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

Understanding Vaginal Bleeding in Early Pregnancy

Vaginal bleeding during pregnancy is relatively common, especially in the first trimester. While it can be alarming, it doesn’t always indicate a serious problem. However, it’s crucial to understand the potential causes and know when to seek medical attention.

Implantation Bleeding

One of the earliest causes of bleeding in pregnancy is implantation bleeding. This occurs when the fertilized egg attaches itself to the lining of the uterus, typically around 10-14 days after conception. Implantation bleeding is usually light and brief, often described as “spotting.”

Miscarriage

Unfortunately, bleeding can also be a sign of miscarriage, especially in the first 12 weeks of pregnancy. A miscarriage occurs when a pregnancy ends on its own before the 20th week. While not all bleeding indicates a miscarriage, it’s important to be aware of other symptoms that may accompany it.

What are the signs and symptoms of miscarriage? Common signs include:

• Cramping or pain in the lower abdomen
• Passage of tissue or clots from the vagina
• Decrease in pregnancy symptoms (such as breast tenderness or nausea)

When does miscarriage typically happen? Most miscarriages occur in the first trimester, with about 80% happening before the 12th week of pregnancy. However, they can occur at any time before 20 weeks.

Ectopic Pregnancy

An ectopic pregnancy is another potential cause of bleeding in early pregnancy. This occurs when the fertilized egg implants outside the uterus, most commonly in the fallopian tube.

What risks are associated with ectopic pregnancy? Ectopic pregnancies can be life-threatening if left untreated, as they can cause the fallopian tube to rupture, leading to internal bleeding. Symptoms may include severe abdominal pain, shoulder pain, and dizziness in addition to vaginal bleeding.

How common are ectopic pregnancies and who is at risk? Ectopic pregnancies occur in about 1-2% of all pregnancies. Risk factors include previous ectopic pregnancy, pelvic inflammatory disease, and certain fertility treatments.

Causes of Bleeding in Late Pregnancy

While bleeding in early pregnancy is more common, it can also occur in the later stages of pregnancy. The causes and implications can be different, and it’s crucial to understand them.

Placental Abruption

Placental abruption is a serious condition that can cause bleeding in late pregnancy. It occurs when the placenta begins to separate from the uterine wall before delivery.

What is placental abruption and what are its symptoms? Placental abruption typically causes sudden, severe abdominal pain along with vaginal bleeding. It can be dangerous for both the mother and baby, potentially leading to preterm delivery or stillbirth if severe.

Placenta Previa

Another potential cause of late pregnancy bleeding is placenta previa. This condition occurs when the placenta partially or completely covers the cervix.

What is placenta previa and how is it diagnosed? Placenta previa is usually diagnosed during routine ultrasound scans. It can cause painless, bright red bleeding, especially after sexual intercourse. In severe cases, it may necessitate a cesarean section delivery.

Cervical Changes

Sometimes, bleeding in late pregnancy can be caused by changes in the cervix. The cells on the cervix can become more sensitive during pregnancy, leading to light bleeding, especially after intercourse. This condition, known as cervical ectropion, is generally harmless but should still be evaluated by a healthcare provider.

The ‘Show’: A Sign of Impending Labor

As pregnancy nears its end, some women may experience what’s known as a “show.” This is a small amount of blood mixed with mucus, signaling that the cervix is beginning to prepare for labor.

Can bleeding be a sign of labor? Yes, the “show” is often one of the first signs that labor may be approaching. It occurs when the mucus plug that has sealed the cervix during pregnancy comes away. However, it’s important to note that labor may not start immediately after the show – it could be hours or even days away.

Rare but Serious: Vasa Previa

Vasa previa is a rare but potentially life-threatening condition that can cause bleeding in late pregnancy. It occurs when fetal blood vessels from the placenta or umbilical cord cross the entrance to the birth canal beneath the baby.

How rare is vasa previa and what are its risks? Vasa previa occurs in about 1 in 2,500 pregnancies. If these vessels rupture during labor, it can cause rapid fetal blood loss and potential death if not immediately addressed.

Diagnostic Procedures for Pregnancy Bleeding

When a pregnant woman experiences vaginal bleeding, healthcare providers may use various diagnostic tools to determine the cause and ensure the health of both mother and baby.

Physical Examination

A physical exam, including a pelvic exam, is often the first step in evaluating pregnancy bleeding. This can help the healthcare provider assess the amount of bleeding and check for any visible causes.

