What are the common causes of vaginal bleeding during pregnancy. How can you differentiate between normal and concerning bleeding. When should you contact your healthcare provider about pregnancy-related bleeding.

Vaginal Bleeding in Early Pregnancy: What’s Normal and What’s Not?

Experiencing vaginal bleeding during pregnancy can be alarming for expectant mothers. While some bleeding may be normal, it’s crucial to understand the differences between harmless spotting and potentially serious bleeding. Let’s explore the various causes and implications of vaginal bleeding throughout pregnancy.

Spotting vs. Heavy Bleeding: Understanding the Difference

Spotting is characterized by a few drops of blood that may appear on your underwear, while heavy bleeding is more noticeable and may require the use of a sanitary pad. Regardless of the amount, it’s essential to inform your healthcare provider about any bleeding during pregnancy.

Common Causes of Bleeding in Early Pregnancy

• Implantation bleeding
• Sexual intercourse
• Hormonal changes
• Cervical changes or infections

Is implantation bleeding common in early pregnancy? Implantation bleeding can occur 6-12 days after conception as the fertilized egg attaches to the uterine lining. This light spotting is usually pink or brown and lasts for a short period.

Potential Complications Associated with Pregnancy Bleeding

While some causes of bleeding during pregnancy are benign, others may indicate serious complications that require immediate medical attention.

Serious Causes of Bleeding in Early Pregnancy

1. Ectopic pregnancy
2. Miscarriage
3. Molar pregnancy

What is an ectopic pregnancy? An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, typically in the fallopian tube. This condition is not viable and can be life-threatening if left untreated.

Bleeding in Later Stages of Pregnancy: Causes and Concerns

As pregnancy progresses, the causes of vaginal bleeding may change. Understanding these potential issues is crucial for maintaining maternal and fetal health.

Common Causes of Bleeding in the Second and Third Trimesters

• Placental abruption
• Placenta previa
• Placenta accreta
• Preterm labor

How does placental abruption differ from placenta previa? Placental abruption occurs when the placenta detaches from the uterine wall before delivery, while placenta previa is a condition where the placenta covers part or all of the cervix. Both can cause significant bleeding and require immediate medical attention.

When to Seek Medical Help for Pregnancy-Related Bleeding

Any vaginal bleeding during pregnancy warrants a call to your healthcare provider. However, certain symptoms may indicate a more urgent situation.

Red Flags: When to Call Your Doctor Immediately

• Heavy bleeding (soaking through a pad in less than an hour)
• Severe abdominal or pelvic pain
• Dizziness or fainting
• Fever or chills
• Tissue passing through the vagina

Can bleeding during pregnancy always be prevented? While not all causes of pregnancy bleeding can be prevented, maintaining a healthy lifestyle, attending regular prenatal check-ups, and avoiding known risk factors can help reduce the likelihood of some complications.

Diagnostic Procedures for Pregnancy-Related Bleeding

When you report bleeding to your healthcare provider, they may recommend various diagnostic tests to determine the cause and ensure the well-being of you and your baby.

Common Diagnostic Tools

• Ultrasound
• Blood tests
• Pelvic exam
• Fetal heart rate monitoring

How accurate is an ultrasound in diagnosing the cause of pregnancy bleeding? Ultrasound is a highly effective tool for visualizing the uterus, placenta, and fetus. It can often identify issues such as placenta previa or ectopic pregnancy with a high degree of accuracy.

Treatment Options for Pregnancy-Related Bleeding

The treatment for vaginal bleeding during pregnancy depends on the underlying cause, the stage of pregnancy, and the severity of the bleeding.

Potential Treatments Based on Cause

• Bed rest
• Medications
• Cervical cerclage
• Emergency cesarean section (in later pregnancy)

Is bed rest always necessary for pregnancy-related bleeding? While bed rest was once commonly prescribed for various pregnancy complications, current research suggests its effectiveness may be limited. Your healthcare provider will recommend the most appropriate course of action based on your specific situation.

Preventing Complications: Tips for a Healthy Pregnancy

While not all causes of pregnancy bleeding are preventable, there are steps you can take to promote a healthy pregnancy and reduce the risk of complications.

Lifestyle Recommendations for Expectant Mothers

• Attend all scheduled prenatal appointments
• Maintain a balanced, nutritious diet
• Stay hydrated
• Avoid smoking, alcohol, and illicit drugs
• Exercise as recommended by your healthcare provider
• Manage stress through relaxation techniques

How important is prenatal care in preventing pregnancy complications? Regular prenatal care is crucial for monitoring the health of both mother and baby throughout pregnancy. It allows for early detection and management of potential issues, including those that may lead to vaginal bleeding.

Emotional Support and Coping Strategies for Expectant Mothers

Experiencing vaginal bleeding during pregnancy can be emotionally challenging. It’s important to address both the physical and psychological aspects of this experience.

Coping Mechanisms for Pregnancy-Related Stress

• Open communication with your partner and healthcare provider
• Joining support groups for expectant mothers
• Practicing mindfulness and relaxation techniques
• Seeking professional counseling if needed

How can partners support pregnant women experiencing bleeding? Partners can provide emotional support, assist with daily tasks to promote rest, attend medical appointments, and help gather information about the situation to make informed decisions together.

Understanding the various causes and implications of vaginal bleeding during pregnancy is crucial for expectant mothers. While some instances of bleeding may be harmless, others can indicate serious complications that require immediate medical attention. By staying informed, maintaining regular prenatal care, and promptly reporting any bleeding to your healthcare provider, you can help ensure the best possible outcome for both you and your baby.

Remember, every pregnancy is unique, and what’s normal for one woman may not be for another. Trust your instincts, communicate openly with your healthcare team, and don’t hesitate to seek help if you have any concerns about bleeding or other pregnancy-related symptoms. Your health and the health of your baby are paramount, and there are numerous resources and support systems available to guide you through this important journey.

Bleeding during pregnancy Causes – Mayo Clinic

Vaginal bleeding during pregnancy has many causes. Some are serious, and many aren’t.

1st trimester

Possible causes of vaginal bleeding during the first trimester include:

1. Ectopic pregnancy (in which the fertilized egg implants and grows outside of the uterus, such as in a fallopian tube)
2. Implantation bleeding (which occurs about 10 to 14 days after conception when the fertilized egg implants in the lining of the uterus)
3. Miscarriage (the spontaneous loss of pregnancy before the 20th week)
4. Molar pregnancy (a rare occurrence in which an abnormal fertilized egg develops into abnormal tissue instead of a baby)
5. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix

2nd or 3rd trimester

Possible causes of vaginal bleeding during the second or third trimester include:

1. Incompetent cervix (a premature opening of the cervix, which can lead to preterm birth)
2. Miscarriage (before the 20th week) or intrauterine fetal death
3. Placental abruption (when the placenta — which supplies nutrients and oxygen to the baby — separates from the wall of the uterus)
4. Placenta previa (when the placenta covers the cervix, resulting in severe bleeding during pregnancy)
5. Preterm labor (which might result in light bleeding — especially when accompanied by contractions, dull backache or pelvic pressure)
6. Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix
7. Uterine rupture, a rare but life-threatening occurrence in which the uterus tears open along the scar line from a prior C-section

Normal vaginal bleeding near the end of pregnancy

Light bleeding, often mixed with mucus, near the end of pregnancy could be a sign that labor is starting. This vaginal discharge is pink or bloody and is known as bloody show.

Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.

