All about pregnancy
Is it true that the baby breathes the gills, and 7 more important questions about amniotic fluid
For most future parents, the intrauterine life of the baby is a mystery and is often troubling. How does a baby breathe in water, what does he eat, where do the products of his life go? Do not get water in the mouth and nose to the baby, can not he "choke" them? These and many other questions we will answer in our article.
Elizaveta Novoselova obstetrician-gynecologist, Moscow
During pregnancy the baby is in a fetal bladder filled with a special fluid - amniotic fluid. For a long nine months, water forms a favorable habitat for the fetus. Obviously, the processes of respiration of the fetus and its movement are different from its life after birth. Let's figure out why amniotic fluid is needed.
Is the baby breathing amniotic fluid?
Many parents believe that the baby receives oxygen from the surrounding waters. Perhaps the basis for this myth involuntarily served as a picture from a school textbook of biology, which depicts an embryo with gill slits on the neck. In fact, the fetal breathing is carried out in a very different way. The baby receives oxygen in a "dissolved" form from the blood coming to him through the vessels of the umbilical cord and the placenta. Breathe in for the crumb does mama; from its lungs oxygen enters the pulmonary capillaries (small vessels), where it is "captured" by hemoglobin. With blood flow, oxygen is transported through the vessels of the uterus, the placenta and the umbilical cord to the baby. Back in the mother's body these vessels carry carbon dioxide, formed as a result of the cellular respiration of the fetus, which is excreted through the lungs of women. So amniotic fluid has nothing to do with fetal breathing, and gills are an intermediate stage of embryonic development and disappear by the first month of the intrauterine period.
Do I need amniotic fluid to feed the fetus?
The amniotic fluid is really saturated with proteins, amino acids, organic salts, carbohydrates and other nutrients. This water composition provides an ideal condition for the skin of the baby and the membranes covering the umbilical cord, placenta and uterine walls. It can be said that water performs a nutritional function for the fetal cover tissues and uterine cavity, but the process of feeding and digestion of the baby itself has no amniotic fluid. Nutrition of the child, as well as his breathing, depends only on the placental blood flow. From the food consumed by the mother, during the process of digesting, the end products necessary for the life of the organism are isolated: proteins, fats, carbohydrates, vitamins and trace elements. These substances enter the blood of the expectant mother and are delivered to the uterus. From the capillary capillaries "food" penetrate into the placental bloodstream, and the fetus is delivered from the placenta along the vessels of the umbilical cord. Thus, the baby does not eat in the usual sense of the word: he does not eat, does not drink, does not digest and does not allocate food. All these processes are carried out by the mother's organism, and the fetus only receives the necessary nutrients in a "ready" for assimilation. And these substances do not come from the amniotic fluid, but from the umbilical cord blood, bypassing the digestive tract of the baby.
The more amniotic fluid, the better?
Many mistakenly believe that the more water, the more comfortable the baby. Unfortunately, this is not the case: excess amniotic fluid is not useful either for the baby or for the future mother. With polyhydramnios, the fetus moves freely to the uterus until the last moment. Often, such excessive movement leads to the fetal entanglement of the umbilical cord. Normally, the umbilical cord is quite long (50-70 cm), so in the womb it is located in loops. With polyhydramnios, its loops lie freely, and the actively moving fruit can thrust the head, arms and legs into them. The wrap itself is not dangerous for the baby. However, if a multiple skin is formed, the fetus becomes entangled in the hinges of the umbilical cord. As a result, the crumb will not be able to move, and the length of the cord may not be enough for childbirth. In addition, it can lead to the formation of an incorrect position of the fetus in the uterus before delivery.
Normally, by the end of pregnancy, it is located with the head down and it is no longer possible to change the position at the last moment: it is fixed by the walls of the uterus. With polyhydramnios, the walls of the uterus are overstretched, and this allows the fetus to change its position even on the eve of its birth. As a result, at the onset of childbirth, the baby often appears in the pelvic presentation (with the glutes or legs down) or even in the transverse position.
In the process of childbirth, excess amniotic fluid interferes with the normal development of labor. Overstretched walls of the uterus contract badly, and a huge fetal bladder restrains the force of contractions. As a result, the weakness of the ancestral forces develops - the complication of labor, which is dangerous for the mother and baby. Often, against the background of polyhydramnios, the fetal bladder bursts with the first contraction, when the cervix has only just begun to open. This complication is called premature discharge of amniotic fluid. Because of it often develops weakness and discoordination (violation of nervous regulation) of childbirth, and the risk of infection of the fetus and uterus increases. With polyhydramnios during the outpouring of amniotic fluid more often than usual, there is a prolapse of the loop of the umbilical cord and the knobs or legs of the fetus - this complication requires an emergency caesarean section.
How much amniotic fluid should be normal?
