Amniotic Fluid Leak at 20 Weeks: Understanding Your Options

Question
Hi, my wife and I are now at 20 weeks into our pregnancy, sunday night she saw a gush of fluid coming from her Virgina. We called her doctor and then visited him yesterday morning. He informed us that it was the amniotic fluid. He said that there isn't much that can be done and spoke about terminating the pregnancy. We don't wanna give up on our first child. I am wondering if there is anyway that the sac can heal and is there a chance that the fluid can build back up? The doctor didn't tell us how much of a tear it was to the sac, but I do know that we don't wanna give up and we are praying for a miracle. Thanks for your reply in advance.

Answer
Dear Ken,

Without knowing the particulars of your case, I would have to defer to your doctor. It sounds like a "gush" of amniotic fluid at 20 weeks is unfortunately an ominous sign. This condition is called Premature Rupture of Membranes (PROM) and this early on in pregnancy is a very difficult and frustrating condition to deal with for both parents and medical personnel because there is so very little to be done.

At 20 to 23 weeks, survival is unfortunately poor (less than 25%) and there is a very high incidence of handicap in those who do live. PROM before 20 weeks gestation is associated with significant risk of infection and survival chance is negligible, and usually then with significant handicap(s). Most do elect termination of pregnancy in these cases to protect the mother from what can often turn into an overwhelming infection. Unfortunately there is no therapy available to replace the fluid or, at present, to plug the hole in the membranes. Very rarely the membranes reseal, but again the chance of infection goes up with every minute that passes after the 24 hour mark post-PROM. And resealing at 20 weeks would have a less than 10% chance also. So, the risk to the mother and the very high chance of an unsuccessful outcome in the pregnancy is why most do elect to terminate rather than attempt extraordinary measures this early on.

I am sorry to bear the news you didn't wish to hear repeated after your doctor visit. I do wish you well and hope I answered your question.

Brenda