• Definition
• When to see a doctor

Jan. 22, 2020

Show references

1. Norwitz ER, et al. Overview of the etiology and evaluation of vaginal bleeding in pregnant women. https://www.uptodate.com/contents/search. Accessed Nov. 14, 2019.
2. Frequently asked questions. Pregnancy FAQ038. Bleeding during pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq038.pdf?dmc=1&ts=20131107T1529588773. Accessed Nov. 14, 2019.
3. Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2017. http://www.clinicalkey.com. Accessed Nov. 14, 2019.
4. Chestnut DH, et al. Antepartum and postpartum hemorrhage. In: Chestnut’s Obstetric Anesthesia: Principles and Practice. 6th ed. Elsevier; 2020. http://www.clinicalkey.com. Accessed Nov. 14, 2019.
5. Ferri FF. Molar pregnancy. In: Ferri’s Clinical Advisor 2020. Elsevier; 2020. https://www.clinicalkey.com. Accessed Nov. 14, 2019.
6. AskMayoExpert. Vaginal bleeding in the first trimester of pregnancy. Mayo Clinic; 2017.
7. Wick MJ, ed. Symptoms guide. In: Mayo Clinic Guide to a Healthy Pregnancy. 2nd ed. Mayo Clinic; 2018.
8. Butler Tobah Y (expert opinion). Mayo Clinic. Nov. 19, 2019

Products and Services

1. Book: Mayo Clinic Guide to a Healthy Pregnancy

.

How Much Bleeding Is Normal In Early Pregnancy?

Path to improved health

Vaginal bleeding can happen at any stage of a pregnancy, from conception to delivery. With spotting, you may see just a few drops of blood in your underwear. Heavy bleeding is more noticeable. It will require a sanitary pad to protect your clothing.

Call your doctor whenever you experience bleeding of any kind. Call your doctor if you have vaginal bleeding or spotting. This is important even if an ultrasound test confirms your pregnancy is normal. An ultrasound is where a technician moves a wand around your stomach to see an image of the baby.

Non-serious reasons for bleeding early in your pregnancy can include:

• implantation (as the egg settles in your uterus the first 6-12 days)
• sex
• infection
• hormones.

More serious causes of vaginal bleeding during the early part of pregnancy can include:

• An ectopic pregnancy (a pregnancy that starts outside the uterus and will not survive).
• A miscarriage (losing the baby early in a pregnancy).
• A molar pregnancy (a fertilized egg that implants in the uterus that does not live).

In later pregnancy, the following medical conditions can cause vaginal bleeding:

• Placental abruption (the placenta detaches from the wall of the uterus during birth).
• Placenta previa (the placenta is lying too low in the uterus and nearly covers the cervix).
• Placenta accreta (when the placenta invades and doesn’t separate from the uterine wall).
• Preterm labor (labor that starts before completing 37 of 40 weeks of pregnancy).

Bleeding may be just one sign of preterm labor. It also can include vaginal discharge, pressure in your pelvis or abdomen (lower stomach), a dull backache, cramps, contractions, and your water breaking.

If you are bleeding early in your pregnancy, your doctor will want to know how long and how much. If you have cramps and pain early in the pregnancy, he or she will order tests. This will include an ultrasound, blood, and urine tests.

If continued bleeding is not serious, your doctor may treat it by recommending that you rest, relax, stay off your feet, and not have sex. Keep your body healthy. Take a prenatal vitamin with folic acid daily while pregnant. Take it earlier if you plan to get pregnant. Avoid smoking, drinking alcohol, and taking illegal drugs. Talk to your doctor before taking prescription medicine. Also, when you are pregnant, you should never douche (use vaginal cleansing products) or use tampons. Serious bleeding may need to be treated with a long-term bed rest, hospitalization, or surgery.

You cannot prevent a miscarriage after it has started. The exact cause is usually unknown. It’s rarely something the mother did wrong. Most women can have healthy pregnancies in the future. If you have lost more than 3 pregnancies, talk to your doctor.

Everything you need to know

Here are the most common reasons why you may bleed after sex while pregnant, and when to be concerned.

Pregnancy sex can be pretty steamy but also scary if you happen to have vaginal bleeding afterwards. Here are all your questions answered about bleeding after sex during pregnancy.

How common is bleeding after sex during pregnancy?

Most of the time, there’s no reason to panic. “Bleeding after sex during pregnancy is quite common,” says Dustin Costescu, an OB/GYN in Hamilton. “This is a normal variation for most women in most instances. It’s normal for half of my patients to present with spotting or bleeding related to intercourse at some point throughout their pregnancies.”

Why does bleeding after sex during pregnancy happen?

If you experience bleeding after sex during pregnancy, your healthcare provider will want to know details like when it started, how long it lasted, if it was light or heavy, if there were clots, what colour the blood was and if you experienced pain.

Causes of light bleeding during pregnancy

Cervical changes

If you experience light bleeding, or spotting, after sex, you’ll see pinkish, reddish or brownish blood on toilet paper when wiping, in your underwear or on your panty liner. It is very light, isn’t painful and doesn’t last long. This is likely because your cervix changes during pregnancy and may become more sensitive and more likely to bleed if it’s bumped during sex or during an examination from your doctor or midwife.

Implantation bleeding

Early on in pregnancy, about a week after conception, you can have implantation bleeding, where the embryo burrows into the lining of the uterus and causes light bleeding. After sex, vaginal mucus and semen can carry some of this implantation blood out of the vagina.

Infection

What experts say kids need to learn in sex ed
An untreated sexually transmitted infection, such as chlamydia and gonorrhoea, or a yeast infection can cause spotting. Usually, a yeast infection will have additional symptoms, such as itching and irritation. Your healthcare provider can do a simple urine test or vaginal swab to diagnose an infection. It’s important to seek treatment right away to keep you and your baby healthy.

Cervical polyps

Polyps, or small growths, on the cervix are usually benign and can be related to higher estrogen levels during pregnancy. They can cause bleeding after sex, whether you’re pregnant or not, so it’s a good idea to be up to date on your cervical screening and Pap test.

Vaginal dryness

Dryness, which can lead to tiny tears in the vaginal wall, is another possible source of spotting. “Some people experience hormonal changes in late pregnancy, which can lead to uncomfortable intercourse,” says Costescu, “but there is usually more lubrication in pregnancy, so this is not a common scenario.”

In all of these cases, it’s a good idea to talk to your healthcare provider as soon as possible to figure out what’s going on, but it’s not an emergency.

Preterm labour

During weeks 20 to 37, light bleeding, or spotting, accompanied by contractions, cramping, low backache, feelings of pressure in the pelvis or a watery or bloody vaginal discharge (which could mean that you are leaking amniotic fluid), could be a sign of preterm labour, so be sure to contact your healthcare provider right away. Sex doesn’t cause preterm labour in a typical pregnancy, but if you are at risk of preterm labour, your doctor will recommend that you avoid sex.

Causes of heavy bleeding after sex during pregnancy

Less often, bleeding after sex during pregnancy can be a sign of something more serious. “If the bleeding is enough to fill a pad, you should seek medical attention, particularly if it’s associated with abdominal pain,” says Costescu.

Placenta previa

The placenta nourishes your baby inside the uterus during pregnancy. If you experience placenta previa, the placenta is partially or completely covering the cervix, which can lead to heavier, bright red bleeding. While sex doesn’t cause placenta previa, it can trigger bleeding. Placenta previa can be diagnosed with an ultrasound scan.

Placental abruption

Another serious condition is placental abruption, where the placenta has a small tear and separates from the uterus before birth, causing bright red bleeding and, often but not always, abdominal pain. “Intercourse doesn’t cause placental abruption, but there may be small amounts of blood trapped in the uterus that are dislodged by intercourse,” he says. In both placenta previa and placental abruption, your healthcare provider will recommend avoiding sex for the rest of your pregnancy.

Miscarriage

Heavier, bright red bleeding and pain can also be a sign of miscarriage in the first or second trimester. Remember, though, that sex does not cause miscarriage—bleeding could just happen to coincide with intercourse. “Bright red blood is more worrisome than brown or really dark red blood, which signifies older blood,” says Costescu. “This may still need to be looked at, but it’s less of an emergency.” An ectopic pregnancy, where the fertilized egg implants outside of the uterus (usually in a fallopian tube), can cause light or heavy bleeding and pain in the first trimester and needs quick medical attention (and again it’s not associated with intercourse).

