The rupture of the bladder - signs of childbirth?

definition

If during or at the end of pregnancy the amniotic sac cracks (or, in colloquial terms, it "bursts"), it is called a rupture. This opens the amniotic sac that surrounds the unborn child and contains the amniotic fluid, which then passes through the vagina. A rupture of the bladder is one of the signs of the beginning of childbirth and usually occurs spontaneously after the onset of labor. If the cervix is ​​fully opened, it is called a rupture of the bladder in time. Very rarely is a child born with an intact amniotic sac.

Cause of the ruptured urine

In the most cases the rupture of the bladder is caused by the The child is pushed further down during labor. The resulting pressure tears the amniotic sac and the amniotic fluid escapes.

The second most common cause are Vaginal infections during pregnancy. If these rise to the amniotic sac, they can cause the Amniotic sac more sensitive will and tear faster.

A Weakness of the cervix and increased stress on the amniotic sac by for example Multiple pregnancies, increased amniotic fluid (Polyhydramnios) or deviations from the normal birth position (e.g. breech position) are further causes. Even external medical interventions, like one Amniotic fluid examination, can cause your bladder to crack.

diagnosis

The amniotic fluid can droplet or surge-like go off. If this happens during the normal labor process, no further clarification is required.

It comes to one Rupture of the bladder before the 37th week of pregnancy, a smear of the vagina and the cervix is ​​made and by measuring the pH and a specific tests proven whether the leaked liquid Amniotic fluid is. The doctor also uses ultrasound to assess the amount of amniotic fluid remaining in the amniotic sac. However, an ultrasound assessment is not enough to diagnose a ruptured bladder. If there is an increased (Polyhydramnios) or decreased (Oligohydramnios) Production of amniotic fluid, this can lead to a wrong interpretation of the values. Therefore, a detailed discussion (anamnesis) with the pregnant woman, including previous diagnoses and abnormalities, is very important.

To the Exclusion of infection will be more Laboratory and temperature controln performed and the unborn child is through a CTG supervised.

Can you recognize the harbingers of the impending rupture of the urine?

The rupture of the bladder occurs in 9 out of 10 cases at the beginning of childbirth instead of. This occurs in most cases Labor pains that announce the coming birth and lead to severe pelvic pain.

A rupture of the bladder that occurs before labor is hardly noticeable in advance. Will the Rupture of the bladder caused by an infection, can in advance possibly signs of infection such as fever, increased heart rate in both mother and child, and abdominal pain are observed. But even these are unspecific and do not definitely indicate a rupture of the bladder.

Can a ruptured bladder occur without going into labor?

A crack of the bubble can occur without labor. In this case one speaks of premature rupture of the bladder. Several hours can pass between the rupture of the bladder and the onset of labor; in 90% of cases, delivery occurs within a day. But should no contractions after 24 hours the woman should use one See a doctorto check if the amniotic fluid has actually come off. Infection of the unborn child, who lacks the protection of the amniotic sac, and the pregnant woman should also be excluded.

Is the The rupture of the bladder is caused by an infectionweakness of the cervix or increased strain on the amniotic sac, in most cases it occurs before labor begins and should, especially in the case of an infection, clarified by a doctor as soon as possible become.

Concomitant symptoms

A ruptured bubble is painless. There is a sudden drainage of amniotic fluid from the vagina. Since the amniotic sac can tear in all places and to different distances, the amniotic fluid can from drop by drop to surge go off. If it tears at the top, the amniotic fluid usually flows slowly; if it tears at the opening to the cervix, larger quantities often flow in a short time.

The amniotic fluid can be colorless like water to milky and cloudy and sweetish, but in some cases it can also smell unpleasant. The amniotic fluid is body temperature. Sometimes the amniotic fluid is mistaken for urine that escapes unplanned, for example due to the child's pressure on the bladder.

Is this Amniotic fluid discolored (greenish, yellowish or reddish-brown), this indicates abnormal changes and can Indications of a risk to the child give.

Can you trigger the rupture of the bladder yourself?

A midwife or doctor may make the bladder rupture (Amniotomy). However, this only happens in exceptional cases, if the birth does not precede or is not to be initiated, as the rupture of the bladder often causes labor to start within 1 to 2 hours. For this purpose, the amniotic sac is "burst" with a kind of thimble with a barb at the tip, so that amniotic fluid can escape. In advance, it must be checked that the child's head lies firmly in the pelvis so that it enters the birth canal in front of the umbilical cord. In addition, the cervix must be sufficiently open (approx. 10 cm). Since the risk of infection is increased, the child must be constantly monitored by CTG during the birth and the birth should be ended as soon as possible.

The initiation of childbirth or the promotion of labor activity and thus an increased probability of a rupture of the bladder can also be achieved by administering so-called prostaglandins and oxytocin.

Learn more about: Medication to promote labor

Trying to rupture the bladder yourself without medical support and observation is very dangerous and should not be undertaken under any circumstances, as in the worst case it can be fatal for the unborn child.

Accidental rupture of the bladder, for example through sexual intercourse or heavy physical work, is very unlikely, but the individual risk of premature rupture of the bladder should always be discussed with the attending physician.

What should I do if my bladder ruptures?

If your bladder ruptures, you should first keep calm. If the child lies in the skull position, i.e. with the head towards the cervix, the pregnant woman can drive to the clinic in peace. In most cases, less water escapes even after a short time, as the head blocks the exit like a kind of plug.

If the child lies in breech position, i.e. with the buttocks towards the cervix, there is a risk of an umbilical cord prolapse. Here, the umbilical cord cuts itself into the birth canal in front of the child and can be pulled off by the pressure of the child during labor. There is a risk that the child will not be adequately supplied with oxygen. Therefore, the pregnant woman should lie on her side and be taken to hospital in this position with the help of a patient transport.

Read more on this topic: Childbirth complications

After a rupture of the bladder, the birth should begin within 24 hours, otherwise the risk of infection for mother and child increases significantly. If this is not the case, the birth will be initiated or, if necessary, a caesarean section will be performed.

You might also be interested in the following article: The process of a birth.

What is premature rupture?

Premature rupture of the bladder is a Rupture of the bladder before labor begins, which occurs in 10% of pregnancies before the 34th week of pregnancy (SSW). Depending on the time of pregnancy, it can be more or less dangerous for the pregnant woman and her child and is treated differently.

If the premature rupture occurs after the 34th week of pregnancy one, the child is born. If you don't go into labor for more than 12-24 hours, the Birth initiated. Before the 37th week of pregnancy, additional prophylactic antibiotics administered.

With premature rupture of the bladder between the 24th and 34th week of pregnancy will the Delayed pregnancy as long as possibleif there is no infection. If it comes to birth, will Means to suppress contractions for a maximum of 48 hours given to at this time the Lung maturation of the child using glucocorticoids and if necessary the amniotic sac is filled. After the 30.-32. An operative birth is aimed for in SSW.

Between 20 and 23 weeks of pregnancy, contractions are suppressed, antibiosis are administered and the amniotic sac is filled.

Before the 20th week of pregnancy, the prognosis is poor, since the amniotic sac only rarely closes again. An abortion should be discussed.

Complications of premature rupture of the bladder are infections that are triggered by ascending germs and can lead to an amniotic infection syndrome, which is dangerous for both mother and child. It can also lead to premature birth.