Normally, the amount of water gradually increases and by the end of pregnancy is approximately 800-1500 ml. If they become fewer before delivery, this may indicate a pregnancy overdose. The walls of the fetal bladder "grow old" and release less water, which can cause deterioration of the baby.
Many future mothers think that the amount of water decreases, because the baby drinks them. But this is a misconception: the child does periodically swallow a small amount of liquid, but he does it not at all to quench his thirst. Swallowing the water, the baby "works out" the swallowing reflex and rinses the walls of the digestive tract, but the water is not absorbed into the baby's body, does not participate in its metabolism and is released back. All the necessary liquid, as well as food and oxygen, the baby gets in a dissolved form from the mother's body through the vessels of the placenta and umbilical cord. Thus, the decrease in the amount of amniotic fluid is not related to the fact that the baby "drinks" them.
Why amniotic water is green?
Normally, amniotic fluid is transparent, it has no color, no specific odor. However, sometimes fetal fluid changes color, acquiring different shades of green, which is a sign of chronic hypoxia (lack of oxygen) of the fetus. The green amniotic fluid becomes due to the premature release of meconium - the original feces of the baby. Normally, the baby's intestines are emptied for the first time only after birth and the first independent inhalation. However, with oxygen starvation, the crumbs have spasms of the intestine, and meconium enters the fetal water. In this case, the color saturation indicates the amount of meconium released: the brighter the color, the more severe the fetal hypoxia.
Another possible cause of green water coloring lies in the infection of fetal membranes - the walls of the fetal bladder, producing and filtering water. Infection can penetrate into fetal membranes with blood flow if the future mother has undergone acute viral disease (ARI, influenza) during pregnancy or through an opening in the wall of the bladder with premature outflow of water.
Does the baby suffer after the water has drained away?
Of course, the importance of amniotic fluid for the development of pregnancy and fetus is enormous. They create a unique habitat for the baby, prevent the formation of fusions between the wall of the bladder and the skin of the fetus, create an opportunity for active movements of the crumbs necessary for its correct and full development. At the same time, the waters protect the umbilical cord and the placenta from pressure from large parts of the fetal body, and the baby from shocks and bruises from the outside, make his movements less tangible for the future mother, affect the formation of the correct position of the fetus in the uterus by the end of pregnancy. Fruit bubble filled with water, participates in the process of opening the cervix in the first stage of labor and protects the baby from excessive pressure of the walls of the uterus during labor. In case of premature (before the onset of contractions) the outflow of amniotic fluid increases the risk of infection of the fetus, the process of delivery is often complicated ... However, there is no immediate threat to life of the crumbs. After all, after their pouring out, he still continues to receive oxygen and nutrition through the vessels of the placenta and the umbilical cord. Certainly, the diversion of water is a risk factor for the health of the crumbs, but this is not due to the impossibility of its existence without fetal fluid (as fish can not exist without water), but with the risk of infection into the uterus of the infection through the hole formed in the bursted fetal bladder. Therefore, with a premature outpouring of amniotic fluid, you must immediately go to the hospital.
If you drink a lot, there will be a lot of amniotic fluid?
Often, future mothers are wondering: will not there be hydramnios, if you drink a lot and do not have to try to limit the consumption of liquid for this reason?
This is not so: the amount of amniotic fluid does not directly depend on how much fluid the future mother uses. For the production and maintenance of the desired composition of the amniotic fluid, the walls of the fetal bladder respond. If we examine them under a microscope, it turns out that they look like a spiderweb: the fetal membrane is permeated with a network of tiny blood vessels. From the plasma (liquid part) of the blood in these vessels, a fetal liquid forms. The amount and composition of amniotic fluid can change when the membranes are affected by a viral infection, a placental blood flow is disturbed, or a perishing problem occurs. In these cases, the normal operation of the fetal bladder is disrupted, including the function of allocation of amniotic fluid. As a result, their number can both increase and decrease. In order to prevent the development of polyhydramnios, you need to regularly see a doctor during pregnancy, pass all the recommended examinations on time, carry out prevention and timely treatment of viral infections (acute respiratory viral infection, influenza, etc.). But the restriction of drinking during pregnancy can lead to dehydration of the future mother's body, a decrease in the volume of circulating blood and, consequently, to low water! Therefore, a pregnant woman is recommended to consume at least 1.5 liters of fluid during the day.
Why do the fetal waters become cloudy?
At the beginning of pregnancy, the fetal water is clear and clean. In the second half, and especially towards the end of pregnancy, the amniotic fluid becomes turbid. This is caused by special substances that accumulate as the gestation period increases:
- Lanugo - the so-called gentle hairs, which cover the skin of the baby in a certain period of embryonic development, they subsequently drop out.
- Original grease - fatty lumps covering the skin of the fetus in the form of curd or cheese-like mass. This lubricant protects the skin from excessive fluid effects.
- Degraded epidermis is the scales of dead skin cells of the fetus. The skin of the baby is constantly updated.