Ultrasound

Ultrasound imaging is a crucial tool in diagnosing the cause of pregnancy bleeding. It can visualize the position of the placenta, check for signs of miscarriage or ectopic pregnancy, and assess fetal well-being.

Blood Tests

Blood tests may be performed to check hormone levels, blood type, and to assess for anemia or other complications related to blood loss.

When to Seek Immediate Medical Attention

While some bleeding during pregnancy can be normal, there are situations where immediate medical attention is necessary. Pregnant women should contact their healthcare provider or seek emergency care if they experience:

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

These symptoms could indicate a serious complication that requires prompt medical intervention.

Treatment and Management of Pregnancy Bleeding

The treatment for pregnancy bleeding depends on its cause, the stage of pregnancy, and the overall health of the mother and baby. In some cases, no specific treatment is needed, and the bleeding resolves on its own. In other situations, medical or surgical interventions may be necessary.

Bed Rest

For some causes of pregnancy bleeding, especially in early pregnancy, bed rest may be recommended. This can help reduce stress on the uterus and potentially decrease bleeding.

Medications

In certain situations, medications may be prescribed. For example, if bleeding is due to a threatened miscarriage, progesterone supplements might be recommended. In cases of Rh incompatibility, Rh immunoglobulin may be given.

Surgical Interventions

In cases of ectopic pregnancy or severe placental abruption, surgical intervention may be necessary. This could involve laparoscopic surgery for an ectopic pregnancy or an emergency cesarean section in late pregnancy complications.

Is treatment needed after a miscarriage? In some cases of miscarriage, a procedure called dilation and curettage (D&C) may be necessary to remove any remaining tissue from the uterus. However, many early miscarriages complete naturally without requiring medical intervention.

Preventive Measures and Self-Care

While not all causes of pregnancy bleeding can be prevented, there are steps women can take to promote a healthy pregnancy and potentially reduce the risk of complications:

1. Attend all prenatal appointments and follow healthcare provider recommendations
2. Maintain a healthy diet and take prenatal vitamins as advised
3. Avoid smoking, alcohol, and illicit drugs
4. Exercise moderately, as approved by your healthcare provider
5. Manage stress through relaxation techniques or counseling if needed
6. Report any concerning symptoms to your healthcare provider promptly

Remember, while bleeding during pregnancy can be alarming, it’s important to stay calm and seek appropriate medical care. Many women who experience bleeding go on to have healthy pregnancies and babies. However, prompt evaluation and treatment when necessary can make a significant difference in outcomes for both mother and child.

Bleeding during pregnancy | Pregnancy Birth and Baby

Bleeding during pregnancy is relatively common and doesn’t always mean there is a problem. However, if you have bleeding from the vagina at any time in pregnancy, you should always contact your midwife or doctor immediately.

Bleeding is not often caused by something serious, but it’s very important to make sure and to find out the cause straight away.

Contact your doctor or midwife if you notice bleeding from your vagina at any time during your pregnancy.

In early pregnancy you might get some light bleeding, called ‘spotting’, when the fetus plants itself in the wall of your womb. This is also known as ‘implantation bleeding’ and often happens around the time that your first period after conception would have been due.

Causes of bleeding

During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy (when the fetus implants outside the womb, often in the fallopian tube). However, many women who bleed at this stage of pregnancy go on to have normal and successful pregnancies.

In the later stages of pregnancy, vaginal bleeding can have many different causes. Some of the most common are outlined below.

Changes in the cervix

The cells on the cervix often change in pregnancy and make it more likely to bleed, particularly after sex. These cell changes are harmless, and are called ‘cervical ectropion’. Vaginal infections can also cause a small amount of vaginal bleeding.

A ‘show’

The most common sort of bleeding in late pregnancy is the small amount of blood mixed with mucus that is known as a ‘show’. This occurs when the plug of mucus that has sealed the cervix during pregnancy comes away. This is a sign that the cervix is changing and becoming ready for the first stage of labour to start. It may happen a few days before contractions start or during labour itself. 

Placental abruption

This is a serious condition in which the placenta starts to come away from the inside of the womb wall. Placental abruption usually causes stomach pain, even if there is no bleeding. If it happens close to the baby’s due date, your baby may be delivered early.

Placenta praevia

Placenta praevia, sometimes called a ‘low-lying placenta’, is when the placenta is attached in the lower part of the womb, near to or covering the cervix. This can block your baby’s path out of your body. The position of your placenta is recorded at your morphology scan.

