A pregnant woman sitting on a sofa at home with a hand on her bump

Air Ketuban (Amniotic Fluid): Bocor, Pecah, Kurang & Banyak

October 27, 2026 Drann Editorial Team

Air ketuban (amniotic fluid) is the fluid that surrounds and protects your baby in the womb. Normal amniotic fluid is clear or pale yellow and has little or no smell. When your waters break (pecah air ketuban), you may feel a sudden gush or only a slow trickle that is easy to mistake for urine. Whatever week of pregnancy you are in, contact your hospital and go for a check-up straight away if you think your waters have broken, and go urgently if the fluid is green, brown, bloodstained or smelly. This guide explains what normal amniotic fluid looks like, how to tell if it is leaking, what happens if your waters break early, and what it means to have too little (air ketuban kurang) or too much (air ketuban banyak).

Apa itu air ketuban (amniotic fluid in English)?

Many readers search for "air ketuban in English". The English term is amniotic fluid. It is a water-like fluid inside a bag of membranes called the amniotic sac (kantung ketuban), which sits inside your womb (Cleveland Clinic). Your baby floats in this fluid throughout pregnancy. The fluid moves constantly, as your baby swallows and "breathes in" the fluid and then releases it again (MedlinePlus).

Early in pregnancy, amniotic fluid is mostly water from your body. After about 20 weeks, most of it is your baby's urine, together with hormones, nutrients and antibodies (Cleveland Clinic). Amniotic fluid helps your baby in several ways (Cleveland Clinic; MedlinePlus):

it cushions your baby from bumps and sudden movements;
it gives your baby room to move, which helps the muscles and bones develop;
it helps the lungs and digestive system develop;
it helps prevent pressure on the umbilical cord;
it helps keep a steady temperature around your baby and protects against infection.

Air ketuban normal: warna, bau dan jumlah

Amniotic fluid is mostly clear but can be pale yellow, like the colour of straw (Cleveland Clinic). It should have little or no smell. Some readers search for "warna air ketuban". Here is what different colours may mean:

What you see	What it may mean	What to do
Clear or pale yellow, little or no smell	Usual colour of amniotic fluid (Cleveland Clinic)	Contact your hospital if you think your waters have broken
Green or brown	Your baby may have passed their first poo (meconium) into the fluid, which can cause problems if your baby breathes it in (Cleveland Clinic)	Go to the hospital straight away
Red or bloodstained	Bleeding needs checking (Cleveland Clinic)	Go to the hospital straight away
Smelly (unpleasant smell)	Possible infection, or meconium in the fluid (Cleveland Clinic)	Go to the hospital straight away

Malaysia's Ministry of Health (KKM) lists amniotic fluid contaminated with the baby's stool getting into the baby's lungs among the serious complications that can happen unexpectedly during birth. This is one reason KKM says every mother must be cared for by trained health staff registered with KKM when she gives birth (KKM, Rekod Kesihatan Ibu).

How much amniotic fluid is normal?

The amount changes through pregnancy. It is greatest at about 34 weeks, when it averages about 800 ml, and drops to about 600 ml at full term (40 weeks) (MedlinePlus). Your doctor checks the amount with an ultrasound scan, and between scans they can estimate it by measuring the size of your bump (fundal height) (Cleveland Clinic). KKM's maternal health record notes that ultrasound can be used to check the amount of amniotic fluid, along with your baby's age, position and the placenta (KKM, Rekod Kesihatan Ibu).

On ultrasound, doctors often use the amniotic fluid index (AFI), which adds up the depth of fluid in 4 areas of the womb. Cleveland Clinic says a normal AFI is greater than 5 cm. Ask your doctor to explain your own result, as it is read together with how many weeks pregnant you are and how your baby is growing.

Tanda air ketuban bocor sedikit (leaking amniotic fluid)

When your waters break, it is not always a big gush like in films. Some women feel a popping feeling followed by a gush, while others notice only a slow trickle or dampness in their underwear that can go unnoticed (Cleveland Clinic). It does not hurt. Signs that you may be leaking amniotic fluid include (Cleveland Clinic):

wetness in your underwear or running down your leg, in small or large amounts;
fluid that is clear or pale yellow and has little or no smell;
fluid that is thin and watery, rather than thick and sticky;
leaking that you cannot "hold in";
leaking that comes back when you stand up or move, or with contractions.