“Overall, sex during pregnancy is common and safe,” he says. If you and your partner are comfortable with it and your doctor gives you the green light, go on and get busy (because there will probably be less sex in your future after the baby is born!).

Read more:
5 things nobody tells you about how sex and your relationship might change during pregnancy
The 5 best pregnancy sex positions to keep things safe (and hot)

Signs of Early Miscarriage | Obstetrics & Gynecology

Frequently asked questions about miscarriage

Q: Does having a miscarriage mean I’m more likely to have another one?
A: Having one miscarriage does not increase your chances of having another. If you have had only one prior miscarriage, the rate of miscarriage in the next pregnancy is similar to the overall rate in the general population. 

Q: Can being too active cause a miscarriage?
A: No. Working, exercise and sexual activity do not increase the risk of miscarriage.

Q: After my miscarriage, how long should I wait before I try to conceive again?
A: Patients were told years ago to wait one or two menstrual cycles to wait to get pregnant. We know that it is highly unlikely that any problems occur with a next pregnancy if you get pregnant right away. How soon you decide to try again will depend on whether you want to be pregnant right away and if you feel you need time to recover emotionally from the miscarriage. Ovulation can resume as early as two weeks after a miscarriage, so if you do not want to get pregnant right away, you need effective contraception immediately.

Q: I have had two early miscarriages. Should I have special testing?
A: Since most early miscarriages are caused by problems specific to that fertilized egg, and miscarriage overall is relatively common, most experts do not recommend special testing until you have had three early miscarriages (or two miscarriages in women 40 years and older). At that point it is termed “recurrent” miscarriage and further testing may be needed. Studies have shown that even after a woman has experienced three consecutive miscarriages, her chance of the next pregnancy being normal is still about 70%. All women who have a pregnancy loss later in pregnancy should have further testing.

Rectal bleeding during pregnancy | BabyCenter

What could cause rectal bleeding during pregnancy?

Rectal bleeding during pregnancy is typically caused by hemorrhoids, which are unusually swollen blood vessels in the rectal area. Hemorrhoids are relatively common during pregnancy, particularly in the last trimester and in the weeks after giving birth.

You might notice blood in your stool or on toilet paper if these swollen veins bleed when you:

• Strain during a bowel movement
• Pass hard stools
• Rub too hard when you wipe

Anal fissures are another cause of rectal bleeding. You may get these painful cracks in the skin around your anus if you pass hard stools because of constipation (another common condition during pregnancy).

How can I prevent bleeding hemorrhoids and anal fissures in pregnancy?

Constipation can cause both hemorrhoids and anal fissures (or make them worse), so staying regular helps. Try these tips to prevent and ease constipation:

• Eat high-fiber foods, such as whole grain cereals and breads as well as fresh fruits and vegetables every day. You could also add a couple tablespoons of unprocessed wheat bran (available at health food stores) to your breakfast cereal.
• Drink plenty of water. A glass of fruit juice each day (especially prune juice) can also be helpful.
• Exercise regularly. Walking, swimming, and yoga can all ease constipation.
• Listen to your body. Don’t wait to go to the bathroom when you feel the urge.
• Ask your healthcare provider about taking an over-the-counter fiber supplement and temporarily switching to a prenatal vitamin with less iron (which can be constipating).

How can I soothe bleeding hemorrhoids during pregnancy?

Some women find it soothing to use an ice pack or cold compresses soaked in witch hazel, while others swear by a heating pad. See which works best for you by alternating hot and cold treatments: Start with an ice pack followed by a warm bath.

Use soft, unscented, white toilet tissue because this kind is less irritating than other varieties. Or use premoistened flushable wipes instead.

There are also many hemorrhoid relief products on the market, so ask your provider to recommend a safe topical anesthetic or medicated suppository. Most of these products are intended to be used for only a short course of treatment (a week or less) because continued use can cause even more inflammation.

Should I call my provider about bleeding hemorrhoids and anal fissures?

Let your provider know if you see blood on toilet tissue or in your panties – it can sometimes be difficult to tell whether the blood is coming from your rectum or your vagina, and your provider can determine this with a physical exam.

Rectal bleeding is not usually a sign of a serious problem in women of childbearing age, and bleeding from hemorrhoids and anal fissures usually stops on its own, especially if you take steps to prevent or treat constipation.

If you’ve tried the measures above and the bleeding continues, or if you have severe pain, you may be referred to a specialist for treatment.

Learn more:

Pregnancy symptoms you should never ignore

Icky pregnancy side effects

Varicose veins during pregnancy

Spotting During Early Pregnancy: Is it Normal?

The early days and weeks of your pregnancy are exciting times, and it’s normal to have a million questions, especially if your body starts doing some unexpected things. One of the strange things you might notice is vaginal spotting. Read on to learn more about what can cause it, and what other types of vaginal bleeding can occur in early pregnancy.

What Is Spotting and What Causes It?

Generally speaking, spotting refers to the light vaginal bleeding that can sometimes occur between periods. However, it can also occur during early pregnancy. Although the sight of blood early in your pregnancy can be unnerving (leading you to wonder “Is this spotting normal?”), it’s helpful to know that this is quite common and doesn’t usually mean there’s a problem.

As many as one quarter of moms-to-be experience some spotting during early pregnancy. Two common causes are described here.

Bleeding From the Cervix

One possible reason for spotting during pregnancy is that your body is now pumping almost 50 percent more blood. With more blood vessels forming in your pelvic region, your cervix may bleed more easily. You may be more likely to experience this kind of very light bleeding after sex, a pelvic exam, or a Pap test.

Implantation Bleeding

Another common cause of light spotting in early pregnancy is implantation bleeding. This happens when the fertilized egg implants itself into the lining of your uterus, causing some drops of blood. In terms of timing, implantation bleeding usually happens about one or two weeks after fertilization.

It can be easy to mistake implantation bleeding for a light period, but this type of spotting is in fact an early sign of pregnancy. Implantation bleeding might also be lighter in color than what you normally see during your period, and it only lasts a day or two.

If you think you might be experiencing implantation bleeding, read up on some other symptoms of early pregnancy to see if you recognize any and consult your healthcare provider.

Symptoms and Characteristics of Spotting

Light spotting can be a normal part of early pregnancy. It might even be so light that it’s only noticeable on toilet tissue after you wipe, or you might see a few drops on your panties. It usually lasts about a day, and is usually light in color. Most of the time it’s lighter in color than your normal menstrual flow, though, sometimes, it can be red or brown in color. It is often painless.

Although spotting is usually nothing to worry about, it’s important to report any bleeding to your healthcare provider just to make sure all is well.

Other Types of Vaginal Bleeding During Pregnancy

If you experience vaginal bleeding during what you think is early pregnancy, it could simply be that it is your period and you are not actually pregnant. Sometimes, it can be tough to tell the difference between the light spotting associated with early pregnancy and a light period. Remember, menstrual bleeding can come with abdominal cramps and may appear as a dark red or brownish discharge, as opposed to spotting, which is often painless and light pink in color.

During early pregnancy, there are times when light spotting or heavier bleeding can be a warning sign you should not ignore. That’s why it’s always safest to mention any bleeding to your healthcare provider, especially if it’s a heavy flow.

Heavy bleeding during early pregnancy can sometimes be caused by:

• Early pregnancy loss. Losing a pregnancy in the first 13 weeks is known as an early pregnancy loss or miscarriage, and it can happen in as many as 1 in 10 pregnancies. You may experience some cramping along with bleeding, so always let your healthcare provider know if you have bleeding, either with or without cramping.