If the placenta is near the cervix or covering it, the baby cannot get past it to be born vaginally, and a caesarean will be recommended.

Vasa praevia

Vasa praevia is a rare condition, occurring in about 1 in 3,000 to 1 in 6,000 births. It occurs when the blood vessels of the umbilical cord run through the membranes covering the cervix. Normally the blood vessels would be protected within the umbilical cord. When the membranes rupture and your waters break, these vessels may be torn and this can cause vaginal bleeding. The baby can lose a life-threatening amount of blood and die.

It is very difficult to diagnose vasa praevia, but it may occasionally be spotted before birth by an ultrasound scan. Vasa praevia should be suspected if there is bleeding and the baby’s heart rate changes suddenly after the rupture of the membranes. It is linked with placenta praevia.

Finding out the cause of bleeding

To work out what is causing bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests to check your hormone levels. Your doctor will also ask you about other symptoms, such as cramp, pain and dizziness. It is possible that the tests and investigations will not find the cause of the bleeding.

If your symptoms are not severe and your baby is not due for a while, you will be monitored and, in some cases, kept in hospital for observation. You might have to stay in overnight, or until the birth, depending on the cause of the bleeding and how many weeks pregnant you are. This will enable staff to keep an eye on you and your baby so that they can act quickly if there are any further problems.

Bleeding During Pregnancy – Cherokee Women’s Health

What can cause bleeding during pregnancy?
How is bleeding during early pregnancy checked?
When does miscarriage happen?
What are the signs and symptoms of miscarriage?
Is treatment needed after a miscarriage?
What is an ectopic pregnancy?
What risks are associated with ectopic pregnancy?
How common are ectopic pregnancies and who is at risk?
What causes bleeding late in pregnancy?
What is placental abruption?
What is placenta previa?
Can bleeding be a sign of labor?

What can cause bleeding during pregnancy?

Bleeding during pregnancy can have many causes, some serious and some not:

• Stage of pregnancy – Bleeding can occur in early or late pregnancy. Many women experience vaginal spotting or bleeding within the first 12 weeks of pregnancy.
• Sex – Bleeding of the cervix can occur during or after sex.
• Infection – Infections within the cervix can cause bleeding
• Significance – Small amounts of bleeding often stop on their own.

Bleeding during pregnancy can be a sign of something more serious and increase the chances of:

• Preterm labor
• Giving birth to an abnormally small infant
• Having a miscarriage.

How is bleeding
during early pregnancy checked?

• Your
  health care provider can perform a pelvic exam and ask question regarding
  bleeding you have noticed.
• They can
  also run an HCG test, which measures human chorionic gonadotropin (HCG), a
  hormone produced by the placenta during pregnancy.
• Your
  blood type will be checked to see if treatment is needed for Rh sensitization.
• Ultrasounds
  can be used to find causes of bleeding.

When does
miscarriage happen?

Miscarriage occurs within the first half of the pregnancy, most often within the first 13 weeks. Miscarriage occurs in 15-20% of all pregnancies.

What are the signs
and symptoms of miscarriage?

• Vaginal bleeding
• Cramping pain – low in the abdominal region (stronger than menstrual cramps)
• Tissue passing from the vagina.

Is treatment needed
after a miscarriage?

Sometimes tissue will remain in the uterus, and bleeding will continue. Sometimes more than one treatment option is needed.

Treatment options:

• Medication to help you pass the tissue remaining in the uterus
• Removal of tissue (can be removed by dilation and curettage or by a suctioning device)

What is an ectopic
pregnancy?

Ectopic pregnancy refers to when the fertilized egg does not implant in the uterus, often inside one of the fallopian tubes. Ectopic pregnancy causes pain and bleeding early in the pregnancy.

What risks are
associated with ectopic pregnancy?

The main risk of an ectopic pregnancy is a fallopian tube rupture. A rupture needs immediate treatment, as there may be internal bleeding.

How common are
ectopic pregnancies and who is at risk?

Ectopic pregnancies are far less common than miscarriages. Ectopic pregnancies occur in about 1 in 60 pregnancies.

Women who are at higher risk:

• Infection within the fallopian tube (such as pelvic inflammatory disease)
• Tubal surgery
• Having a previous ectopic pregnancy.

What causes bleeding
in late pregnancy?

The common causes of bleeding in late pregnancy are:

• Growths on the cervix
• Inflamed cervix
• Problems with the placenta (placental abruption and placenta previa)
• Preterm labor.

