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| |    Amniotic Fluid--the Basics by Elisa Ross, MD reviewed by Marjorie Greenfield, M.D. Amniotic fluid surrounds and cushions a baby all through her development. In an ultrasound, it appears that the baby is swimming in the fluid. In fact, in addition to cushioning the baby, amniotic fluid also helps in the maturation of some of her organs. While your baby gets her oxygen through the umbilical cord she also "breathes" fluid into her lungs, which helps them to expand. And babies swallow amniotic fluid into their stomachs, giving the digestive system some practice before milk is introduced after birth. Where does amniotic fluid come from? Early in the pregnancy, the placenta produces amniotic fluid. Later on, about the fourth month or so, the baby's kidneys start to work, and then the amniotic fluid is made there. Although the kidneys ultimately are responsible for filtering waste products out of the blood and making urine, amniotic fluid is not urine as we think of it. The majority of the baby's waste products actually are transported through the placenta to the mother's circulation and are then filtered by her kidneys. This cycle repeats on a regular basis as the baby swallows fluid and releases it through her urinary system, and so on. The baby does secrete some substances and shed fetal skin cells into the amniotic fluid. This is important because sometimes when we need to get information about the fetus' condition, we perform amniocentesis and analyze the fluid's contents. When your water breaks Amniotic fluid is clear, relatively odorless, and is held inside the uterus by a sac made of thin, translucent membranes. When a hole develops in the membranes, the fluid is released. (Many people refer to this as "breaking your water.") In some cases, it may appear that all the fluid has escaped from the uterus, but a little more always seems to come out later. Some mothers worry about a "dry birth" in this situation, but there is no such thing! That's why everything in the labor room is made of plastic. The water can break before labor starts, during labor, or just prior to delivery. This must take place before or during birth because the membranes have to be removed from the baby so that she can breathe. During labor, your practitioner may suggest breaking your water if it hasn't broken on its own before the baby comes. In the old days, it was considered lucky to be born en caul (still in the amniotic sac), but only extremely premature babies are delivered that way today. What the fluid's color indicates In babies who are close to or past their due date, it generally is helpful to break the bag of waters before birth to determine the color of the amniotic fluid. Usually amniotic fluid is clear or slightly yellow; occasionally it will have white flecks in it. (This is the vernix caseosum, the slippery white coating that some babies have on their skin at birth.) If the fluid appears yellow or green, however, the baby may have passed her first bowel movement, known as meconium. Meconium sometimes is passed when a fetus is in distress, but most of the time, its presence is just a sign that the baby's intestinal tract is maturing as she approaches full term. If meconium is present, the practitioner will suction out the baby's nose and mouth just after her head comes out, so she won't inhale the its particles with her first breath.
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