Premature outflow of amniotic fluid - PTGiP issues management guidelines

Premature drainage of amniotic fluid, which occurs in the middle trimester, occurs with a frequency of about 1.5 percent of pregnancies. Annually, about 5,000 women are thus affected by this problem.

- At this point, the fetus is still incapable of surviving outside the mother's body. In itself, the drainage of fluid so early is a very serious complication. This kind of situation must be the reason why we should consider whether there is a health and life threat to the pregnant woman and the fetus," said Prof. Sieroszewski.

The main problem that doctors point out is that the amniotic fluid in more than half of the cases drains as a result of the bacterial threat of very different strains, many of which are very malignant. The infection can therefore have a fulminant course. This is a condition in which a woman can even die within minutes.

- Always consider the risk of septic miscarriage. Intrauterine infection is then an indication for termination of pregnancy. If we do not act, it can lead to sepsis. If we see that inflammation is increasing and the woman is at risk, the pregnancy should be terminated immediately. If, despite this, the symptoms of sepsis progress, we must also remove the uterus," the PTGiP president pointed out.

Conservative management, in which antibiotics are administered after the amniotic fluid has drained and the test results are checked, is also acceptable. It is effective in about 20 percent of cases.

- may succeed in getting to the point where the fetus has a chance to survive outside the mother's body. These are difficult choices. We are the only doctors who treat two people: mother and child. We must always remember to think and save the life of the mother and the fetus. If there are good conditions to continue the pregnancy, it can always be considered, but it should be discussed with the woman," the professor stressed.