What is placental
abruption?

Placental abruption is when the placenta detaches from the uterine wall before or during labor. Placental abruption can cause vaginal bleeding and pain. Immediate care is needed if placental abruption occurs, because the fetus may not be receiving enough oxygen.

What is placenta
previa?

Placenta previa refers to when the placenta sits low within the uterus, possibly covering and blocking the cervix. May cause vaginal bleeding, usually without pain.

Can bleeding be a
sign of labor?

Vaginal bleeding can be a sign of labor during late pregnancy. Bloody show refers to the discharge that is released before labor and contains a small amount of mucus that was used to plug the cervix. Bloody show is not a problem if it occurs within three weeks of the due date.

Some other signs of labor:

• Vaginal discharge
• Increase in the amount of discharge
• Changes within the discharge (watery, mucus, bloody)
• Pressure in the pelvis/lower abdomen
• Dull aches within the lower back
• Stomach cramps
• Regular contractions

Contact your healthcare professional immediately if you have any of these symptoms.

Bleeding from the vagina during pregnancy

During pregnancy, it is quite common to have bleeding from the vagina. This symptom does not always mean that there is something wrong. But occasionally it can be a sign of an ectopic pregnancy or a miscarriage.

Contact your GP, midwife or obstetrician immediately if you are bleeding from your vagina

Causes of vaginal bleeding in the first trimester

The causes of bleeding from your vagina during the first trimester (0 to 12 weeks) include:

Implantation bleeding

This is light bleeding (also known as ‘spotting’). It happens very early on in your pregnancy (after 6 to 10 days), around the time that your period would have been due. It is caused by the fertilised egg attaching to the inner lining of your womb.

Hormonal changes

The hormones of pregnancy can cause changes to your cervix (the neck of the womb). These changes may mean that you bleed more easily, for example after sex.

Threatened miscarriage

If you have bleeding with or without tummy pain in the first trimester, you will often be referred for an ultrasound scan.

You may be diagnosed with a ‘threatened miscarriage’ if the pregnancy is developing normally and no other cause is found. Many women who have a threatened miscarriage go on to have a healthy baby. You may be offered a follow-up scan.

Miscarriage

Unfortunately sometimes bleeding in pregnancy may mean that you are having a miscarriage. During the first trimester, this is sometimes called ‘an early miscarriage’. This means the loss of a pregnancy during the first 12 weeks.

Related topic

Signs of miscarriage

Ectopic pregnancy

Occasionally bleeding from the vagina can be a sign that you have an ectopic pregnancy. This means that the pregnancy is developing outside the womb.

Related topic

Ectopic pregnancy symptoms

A molar pregnancy or hydatidiform mole

This is a rare condition where the placenta is not normal and the pregnancy does not develop as it should. Abnormal cells develop in your womb.

A molar pregnancy is usually treated by a simple procedure. This removes the abnormal cells from your womb. You may have appointments afterwards with your obstetrician for blood tests and/or ultrasound scans. These are to make sure all the cells have been removed.

Related topic

Molar pregnancy

Causes of vaginal bleeding in second and third trimesters

Many women have vaginal bleeding during the second (13 to 26 weeks) and third trimester (26 to 40 weeks).

This does not always mean that there is something wrong. But it can be a sign that there is a problem with your pregnancy. You should always contact your GP, midwife or obstetrician urgently if you experience any bleeding.

Possible causes of bleeding in the second and third trimesters include:

‘Late’ miscarriage

In the second trimester, bleeding from the vagina can be a sign of a late miscarriage. This is the term used to describe the loss of a pregnancy between 12 and 23 weeks.

Problems with the cervix or neck of the womb

This includes infection or inflammation.

Placenta praevia

This is a condition where the placenta or afterbirth is located lower in the womb than normal. This partially or completely blocks the birth canal.

Placenta praevia can cause bleeding which may be severe at times. If you have placenta praevia you will be advised to have a caesarean birth if the placenta does not move up the womb.

Placental abruption

This is a rare and very serious condition. The afterbirth separates from the inner lining of the womb. It can cause bleeding and severe tummy pain and can be dangerous for you and for your baby.

A ‘show’

Bleeding from your vagina can be a sign that you are going into labour, particularly if you also have tightenings or pains in your lower tummy. If you are less than 37 weeks pregnant, this could be a sign of preterm or premature labour.

what causes it, and when to seek help

Bleeding or spotting during pregnancy, especially the late stages, can be worrying.