Air ketuban, air kencing atau keputihan?

Leaking urine is common in pregnancy, and vaginal discharge also increases, so it can be hard to tell the difference (Cleveland Clinic; RCOG). This table can help, but only a doctor or midwife can confirm whether your waters have broken.

	Air ketuban (amniotic fluid)	Air kencing (urine)
Colour	Mostly clear or light yellow	Usually dark yellow
Smell	Little or no smell	A distinct smell
Can you hold it in?	No; it may keep leaking, sometimes with a contraction	Usually yes; your bladder empties and does not fill up again quickly

Source: Cleveland Clinic. Amniotic fluid is thin and watery, while vaginal discharge is usually thicker and stickier (Cleveland Clinic). For more about normal and abnormal discharge, see our guide to keputihan (vaginal discharge). If you often leak urine when you cough, laugh or move, see our guide to kencing tak lawas.

What to do if you think you are leaking

Wear a pad, not a tampon, and note the colour and amount of the fluid (RCOG).
Cleveland Clinic suggests lying down for 15 to 30 minutes, then standing up to see if more fluid comes out. Amniotic fluid usually leaks again when you stand.
Contact your hospital and go for a check-up straight away if you think your waters may have broken (RCOG). Do not wait to see if it stops.

At the hospital, a doctor may look at your cervix with a speculum to see whether amniotic fluid is pooling, test a swab of the fluid, and check your baby's heartbeat. An ultrasound scan can help estimate the amount of fluid around your baby (RCOG; Cleveland Clinic). If only a small amount is leaking, it can be hard to confirm, so go back if you keep leaking at home (RCOG).

Air ketuban pecah: what happens next?

KKM lists pecah air ketuban as one of the signs of labour, together with contractions that come more often and last longer, and mucus mixed with blood (a "show") coming from the vagina (KKM, Rekod Kesihatan Ibu). For the other signs, see our guide to tanda bersalin (signs of labour).

Most women are already in labour when their waters break: for up to about 90%, labour starts first (Cleveland Clinic). When the waters break before labour starts, this is called prelabour rupture of membranes (PROM), and it happens in up to 10% of pregnancies (Cleveland Clinic).

If your waters break from 37 weeks

About 90% of women who are 37 to 40 weeks pregnant go into labour on their own within 24 hours (Cleveland Clinic).
The longer it takes for labour to start, the greater the chance of infection. Women who deliver within 24 hours after their waters break are less likely to get an infection, so if labour does not start on its own, your doctor may offer to induce labour (MedlinePlus).
KKM's antenatal checklist puts "keluar air ketuban tanpa kontraksi" (amniotic fluid leaking without contractions) in its red code, which means urgent referral to hospital (KKM, Rekod Kesihatan Ibu).

So even if you feel well and have no pain, go to the hospital where you plan to give birth, or the nearest hospital, after your waters break. Your care team will check you and your baby and explain the next steps.

Air ketuban pecah sebelum 37 minggu (PPROM)

If your waters break before labour and before 37 weeks, it is called preterm prelabour rupture of membranes (PPROM). It happens in up to 3 in every 100 pregnancies and is linked with 3 to 4 in every 10 preterm births (RCOG). KKM lists "pecah ketuban sebelum cukup bulan" as a danger sign in pregnancy that needs checking at a klinik kesihatan or hospital (KKM).

The reason is not always known. Possible causes and risk factors include (MedlinePlus; Cleveland Clinic):

infections of the womb, cervix or vagina;
a stretched amniotic sac, for example with too much amniotic fluid or more than 1 baby;
smoking;
previous surgery or biopsy of the cervix, or a short cervix;
vaginal bleeding;
PROM or PPROM in a previous pregnancy.

Most women whose waters break before labour do not have a risk factor (MedlinePlus). There is no sure way to prevent it, but not smoking and going to all your antenatal check-ups help keep your pregnancy healthy (Cleveland Clinic).

What happens in hospital

You will usually be advised to stay in hospital for a few days, sometimes longer, so that you and your baby can be watched closely for infection (RCOG). The membranes cannot be repaired and the fluid cannot be replaced, and you may keep leaking for the rest of the pregnancy, because your body keeps making amniotic fluid (RCOG). Depending on how many weeks pregnant you are, you may be offered (RCOG; NHS):

a course of antibiotics to lower the risk of infection, which can also help delay labour;
steroid injections to help your baby's lungs if they are born early;
magnesium sulfate if your baby may be born very early, to help protect your baby's brain.

