is a normal part of the fetal development process.
  6. Antibodies: The content of amniotic fluid also consists of antibodies produced by the mother and fetus. These antibodies provide additional protection against infection and help keep the fetus healthy in the womb.

What is normal amniotic fluid? 

Normal amniotic fluid, also known as adequate amniotic fluid, is a condition where the amount and quality of amniotic fluid is within a healthy range and is sufficient for the developing fetus.

Some of the characteristics of it are the following: 

  • Sufficient amount of amniotic fluid: The normal amount of it varies during each trimester of pregnancy. In mid-pregnancy, around weeks 20 to 24, the amount of amniotic fluid reaches its peak.
  • Normal color and consistency: It is usually clear or slightly yellow. The consistency is similar to water, not too thick and not too runny. Keep in mind that the color or clarity of the amniotic fluid can change if there is a problem, such as the presence of meconium (fetal feces) in the amniotic fluid.
  • Balanced pH: The normal pH of amniotic fluid is between 7 and 7.5. A balanced pH level is important to maintain acid-base balance and fetal health.
  • Infection free: It does not contain bacteria or other infections. If there are signs of infection, such as an unusual smell, a suspicious color, or a fever in the mother, it can be an indication of an infection in the amniotic fluid.

Amniotic fluid color

The normal color of amniotic fluid is clear or slightly yellow. However, there are some situations where the color of the AF can be different and indicate a special condition.

Here are some changes in the color that may occur:

  • Yellow

If a pregnant woman is physically active or does sports before giving birth, the amniotic fluid can appear more yellow. This is usually caused by the presence of meconium, which is fetal feces, in the AF.

If meconium is present in the AF, further monitoring is necessary to ensure the health of the fetus.

  • Green or brown

If it is green or brown in color, this may indicate the presence of very concentrated or oxidized meconium. Fetal meconium is usually dark green or brown.

This color may indicate a fetal disorder or a problem with the placenta. In a situation like this, medical personnel need to be evaluated immediately and medical action may be necessary.

  • Red or Bloody

If the fluid appears red or bloody, this could indicate bleeding in the uterus. Bleeding can be caused by placental abruption, placenta previa, or other problems. Significant bleeding during pregnancy should be treated immediately by medical personnel.

How to keep amniotic fluid normal? 

To maintain normal amniotic fluid during pregnancy, there are steps you can take. Although there is no guarantee that your AF will remain normal, the following steps can help maintain the balance and quality of it:

  1. Drink enough water Make sure you drink enough water and other fluids every day. Maintaining good hydration helps maintain an adequate amount of amniotic fluid. Drink at least 8-10 glasses of water daily or as recommended by your doctor.
  2. Balanced nutrition: Take a healthy and balanced diet during pregnancy. Make sure your nutritional intake includes protein, vitamins, minerals, and omega-3 fatty acids that are important for fetal growth. Consult a doctor or nutritionist for proper dietary guidelines.
  3. Avoid dehydration: Apart from ensuring adequate fluid intake, avoid factors that can cause dehydration. Avoid strenuous physical activity, especially in hot weather, and avoid prolonged exposure to dry environments. If you feel thirsty, drink water to meet your body’s fluid needs.
  4. Watch for signs of infection: Infection can affect the quality of amniotic fluid. Watch for signs of infection such as fever, unusual odors in your amniotic fluid, or foul-smelling discharge. If you suspect an infection, seek medical advice immediately.

Types of amniotic fluid problems

Amniotic fluid problems during pregnancy include polyhydramnios, characterized by excessive fluid accumulation, and oligohydramnios, where there is insufficient fluid surrounding the fetus.

Premature Rupture of Membranes (PROM) refers to the early breaking of the amniotic sac, which can lead to infection and premature birth if it occurs before 37 weeks.

Hydramnios is another term for polyhydramnios, causing discomfort for the mother and increasing preterm birth risk. AF(Amniotic fluid) infections pose serious risks to both mother and baby.

Regular prenatal check-ups and ultrasound monitoring are vital to detect and address these issues promptly.

Signs that the amniotic sac had broken up

Recognizing whether it has broken or not can be a difficult task. However, there are some signs and symptoms that can help you recognize that your water has broken.

Here are some ways to tell if the water has broken:

  • Pay attention to vaginal discharge: Pay attention to vaginal discharge. Amniotic fluid rupture usually results in more discharge than normal discharge or mucus. It generally has a clear texture and is usually colorless. However, sometimes it can have blood spots or a slight yellow color. If the discharge continues and does not stop, it could be a sign that the water has broken.
  • Note the smell of the fluid: It usually has a distinct odor that is different from vaginal discharge or other fluids. A slightly sweet or chlorine-like odor is a common odor associated with broken AF.
  • Pay attention to the color of the fluid: If it looks green, brown, or has an unusual color, this could be a sign of a problem and you should seek medical attention immediately.
  • Watch for changes in sensation: Your water breaking may cause a wet or moist sensation that is different from normal vaginal discharge. You may find that your underwear continues to be wet even after you change your pads or pantyliner.
  • Watch for contractions: Amniotic fluid breaking is often followed by contractions. If you start to feel regular contractions, this may be a sign that labor has begun.

 

Translated with permission from theAsianparent Malaysia.

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