• Ectopic pregnancy. An ectopic pregnancy happens when the fertilized egg doesn’t make it all the way to the uterus, and instead implants itself somewhere else, usually in one of the fallopian tubes. An ectopic pregnancy cannot progress. As the fertilized egg grows, the fallopian tube can rupture, leading to bleeding. An ectopic pregnancy can also cause abdominal or pelvic pain, so if you notice these symptoms along with any bleeding, let your provider know right away.

• Infection. A cervical infection or cervical inflammation can also cause bleeding in the first trimester. Your healthcare provider will be able to diagnose and treat any cervical issues causing the bleeding.

FREQUENTLY ASKED QUESTIONS

• What does spotting look like in early pregnancy?

  In early pregnancy it can be pink, red, or brown. Often, it’s slightly lighter in color than what you might normally see during your period.

• How much spotting is normal in early pregnancy? It should be infrequent, and it shouldn’t last longer than a day or so. If you have any heavy bleeding or any other kind of unusual pregnancy discharge (foul-smelling or chunky discharge, for example), let your healthcare provider know right away.
• What does bright red spotting in early pregnancy mean?

  Bright red blood is usually associated with heavier bleeding, and may occur with painful symptoms like abdominal cramps. If you see bright red blood and you’ve already confirmed your pregnancy, ask your healthcare provider right away for advice.

During early pregnancy, a little light spotting might seem scary. It’s reassuring to know that it’s often normal and nothing to worry about, but your healthcare provider will be able to completely put your mind at ease.

In the meantime, you can download our go-to Pregnancy Guide that’s full of information about pregnancy health, nutrition, fitness, and more.

Bleeding in Early Pregnancy: What Does It Mean?

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

What causes bleeding during early pregnancy?

About one in every four women will have vaginal bleeding during the first few months of pregnancy. Many things can cause it. Some of the most common causes are threatened abortion, ectopic (eck-TAH-pick) pregnancy, and spontaneous abortion.

A threatened abortion is when there is bleeding from the uterus but the pregnancy is still normal. Sometimes a blood clot forms in the uterus, increasing the risk of miscarriage. However, most women who have a threatened miscarriage will deliver a healthy baby.

An ectopic pregnancy is when the fetus grows outside the uterus, usually in the fallopian tubes. If this happens, the area where the pregnancy is can bleed heavily. This can put the mother’s life at risk.

A spontaneous abortion means there is a miscarriage. This happens when the pregnancy fails and there is no living tissue in the uterus. Sometimes the mother needs to take medicines or have a procedure done to remove tissue or to stop the bleeding.

Other causes of early pregnancy bleeding include infections, hemorrhoids (HEM-roids; swollen veins in your rectum or anus), cervical cancer, and rare pregnancy-related cancers.

What should I do if I am bleeding?

Call your doctor right away. If you have heavy bleeding or severe pain, you should go to the emergency room.

Your doctor can do different tests to see why you are bleeding. You may need a pelvic exam, an ultrasound, or blood or urine tests. Sometimes an ultrasound is enough to make sure your pregnancy is healthy. However, if you are very early in your pregnancy, you may need more tests to help your doctor find the cause of the bleeding.

How is it treated?

The treatment depends on the cause of the bleeding. There is no way to stop a threatened miscarriage with medicines after the bleeding starts. If you have a miscarriage, your doctor will watch to see if the tissue passes on its own, or if you will need medicines or a procedure to help remove it. Tissue from an ectopic pregnancy needs to be removed with medicines or surgery. Some women with certain blood types may need a shot to help prevent problems in future pregnancies.

What can I do to prevent a miscarriage?

Keeping your body healthy is the best way to have a healthy pregnancy and baby. You should not smoke cigarettes, drink alcohol, or take street drugs. Taking a prenatal vitamin with folic acid before you get pregnant can lower the risk of brain and spinal cord problems in your baby. If you have medical problems like high blood pressure or diabetes, talk with your doctor about the care you will need during your pregnancy. It is best to talk about this before you get pregnant, if possible.

There is no way to prevent a miscarriage after bleeding has started. There is also no way of knowing exactly why a miscarriage happens. Usually it is not because the mother did anything wrong. Most women who have had a miscarriage can have healthy pregnancies in the future. If you have lost more than three pregnancies, talk to your doctor about other tests and treatments.

90,000 Help with early miscarriage

In case of miscarriage, the fetus is rejected from the endometrium – the inner lining of the uterus. According to experts, two out of 10 clinically established pregnancies end in spontaneous abortion. It is necessary to understand in more detail the causes, symptoms and methods of dealing with miscarriage.

How does a miscarriage occur in early pregnancy

This process takes three sequential steps. First, the fetus dies, after which it detaches from the endometrial layer.This is manifested by the fact that bleeding begins.

At the third stage, everything that has exfoliated is removed from the uterine cavity. The process can be complete or incomplete. In the early stages – five to six weeks – the process resembles a regular period. They are characterized by painful and much more unpleasant sensations. You can find out that it was an early miscarriage by taking tests for the ratio of hCG in the blood.

Symptoms of miscarriage

The harbingers of spontaneous abortion are abdominal cramps, cramps or spotting.However, they do not always appear. It should be noted the most typical manifestations of the presented state and their main characteristics.

Temperature

For a short period of time, hyperthermia may well not be observed. Fever is not the most common symptom. In some cases, thermometer readings actually rise to 38 degrees or more.

Moreover, when hyperthermia is accompanied by a number of additional symptoms, septic miscarriage is likely.These are his signs:

• severe pain in the abdomen and deep in the vagina;
• Increased tone of the uterus, which is felt by tremors inside;
• pungent, pungent and unpleasant odor.

All this indicates that an infection has joined. In such a case, urgent hospitalization is strongly recommended to stop the development of the process. It is better not to engage in self-medication or the use of folk recipes.

Allocations

Early miscarriage can indeed be accompanied by discharge.They may be as habitual as during menstruation. Also, the discharge may turn out to be smearing, insignificant.

Secretion brown, scanty, much less often ends in spontaneous abortion. Most often, this is indicated by abundant and bright red discharge. It is the blood that normally appears when the fetus is rejected from the inner layer of the uterus.

Pain

The severity of unpleasant and specific sensations may differ from each other depending on the duration of pregnancy.Probably the addition of pain similar to menstrual pain. Most often, such a symptom indicates an early miscarriage – no more than six weeks.

Cramping pains in the abdomen, which pull in the back, are possible. Their strength can vary from subtle to much more pronounced. In the rarest cases, when the clinical picture is complicated by a long course, this leads to a state of shock.

Another typical manifestation of pain is discomfort in the back or abdomen.Only then is the discharge identified. This situation is most typical for a spontaneous abortion in the seventh to eighth week of pregnancy.

Causes of miscarriage

The first factor is genetic abnormalities in the development of the fetus. They are the ones that most often lead to early miscarriage. Violations can be expressed in qualitative or quantitative abnormalities in the chromosomes. In this regard, the female body recognizes the defect, and therefore does not allow such a fruit to develop further.Most often, such rejection is noted in the third week of pregnancy.

The next reason that a miscarriage developed at an early stage may be disturbances in the work of the endocrine gland. Hormones determine not only the success and regularity of the cycle, but also how well the fetus is attached to the lining of the uterus. If, due to a malfunction of the thyroid gland, the endometrium is not able to provide the fetus with all the necessary components, the pregnancy will not go well. Most often, a miscarriage occurs early or late in the fourth week.