About half of women with PPROM go into labour within a week (RCOG). If you and your baby are well with no signs of infection, it may be better to continue the pregnancy until 37 weeks. If there are signs of infection or other problems, your baby may need to be born straight away (RCOG). If you carry group B streptococcus (GBS), you may be advised to give birth from 34 weeks (RCOG).

Why PPROM needs close care

Once the membranes have broken, infection can get into the womb (chorioamnionitis), which can make you and your baby very unwell. Babies born early may have problems with breathing, feeding and infection. Less common complications include cord prolapse (the umbilical cord slipping down through the cervix, which is an emergency), placental abruption and, if the waters break very early (before 24 weeks), problems with the baby's lung development (RCOG). Sadly, sometimes a baby does not survive, and the risk is higher the earlier the waters break (RCOG). Going through PPROM can be very stressful, and you should be offered emotional support (RCOG).

Air ketuban kurang (oligohydramnios)

Air ketuban kurang (low amniotic fluid) is called oligohydramnios. It affects about 4% of pregnancies, is most common in the last 3 months, and rises to about 12% in pregnancies that go past the due date (Cleveland Clinic).

You often do not know you have it. It is usually found on an ultrasound done for another reason. Your doctor may suspect it if you are leaking fluid from your vagina, your womb measures small for your stage of pregnancy, or you feel your baby moving less (Cleveland Clinic).

Punca air ketuban kurang

Often there is no known cause. Possible causes include (Cleveland Clinic):

your waters breaking early (PROM);
going more than 2 weeks past your due date;
problems with the placenta;
high blood pressure or pre-eclampsia; see our guide to darah tinggi (high blood pressure);
dehydration;
a problem with how the baby's kidneys or urinary tract develop.

Is it dangerous?

Low fluid in the first 6 months of pregnancy is generally more serious and can affect how the baby's lungs and limbs develop, or lead to preterm birth. Later in pregnancy, it can lead to pressure on the umbilical cord, slower growth for the baby, a higher chance of caesarean birth or the need to deliver early (Cleveland Clinic). Even so, most women with low amniotic fluid go on to have healthy babies (Cleveland Clinic).

Treatment depends on how many weeks pregnant you are and whether you have other complications. You will usually have extra check-ups, such as ultrasounds and tests of your baby's heart rate. If you are near full term, your doctor may suggest inducing labour (Cleveland Clinic).

Minum air boleh tambah air ketuban?

Many readers ask whether drinking more water helps. A Cochrane review of 2 small trials (77 women) found that drinking about 2 litres of water before a repeat ultrasound increased the measured amount of amniotic fluid, but the trials did not look at important outcomes for babies (Hofmeyr and Gülmezoglu, 2002). A 2025 review also found that drinking more fluids raised the amniotic fluid index, but the studies varied a lot in how much and what women drank (Yadav and colleagues, 2025). Drinking enough water is sensible in pregnancy, but it does not replace monitoring. Ask your doctor what they recommend for you (Cleveland Clinic).

Air ketuban banyak (polyhydramnios)

Air ketuban banyak (too much amniotic fluid) is called polyhydramnios. According to the NHS, it is not usually serious and often has no cause. It usually causes no symptoms and is found at a routine scan or check-up, for example if your bump is larger than expected for your due date.

If you do have symptoms, they might include indigestion and heartburn, constipation, breathlessness, swollen feet and legs, or urinary tract infections (NHS). These can also be normal in pregnancy. If your legs are swollen, see our guide to kaki bengkak.

Punca air ketuban banyak

The cause is often unknown. Possible causes include (NHS):

diabetes during pregnancy (gestational diabetes); KKM also lists polyhydramnios among the effects of diabetes in pregnancy, so see our guides to kencing manis semasa mengandung and kencing manis (diabetes);
being pregnant with more than 1 baby;
an infection during pregnancy;
a problem with the baby's swallowing;
the baby having a genetic condition.

Treatment and complications

Polyhydramnios usually does not need treatment, but you may have extra check-ups for the rest of your pregnancy and during labour. If it is caused by a condition such as gestational diabetes, that condition will be treated. In severe cases, some fluid may be drained from the womb using a thin needle (NHS).

