Amniotic fluid leak along with bleeding. Termination needed?

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If you have been experiencing an outflow of amniotic fluid since 10 days and now bleeding for a day then only this history is showing the history of preterm premature rupture of membranes that can lead to chorioamnionitis (infection within the womb) and intrauterine fetal death as well. ultrasound confirms this rupture and leaking of amniotic fluid by measuring fluid amount within the uterus (attachment removed to protect patient identity). It might be possible that you will get labor like pain and cervical changes in recent future that could lead to the delivery of the fetus. You should have related tests to immediately check infection, scan to properly measure cervical length to check any changes locally,fetal viability and the exact amount of amniotic fluid remains inside uterus.

Get complete blood count for checking leucocytes count (shows infection), C-reactive protein and need to start antibiotics and immediately get a speculum examination and a litmus test for confirming leaking. If blood tests confirm infection, the only option will be the termination of pregnancy. If amniotic fluid already come out, that means protection for fetus has gone and any time it can lead to an infection that could be hazardous. Early or late either cervical changes will occur itself or due to infection will urgently need to terminate the pregnancy with antibiotics cover. As per your description, gestational age is 23 weeks at which lungs development is in very very early stage and the fetus is not completely reached at viability age so it is count as a fetal loss not stillbirth of the viable fetus. So, it is almost impossible to try for the survival of 23 weeks fetus. The infection can harm you as well. It can lead to severe sepsis even need of ICU admission, if not treated well.