Other reasons why pregnancy is terminated:

1. Rhesus conflict. If the parents have different Rh factors, then the risk that a miscarriage will occur after the first weeks of pregnancy increases significantly. A similar thing happens if a woman has a negative rhesus, and the child has a positive, inherited from the father. In such a situation, the female body recognizes the fetus as a foreign object. Therefore, it is excreted from the uterus. Timely diagnosis allows you to save the child due to full-fledged drug therapy.
2. Sexually transmitted diseases, other infections. Such problematic conditions also lead to spontaneous abortion. In this case, the embryo is infected at a very early stage. That is why the body will perceive it as a foreign object. In this regard, a miscarriage will occur in the fifth week.
3. Previous abortions. Another common reason why there was a miscarriage. Abortion is a huge stress on the reproductive system, which leads to thinning of the lining of the uterus.That is why the risk of miscarriage may be more significant.

Injuries, abdominal injuries should not be excluded from the list. Sudden pressure on the peritoneum, including when lifting weights, can provoke an abortion. Also in the presented list are strong stress, anxiety and depression. Anything that disrupts a woman’s normal condition can lead to serious consequences.

How to avoid miscarriage

The main objective of treatment is to relieve tension in the uterus.It will be equally important to stop bleeding and prolong the pregnancy, but only if the embryo is viable. The sooner medical assistance is provided, the higher the likelihood of preserving the fetus, without the need to determine the expected timing of miscarriages.

Our specialists will help you with this. Only we have the most qualified and experienced doctors who know exactly how to treat even the most difficult cases. They will carry out a full diagnosis and prescribe the most effective, effective drugs.

Drug treatment

Hormonal preparations are used. They determine the normal course of pregnancy at an early stage. Medicines based on the hormone progesterone are effective.

1. Use of hemostatic drugs. In the case of pregnant women, droppers are used with drugs such as Dicinon or Tranexam. They are needed to stop bleeding.
2. Antispasmodics. Experts recommend injections of Drotaverin, followed by a switch to pain-relieving pills such as No-shpa.Also used suppositories Papaverine, droppers with the addition of magnesia. All of them are necessary in order to remove a number of signs of a pathological condition, namely, an increased tone of the uterus and pronounced pain.
3. Use of Tocopherol. Vitamin E is an essential ingredient for women, including pregnant women. It ensures the normal and full functioning of the ovaries. Tocopherol also strengthens the vascular walls, eliminates the formation of blood clots.
4. Sedatives. Motherwort or valerian tincture is used.The presented measure is recommended for increased irritability or nervousness of a pregnant woman.

To exclude early miscarriage, the specialists of our clinic recommend glucocorticosteroids. Apply Dexamethasone or Metipred. They are prescribed to patients with diagnosed immune disorders that can lead to early termination of pregnancy.

Optionally, a special relief ring can be fitted. The presented procedure is carried out in the second trimester, or rather, after 20 weeks of gestation.

Remove such a device no earlier than 38 weeks. It is necessary for a woman to maintain the correct position of the uterus. Also, the unloading ring allows you to prevent premature birth.

Additional Measures

To avoid early miscarriage, it is recommended to give up physical activity. Especially when it comes to jumping, lifting weights. Rest, lack of sudden physical activity and adherence to bed rest will help keep the pregnancy.

Another preventive measure will be the elimination of sudden movements. At any stage of pregnancy, they can provoke detachment of the embryo or lead to serious complications in its development.

Eliminate early miscarriage will allow:

• emotional calmness and absence of stress;
• refusal to take a hot bath or visit a bath, sauna – this is due to the fact that high temperatures provoke increased bleeding, as well as detachment of the fetus;
• restriction of sexual intercourse – if there is a threat that an early miscarriage will occur, they refuse to have sex;
• exclusion of alcohol, nicotine addiction.

It is also important to stop eating certain foods. The ban applies to chocolate, coffee and any other caffeinated beverages. In no case should you self-medicate. The fact is that the use of drugs without the appointment of a specialist will only aggravate the situation. It is not recommended to use folk remedies to stop bleeding, relieve pain. All medications and prescriptions used must be agreed with a specialist, because there is a high likelihood of harm to the embryo.

It is really possible to exclude such a problem as early miscarriage. It is necessary to comply with all safety measures, to be fully and promptly treated. It is in this case that the pregnancy will end with the birth of a healthy child.

90,000 clinic, diagnostics, hemostatic therapy – the topic of a scientific article on clinical medicine

N.K. TETRUASHVILI, MD, DSc, A.A. AGADZHANOVA, T.B. IONANIDZE

Scientific Center for Obstetrics, Gynecology and Perinatology. IN AND. Kulakova, Ministry of Health of Russia

BLEEDING UP TO 22 WEEKS OF PREGNANCY:

CLINIC, DIAGNOSTICS, HEMOSTATIC THERAPY

According to the current in our country since 2012.By definition, early pregnancy loss is classified before 21 weeks. and 6 days of pregnancy, from 22 to 37 weeks. preterm births are registered. Such an international approach to registering perinatal mortality requires the prevention of complications from early pregnancy in order to avoid the birth of a deeply premature baby.

Keywords: bleeding, pregnancy, threatened abortion, miscarriage, tranexamic acid

At present, foreign authors have obtained data indicating an increasing risk of pregnancy complications in the presence of retrochorial and transococcal hematomas, starting from the first trimester of pregnancy.Thus, in a meta-analysis that summarized the data on the course and outcomes of pregnancies over 28 years, the following key findings were obtained:

1. Patients who have lost two or more pregnancies – a risk group for the development of premature birth, including very early premature birth, fetal growth retardation, premature effusion of water, placental abruption, placenta previa, bleeding in the second and third trimesters of pregnancy …

2.In women with bleeding in early pregnancy, the formation of retroplacental hematomas, there is an increased risk of premature birth (including very early premature birth), fetal growth retardation, premature effusion of water during premature pregnancy, placental abruption in the second and third trimesters of pregnancy [9] …

In this regard, it becomes clear that stopping bleeding is important from early pregnancy not only to avoid miscarriage and increased blood loss, but also to prevent the formation of large retroplacental hematomas and late gestational complications.

Bleeding during pregnancy is one of the most dangerous complications requiring urgent treatment. Obstetric tactics for bleeding is different depending on the amount of blood loss, causative factors, gestational age, the condition of the woman and the fetus.

Bleeding before 22 weeks of gestation is often accompanied by the formation of intrauterine hematomas, which can be either retrochorial / retroplacental or trans-enveloped [8].

Up to 12 weeks pregnancy with the appearance of spotting from the genital tract, it is necessary to carry out differential diagnosis between the following conditions:

implantation bleeding, ectopic pregnancy, threatened abortion, started abortion, completed abortion, undeveloped pregnancy, gallbladder drift. A very important role in the diagnosis belongs to ultrasound examination, which allows timely diagnosis of conditions requiring surgical intervention (ectopic pregnancy, cystic drift), as well as to determine the tactics of managing women with an abortion that has begun, to make a differential diagnosis with a non-developing pregnancy.

Depending on the cause leading to the onset of miscarriage, the selection of etiopathogenetic therapy is carried out. However, with bleeding up to 22 weeks. pregnancy, the need to stop bleeding without harming the mother’s body and the developing fetus comes to the fore.

■ Stopping bleeding is important from early pregnancy not only to avoid miscarriage and increased blood loss, but also to prevent the formation of large retroplacental hematomas and late gestational complications

Bloody discharge from the cervical canal up to 22 weeks.pregnancy can be the result of various conditions, among which the most common are:

■ placental abruption without hematoma formation

■ placental abruption with the formation of retroplacental hematoma

■ Formation of transmembrane hematoma

■ bleeding with low attachment of the placenta or its presentation

■ decidual reaction of an empty uterine cavity in case of malformations of the uterus (two-horned uterus, doubling of the uterus)

■ Antenatal fetal death from twins or triplets.Correct assessment of the clinical situation helps

to determine the intensity and the required duration of hemostatic therapy.