Complications are rare. In more severe cases they can include your waters breaking early, placental abruption, cord prolapse, premature birth and low birth weight (NHS). If you have moderate or severe polyhydramnios, you may be advised to give birth in hospital (NHS).

Get urgent advice if your tummy suddenly gets bigger or you have tummy pain, as fluid can sometimes build up quickly, especially with twins (NHS).

Bila perlu segera ke hospital

Go to the hospital straight away, at any stage of pregnancy, if (NHS; RCOG; KKM):

your waters break, or you think they might have, even if you have no contractions;
the fluid is green, brown, bloodstained or smelly;
you have vaginal bleeding;
you have a fever, or feel hot and shivery;
you have tummy or back pain, cramping or contractions, especially before 37 weeks;
your baby is moving less than usual, or the pattern of movements changes;
your tummy suddenly gets much bigger.

The NHS says not to wait until the next day if your waters break: call immediately, even in the middle of the night. In Malaysia, KKM's fetal movement chart in its maternal health record advises going to the hospital straight away if you feel fewer than 10 movements in 12 hours (KKM, Rekod Kesihatan Ibu). Call 999 for an ambulance if you think your baby is coming now and you have a strong urge to push (NHS).

For earlier stages of pregnancy, see our guide to tanda-tanda mengandung (early pregnancy signs).

Frequently asked questions (FAQ)

Air ketuban in English: what is it called?

Air ketuban is amniotic fluid, the fluid that surrounds and protects your baby in the womb. It sits inside a bag of membranes called the amniotic sac (kantung ketuban). When the sac breaks and the fluid comes out through your vagina, this is called your waters breaking (pecah air ketuban), or rupture of the membranes.

Apa warna air ketuban yang normal (what colour is normal amniotic fluid)?

Normal amniotic fluid is clear or pale yellow, like the colour of straw, and usually has little or no smell (Cleveland Clinic). Fluid that is green or brown may mean your baby has passed their first poo (meconium), and fluid that is red or bloodstained, or smells unpleasant, also needs checking. Go to the hospital straight away if your fluid is coloured or smelly.

Macam mana nak tahu air ketuban bocor atau air kencing (how do I know if it is amniotic fluid or urine)?

Urine is usually darker yellow, has a distinct smell and you can usually stop the flow. Amniotic fluid is usually clear or pale yellow, has little or no smell, and you cannot hold it in; it may keep leaking, especially when you stand up or move (Cleveland Clinic). Put on a pad, not a tampon, and note the colour and amount. Leaking urine is common in pregnancy, but if you think your waters may have broken, contact your hospital and go for a check-up straight away (RCOG).

Berapa lama selepas air ketuban pecah akan bersalin (how long after my waters break will labour start)?

If your waters break at term (from 37 weeks) before labour starts, about 90% of women go into labour on their own within 24 hours (Cleveland Clinic). Delivering within 24 hours lowers the chance of infection, so if labour does not start, your doctor may offer to induce labour (MedlinePlus). If your waters break before 37 weeks, about half of women go into labour within a week (RCOG).

Air ketuban kurang bahaya ke (is low amniotic fluid dangerous)?

It can be, especially early in pregnancy, but most women with low amniotic fluid go on to have healthy babies (Cleveland Clinic). Low fluid (oligohydramnios) affects about 4% of pregnancies and is often found on a routine ultrasound. Your doctor will monitor you and your baby more closely, and if you are near your due date, they may suggest delivering your baby.

Minum air banyak boleh tambah air ketuban (can drinking water increase amniotic fluid)?

Possibly a little. Small studies found that drinking more water raised the amount of amniotic fluid measured on ultrasound, but they did not show whether this improves outcomes for babies (Cochrane review, 2002; systematic review, 2025). Drinking enough water is sensible in pregnancy, but it does not replace monitoring. Ask your doctor what they recommend.

Air ketuban banyak sebab apa (what causes too much amniotic fluid)?

Too much amniotic fluid (polyhydramnios) often has no known cause and is not usually serious (NHS). Possible causes include diabetes in pregnancy, carrying more than 1 baby, an infection, a problem with the baby's swallowing, or the baby having a genetic condition. Get urgent advice if your tummy suddenly gets bigger or you have tummy pain.

Disclaimer

This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor or midwife. If you are pregnant and worried about leaking fluid, contact your hospital or klinik kesihatan straight away.

References

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