In addition, an extremely important point is the differential diagnosis between bleeding from the genital tract and bleeding accompanied by leakage of amniotic fluid with a high lateral rupture of the fetal bladder. Diagnosis of this condition sometimes presents significant difficulties, i.e.Because tests for leakage of amniotic fluid often turn out to be false-negative in conditions of bleeding. In some clinical situations, only growing oligohydramnios, according to dynamic ultrasound, allows a correct diagnosis. With leakage of amniotic fluid in periods up to the 22nd week. pregnancy prognosis is usually poor.

With reductions of one fetus in multiple pregnancies (twins or triplets), it is extremely important to timely prescribe antibiotic therapy (course duration at least 7 days), control leukocytosis and rod-nuclear shift in dynamics, as well as hemostasiological control for timely diagnosis and correction of DIC manifestations -syndrome.

The same approach is necessary in the presence of large (more than 3 cm) retroplacental and trans-enveloping hematomas in the uterine cavity resulting from detachment of a normally or low-lying placenta. In the presence of inflammatory changes according to the data of a clinical blood test (leukocytosis, an increased level of C reactive protein), the question of the advisability of antibiotic therapy is decided.

Timely stopping of bleeding seems to be extremely important, i.e.because prolonged spotting disrupts the functioning of the fetoplacental complex, creates the prerequisites for the formation of placental insufficiency and contributes to the activation of inflammatory processes in the uterine cavity.

A drug for hemostatic therapy used in the first and second trimesters of pregnancy must meet a number of requirements:

■ no embryotoxic and teratogenic effects

■ fast and effective action, i.e.because the time factor for a threatening and incipient abortion comes to the fore

■ no cumulative effect

■ insignificant systemic effect on hemostasis.

The latter factor is especially important, since the activation of intravascular coagulation, on the one hand, can lead to microthrombosis, which disrupts placentation, especially in conditions of physiological hypercoagulation during pregnancy, and, on the other hand, it is unsafe for the mother’s body due to the danger development of thrombosis.

The drug tranexamic acid (tranexam), being an antifibrinolytic agent, inhibits the action of the plasmin and plasminogen activator, which causes a hemostatic effect without a pronounced effect on the hemostatic system as a whole at the systemic level [3, 6].

Thus, studies carried out in Scandinavia showed that over a period of over 19 years, on the example of 238 thousand women, there was no increase in the incidence of thrombotic complications compared to the usual level of thrombosis among patients of the same age.In studies carried out in pregnant women, it was proved that the use of tranexamic acid does not increase the coagulation potential of the blood and, therefore, the risk of thrombosis does not increase in comparison with patients who did not take the drug [4].

The second, undoubtedly important pharmacological property of tranexamic acid is its anti-inflammatory effect by suppressing the formation of kinins, pro-inflammatory cytokines (tumor necrosis factor, interleukin 1, interleukin 2) and other active peptides involved in inflammatory and allergic reactions.

Researchers in hematology have noted that tranexamic acid is more effective than other anti-fibrinolytics.

TRANEXAM®

tranexamic acid

An effective means of prevention and treatment of obstetric bleeding

• Does not cause thrombotic complications1

• Does not have a teratogenic effect, can be changed from the first three places

1.sat laenyutJade lcda $ H ~ 2>: a rabotvn !, pia £ ebo-con £ wlly (na1.1ance [2010; 376: 23-32.

2. Instructions for medical use of the drug

Marketing and communication:

LLC “Shtada Marketing ■ CTA D) A

telex: +7 {№) 797-31-10 WWW.4tOdO.ru

In recent years, there are data indicating a decrease in the volume of blood loss after childbirth and during cesarean section operations, in connection with which some authors suggest that it is possible to use the drug in order to prevent increased blood loss routinely during childbirth and cesarean section [1, 5 , 6].This prophylactic approach is of particular importance in risk groups for the development of bleeding (in women with thrombocytopenia, with uterine myoma, low attachment of the placenta, etc.) [5, 6]. And although the prophylactic use of tranexamic acid is subject to further study, tranexamic acid is actively used as a therapeutic drug for stopping postpartum bleeding and is included in the algorithm of actions for bleeding, according to domestic and foreign guidelines [2, 3, 5, 7].

The use of the drug for bleeding during pregnancy allows you to quickly and effectively stop bleeding. Intravenous administration of the drug is carried out at the rate of 10-15 mg per kg of body weight of a pregnant woman, depending on the volume of blood lost. On average, in the first trimester of pregnancy, the daily dose of tranexamic acid for bleeding is up to 1,000 mg, in the second and third trimesters of pregnancy from 1,000 to 2,000 mg per day.After intravenous administration, it is advisable to switch to tablet administration of the drug.

■ Tranexamic acid preparation

(tranexam), being an antifibrinolytic agent, inhibits the action of the plasmin activator

and plasminogen, which causes a hemostatic effect without a pronounced effect on the hemostatic system as a whole

Tranexamic acid up to 22 weekspregnancy is used in a daily dose of 750 to 1,500 mg (250 mg per tablet). The drug is used at 250-500 mg 3 times a day for 5-7 days, then according to indications.

After clarification of the reasons for the threat of termination of pregnancy, drugs are used to correct the identified violations.

This study was about the efficacy of tranexamic acid for stopping bleeding during pregnancy.

PURPOSE OF THE STUDY

Study of the effectiveness of hemostatic therapy with tranexamic acid Tranexam in women with an early miscarriage.

MATERIALS AND RESEARCH METHODS

Criteria for inclusion in the study group: ■ gestational age from 5 to 22 weeks;

■ threatened miscarriage at the time of inclusion in the study, manifested by pain in the lower abdomen and lower back and bleeding from the genital tract;

Exclusion Criteria:

■ anomalies of development of the embryo / fetus

■ severe extragenital diseases of the mother, which are contraindications for prolonging pregnancy;

■ violation of the integrity of the fetal bladder (leakage of amniotic fluid).

Based on these criteria, 220 women were selected, who were divided into 2 groups, depending on the type of hemostatic therapy. The main group consisted of 110 women who received tranexam for a hemostatic purpose in a daily dose of 1,000-1,500 mg until bleeding stopped. The comparison group consisted of 110 women with threatened miscarriage in the same gestational period who received standard hemostatic therapy with sodium ethamsylate.

Statistical data processing was performed on an individual computer using Microsoft Excel spreadsheets and Statistica for Windows v. 8.0, StatSoft Inc (USA). The arithmetic mean (M), mean error (m), and significance of differences (p) were calculated. Differences between the sample sets were considered significant at a probability level of p <0.05 (95% significance level) and at p <0.01 (99% significance level).

RESULTS

The patients were comparable in age (33.2 ± 2.3 and 32.1 ± 2.4 years, respectively), gynecological and reproductive history.

In the structure of causal factors of threatening miscarriage, endocrinopathies accounted for 14.5% in the main group, 13.6% in the comparison group, immunological causes – 10.0 and 10.9%, infectious-inflammatory factor – 26.4 and 25.5% , uterine malformations 12.7 and 11.8%, respectively.Thus, the patients were selected for the study on the basis of the principle of comparability of age and causal factors of the threat of miscarriage.

Ultrasound examination revealed retrochorial / retroplacental hematomas in 48 women of the main group (43.6%) and 47 patients from the comparison group (42.7%), transcochial hematomas were diagnosed in 15 (13.6%) and 18 (16.4 %) women, respectively. Placenta previa was observed in 14 (12.7%) and 12 (10.9%) women in both groups, respectively.The rest of the pregnant women had bloody discharge from the genital tract due to detachment of the chorion / placenta or membranes without the formation of hematomas.

The duration of bleeding from the genital tract, regression of retrochorial / retroplacental and trans-ocular hematomas, length of hospital stay, prolongation and outcome of pregnancy were assessed.

It was found that the cessation of bleeding when using tranexamic acid, on average, occurred on the 2nd day from the start of therapy, the duration of bleeding averaged 2.1 ± 0.2 days, while in the group taking sodium etamsylate, the duration of bleeding was significantly longer 5.7 ± 0.3 (p <0.01).The need for inpatient treatment in the main group was 9.7 ± 0.8 bed-days and 15.6 ± 2.7 bed-days, respectively (p <0.05).

■ In recent years, data has appeared indicating a decrease in the volume of

blood loss after childbirth and during caesarean section operations, in connection with which some authors suggest that it is possible to use tranexamic acid in order to prevent increased blood loss routinely during childbirth and during cesarean section

These data also correlated with the ultrasound picture, indicating regression of hematomas in the uterine cavity.When using tranexam, the bleeding was quickly stopped and, as a result, the organization and resorption of hematomas in the uterine cavity in a shorter time – in 33 out of 63 (52.4%) women in the main group and in 22 out of 65 (33.8%) women in the comparison group at the stage of inpatient treatment. The complete absence of hematomas was noted in the main group for 1.2 ± 0.4 weeks, in the comparison group for 4.8 ± 0.5 weeks. (p <0.05).

When analyzing hemostasis indicators in women treated with tranexam, no significant changes in hemostasis indicators (at the systemic level) were observed before and after treatment.

Successful prolongation of pregnancy was observed in the main group in 95.5% of cases, in the comparison group in 91.8% (p> 0.05).

In 5 patients in the main group, missed pregnancies were diagnosed in the periods from 5 to 8 weeks, in 9 cases in the comparison group – pregnancy losses in the periods from 5 to 12 weeks.

Thus, it has been established that the drug tranexam in doses from 750 to 1,500 mg per day with a duration of treatment of 5-7 days has a pronounced hemostatic effect in bleeding up to 22 weeks.pregnancy.

CONCLUSIONS

The inclusion of tranexam in the complex therapy of patients with threatened miscarriage and miscarriage allows you to quickly stop bleeding without affecting the indicators of the hemostasis system. The cessation of bleeding in the group of patients receiving tranexam occurred in a shorter time compared to women using sodium ethamsylate, which required a shorter duration of inpatient treatment.

Thus, the inclusion of tranexam in the treatment program for women with an onset of miscarriage makes it possible to quickly stop bleeding, promote rapid regression of hematomas in the uterine cavity and prolong pregnancy.

%

REFERENCES

1. Baev O.R. Prevention of bleeding in the postpartum and early postpartum period.Active or expectant tactics? 2011, 6: 27-30.

2. Kulikov A.V., Martirosyan S.V., Oboskalova T.A. Protocol for Emergency Bleeding in Obstetrics. Guidelines. Yekaterinburg, 2010.

3. de Lange NM, Lancé MD, de Groot R, Beckers EA, Henskens YM, Scheepers HC. Obstetric hemorrhage and coagulation: an update. Thromboelastography, thromboelastometry, and conventional coagulation tests in the diagnosis and prediction of postpartum hemorrhage.Obstet Gynecol Surv. 2012, Jul. 67 (7): 426-435.

4. Lindoff C, Rybo G, Astedt B. Treatment with tranexamic acid during pregnancy, and the risk of thromboembolic complications. Thromb. Haemost, 1993, 2, 70 (2): 238-240.

5. Onwuemene O, Green D, Keith L. Postpartum hemorrhage management in 2012: predicting the future. Int J Gynaecol Obstet., 2012, Oct., 119 (1): 3-5.

6.Peitsidis P, Kadir RA. Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum. Expert OpinPharmacother 2011, 12 (4): 503-516.

7. Su LL, Chong YS Massive obstetric haemorrhage with disseminated intravascular coagulopathy. BestPract Res Clin Obstet Gynaecol. 2012 Feb 26 (1): 77-90.

8. Tower CL, Regan L. Intrauterine haematomas in a recurrent miscarriage population.Human Reproduction. 2001, 16 (9): 2005-2007.

9. van Oppenraaij RHF, Jauniaux E, Christiansen OB, Horcajadas JA, Farquharson RG and Exalto N, ESHRE Special Interest Group for Early Pregnancy (SIGEP) Predicting adverse obstetric outcome after early pregnancy events and complications: a review. Human Reproduction Update, 2009, 15 (4): 409-421.

90,000 Critical periods of pregnancy – how are they dangerous?

A wonderful period of waiting for a baby for almost every woman is far from serene: how many anxieties, worries and doubts expectant mothers have at this time – it is simply impossible to count them.In most cases, all fears are in vain – the baby is developing and growing safely. However, one must remember that there are also so-called critical periods of pregnancy, when inattention to oneself and one’s body can lead to a disastrous result – its spontaneous interruption.

First trimester

The beginning of the emergence of a new life in a woman’s body, or 2-3 weeks of pregnancy, is considered the first critical period. This is due to the fact that the egg can be fertilized, but due to changes as a result of inflammation, hormonal imbalance, the presence of nodes, scars, fibroids or synechiae on the inner mucous membrane of the uterus, implantation does not occur, the embryo dies and is removed from the mother’s body during menses.However, even if implantation did occur, the embryo may stop developing and spontaneous miscarriage will occur at an early stage , and the main reason for this course of events is chromosomal abnormalities.

The second critical period of the first trimester begins at 8 and ends at 12 weeks of gestation. At this time, the main reason for the interruption is considered to be hormonal deficiency, which disrupts the process of formation of the placenta. This condition may be associated with decreased work of the corpus luteum of the ovaries, excessive production of androgens by the adrenal glands – male sex hormones, as well as malfunctions of the pituitary gland or thyroid gland. The threat of termination of pregnancy can be eliminated with the help of correctly selected and timely prescribed hormonal treatment, which will allow the baby to safely before the due date.

In addition, throughout the first trimester of pregnancy, the fetus may stop developing due to of the following adverse environmental factors:

• maternal intake of drugs incompatible with pregnancy
• harmful working conditions
• presence of bad habits
• physical influences – radiation, vibration, intense sports training, etc.p.
• acute infectious diseases (influenza, cytomegalovirus, herpes, rubella and others)
• severe stressful situations

And even if the fetus develops further, the negative impact of most of these factors can appear after a few months of pregnancy or even after the baby is born: these can be anatomical disorders or severe malformations. Therefore, the entire first trimester of the development of a new life can be considered “critical”.

Second trimester

The third critical period of pregnancy falls at 18-24 weeks of gestation and is largely associated with the active growth of the uterus. At this time, spontaneous interruption most often occurs due to isthmic-cervical insufficiency (ICI), as a result of which the ovum under the influence of gravity falls down, loses its integrity and starts the mechanism of labor. However, the timely detected shortening and expansion of the cervical canal makes it possible to suture the cervix or install an obstetric pessary and safely prolong the pregnancy.Here, one should also remember about infectious diseases, including intrauterine infections, which can disrupt the function of the placenta, lead to the outpouring of water from the fetal bladder and late miscarriage.

Another common reason for interrupting the gestation process at this time is placenta previa or its low location: for various reasons, it can exfoliate, cause severe bleeding and death of the fetus. In addition, at this time, pregnancy may stop developing due to disorders in the development of the brain and the most important functional systems of the baby, caused by the harmful effects of various negative factors on them in the first trimester.

Third trimester

In this trimester – at 28-32 weeks – the fourth critical period takes place. The threat of premature birth may arise due to insufficient work of the placenta, its premature detachment, severe forms of late toxicosis of pregnant women, ICI and various hormonal disorders. In addition, due to overstretching of the uterus, most multiple pregnancies end at this time. Children born during this period are already viable, but they need long-term qualified medical care.

In addition to all the periods listed above, the critical periods for women who have had reproductive losses in the past are the days of planned menstruation, miscarriages or “freezing” of pregnancies. Doctors believe that during these periods the body can “remember” the need for hormonal changes, so they carefully monitor the condition of the expectant mother and baby and prescribe treatment in a timely manner if any threat arises.

In order to safely overcome the dangerous periods of pregnancy , it is necessary to avoid any physical exertion, stress and, if necessary, visit a doctor when these terms approach.In addition, if you experience pain, spotting, or other warning signs, you should also seek medical attention as soon as possible. Only an attentive attitude towards yourself will help to safely carry a healthy baby and give birth to him at the time set by nature.

Take care of yourself and your baby!

Page not found |

Page not found |

404.Page not found

Archive for the month

MonTueWedThuFtSaSun

12

12

1

3031

12

15161718192021

25262728293031

123

45678910

12

17181920212223

31

2728293031

1

1234

567891011

12

891011121314

11121314151617

28293031

1234

12

12345

6789101112

567891011

12131415161718

19202122232425

3456789

17181920212223

24252627282930

12345

13141516171819

20212223242526

2728293031

15161718192021

22232425262728

2930

Archives

Aug

Sep

Oct

Nov

Dec

Tags

Settings
for visually impaired

90,000 Can pregnant women continue their periods?

The appearance of bloody discharge from the vagina after conception can disturb any woman.Some girls confuse them with menstruation, especially if they coincide with her expected dates. However, it should be remembered that there can be no menstruation during pregnancy. Therefore, for any bloody discharge, you should quickly contact a gynecologist in Krasnodar.

Causes of bleeding

Most often, women experience spotting during the first trimester. If they are represented by only small spots on the panties, this may indicate that the placenta has been implanted into the uterus.Sometimes a woman can also observe mild bleeding after intercourse, which is explained by the transformations of uterine cells that occur during pregnancy.

However, there are more serious causes of bleeding in the first trimester of pregnancy, among which are:

• Miscarriage.
• Infection.
• Subchorionic hemorrhage that occurs between the uterus and the placenta.
• Ectopic pregnancy.
• Gestational trophoblastic disease. It is an extremely rare condition that can simulate pregnancy through the development of a tumor containing abnormal fetal tissue.
• A sharp decrease in the level of hormones. A decrease in the amount of estrogen in the body of the expectant mother can occur due to stress, a viral disease or an inflammatory process. It leads to endocrine disorders, which are expressed by the appearance of bloody discharge on those days when a woman should have had her period.This condition can last 3-4 months, it significantly increases the likelihood of miscarriage.

Bloody discharge, which is observed in early pregnancy, can be distinguished from menstruation in a number of ways. First, they often have a light pink or brown hue and are not particularly abundant. During menstruation, women usually have a weak discharge at first, which then intensifies and acquires a rich red color. Towards the end of menstruation, the intensity of bleeding decreases, and the shade of the discharge becomes less bright.

Bleeding can occur at a later date. If they happen after the 20th week, this is most often due to such reasons as:

• Examination of the cervix by a gynecologist. Rarely enough, this procedure causes mild and short-term bleeding.
• Placenta previa. This is the name of the condition when it blocks the exit from the uterine cavity.
• Sexual contacts. During pregnancy, the tissues of the vagina and cervix acquire increased sensitivity, so they can easily be injured during an active sex life.
• Premature or normal labor. Compression of the uterus and expansion of the cervix, which helps the fetus move downward, can also cause bleeding.
• Uterine rupture. It can happen during childbirth and requires emergency medical attention. This is a very rare pathology, but the risk of its occurrence does exist.
• Placental abruption. This is the name of the condition when it begins to detach from the walls of the uterus before the onset of labor.

If bleeding occurs during pregnancy, a woman should contact our gynecological clinic in Krasnodar.But there are cases when it needs to be done urgently. These are situations in which bleeding from the vagina is accompanied by pain and cramps, fainting or dizziness. You should also be alert to heavy bleeding with clots.

The appearance of bleeding from the vagina during pregnancy does not always mean that you may lose your baby. Therefore, with such symptoms, you do not need to panic and get upset. Many women who have mild bleeding then have normal pregnancies and healthy babies.However, in about a third of the fair sex, such bleeding becomes more intense over time and ultimately leads to unpleasant consequences.

Treatment of hemorrhoids during pregnancy

Hemorrhoids – a disease associated with inflammation and pathological expansion of hemorrhoidal veins that form nodes around the rectum. It is a very common condition and is usually caused by stagnation of venous blood in the lower trunk and legs.

The development of hemorrhoids is gradual – at the initial stage, there is heaviness and itching in the anus, pain, constipation, later – bleeding, sagging and prolapse of elastic hemorrhoids.

Factors causing hemorrhoids

are a sedentary lifestyle, unhealthy diet, obesity, alcohol abuse, cirrhosis of the liver of life.

This ailment often accompanies pregnancy – about half of women who are expecting a baby suffer from it.To the main reasons in pregnant women, the pressure of the growing uterus on the lower abdomen, which compresses the veins, and constipation due to low motor activity of the intestines are added.

In healthy women, hemorrhoids can develop in the second half of pregnancy, but if there is a hereditary predisposition, or the symptoms of hemorrhoids manifested themselves before pregnancy, then hemorrhoids can develop at an earlier date – already from the 12th week.

Symptoms of hemorrhoids during pregnancy

Hemorrhoids during pregnancy can take two forms:

• sharp;
• chronic.

The acute form is characterized by the sudden formation of a blood clot in the veins of the rectum, which causes burning pain, especially after the process of defecation. Dense external nodes are formed, the diameter of which can reach 2-3 cm, the skin under them swells and turns red.

After 5-10 days, the acute form becomes chronic – the nodes soften and swell only when straining. The process is accompanied by discomfort in the anus and itching.

Blood appears in the fecal masses, sometimes in rather large quantities, hemorrhoids can fall out of the anus, adjusting independently after a while. There may be no pain, there may be a feeling of incomplete bowel movement, discomfort, and bloating. Walking and sitting becomes painful.

Thank you for your application.
Our operator will contact you from 8:00 to 22:00
Applications received after 22:00 will be processed the next day.

Treatment of hemorrhoids during pregnancy

The main methods of treating non-acute hemorrhoids during pregnancy are strict adherence to diet and hygiene rules. The diet prescribed by a dietitian should help avoid constipation and regulate bowel movements – for this, dried fruits, nuts, cereals, and fermented milk products are recommended. Spicy food, baked goods, strong tea should be excluded.

For hygienic procedures, it is recommended to use wet toilet paper, wash the anus after a bowel movement.If external nodes occur, you can take baths with a weak solution of chamomile or potassium permanganate.

To reduce blood stagnation, it is necessary to perform preventive gymnastics – its main exercises should be aimed at stimulating the muscles of the pelvis, anus and legs. In addition, it is necessary to adjust the daily routine – to go for walks, combining them with moderate rest and sleep.

If these measures do not bring the desired result, it is possible to use medicines – suppositories, ointments, creams.However, it is worth remembering that any drug treatment must be agreed with the gynecologist – during pregnancy, self-medication and the use of drugs without prescription is unacceptable.

If conservative treatment is ineffective, surgery may be required, but usually during gestation it is performed only in extreme cases, with the close supervision of a proctologist and surgeon. Usually, if there is a need for surgery, the operation is postponed until the postpartum period.

After giving birth, during the first two months, hemorrhoids may continue to bother, but usually – with the normalization of lifestyle and increased physical activity – it goes away. However, it is not worth starting hemorrhoids during pregnancy – see your doctor at the first sign.

This will help to avoid complications, reduce uncomfortable sensations, and also distinguish the disease from those that occur with similar symptoms (cracks in the anus, tumors), but requiring different treatment.

You can find out more details and sign up for a specialist consultation by phone +7 (495) 292-39-72

.