While it does not necessarily indicate a problem with mother or baby, you should always discuss with a midwife or doctor if you have any bleeding or pain during pregnancy or feel that your baby’s movements or their pattern has changed.

Dr Louise Wiseman looks at the possible causes of bleeding or spotting during the late stages of pregnancy, and when to seek help:

What causes bleeding in late pregnancy?

A pregnant woman should always tell her doctor or midwife straight away if she has any bleeding in pregnancy.

In some cases, it might be harmless, but in others, a medical emergency, so it is important to be properly assessed to find out the cause.

Is bleeding in late stages of pregnancy normal?

The medical word for bleeding in late pregnancy is “antepartum haemorrhage”. It describes bleeding that occurs any time from 24 weeks into the pregnancy, up until the time before the birth of the baby. The bleeding can be from anywhere in the genital tract; the vagina, vulva or cervix alongside being from the womb (uterus) or pregnancy itself.

Only three to five per cent of pregnancies are affected by antepartum haemorrhage. In about a fifth of babies born very early (preterm or premature), there is some bleeding in the time before delivery.

There is a broad range of problems that come under the umbrella of bleeding during pregnancy – from fairly innocent causes of minor spotting in pregnancy to genuine bleeding. All must be checked with your antenatal team to exclude the risk of a proper obstetric emergency that must be dealt with promptly. Deaths from maternal obstetric haemorrhage are thankfully uncommon in the UK and obstetric teams are highly skilled at working together to ensure a good outcome for mother and baby. To make sure this is so, there are strong guidelines for looking after women in late pregnancy to assess the cause of any bleeding and work out what to do in the safety of a hospital environment.

What is spotting?

The Royal College of Obstetricians and Gynaecologists have clear guidelines for the healthcare profession and these explain what spotting actually is: staining, streaking or blood spotting noted on underwear or sanitary protection. This is different to haemorrhage (heavier or continued bleeding) that is graded according to how much blood is thought to be lost. The concern is that with a certain amount of blood loss, the body goes into shock as there is less blood circulating and this can compromise the mother and baby.

Of course, spotting or a small bleed may settle without any intervention with care in a hospital, but this can be a sign of further bleeding to come, so the antenatal team takes all different types of bleeding seriously.

A woman bleeding in the late stages of pregnancy should never have a vaginal examination outside a hospital, as such an examination may cause further brisk bleeding.

Causes of spotting in late pregnancy

Cervical changes

Alongside all the many changes in your body that occur during pregnancy, the womb and cervix prepare for delivery in a very specific way. The cervix area has to become thinner and more delicate to prepare for labour. This can mean it is more likely to bleed, for example, after sex. Hormonal changes of pregnancy can make the tissue of the cervix change to form what we call an “ectropion” or “erosion”. The glandular cells which usually line the inside surface or neck of the cervix travel downwards and sit on the outside surface of the cervix.

Some women have an ectropion even when not pregnant, and it is something doctors and nurses are used to seeing at the time of having a smear when they examine you with a speculum. It is seen as a kind of “raw” area. It is thought to be caused by higher oestrogen levels and can occur when taking oral contraceptives as well as in pregnancy. This is not associated with cancer.

This area can subsequently be more delicate and more likely to bleed e.g. after sex although the spotting may not be noticed for quite a while after intercourse has taken place.

Lesions or infections in the genital tract

As is the case when not pregnant, vulval or cervical lesions can potentially cause light bleeding or spotting within pregnancy. For example, polyps can be little extra growths on the cervix that may cause light bleeding.

Any vaginal infections need to be managed carefully by your obstetric team so as not to affect the pregnancy or baby in any way.

A show

A ‘show’ is the natural mucus plug (that has sealed the cervix closed during pregnancy) coming away. This is completely normal when labour is due. Women see this sometimes as a blob of “jelly like substance” which may be tinged pink or with a small amount of red blood or brown, older blood. This tends to signify that labour will start, although it may be hours or even days before contractions actually come. Tell your midwifery unit if you think you have had a show. If this is earlier than expected for your dates there may be specific treatment in the hospital. For example, you may be given steroid injections to help baby’s lungs mature if it is likely the baby is coming earlier than expected and before 35 weeks.

Kelvin MurrayGetty Images

What causes bleeding in late pregnancy?

Bleeding in late pregnancy can be painless or painful.

If you bleed in pregnancy you should always urgently call your midwifery team or doctor for help and depending on the situation you may be asked to dial 999 to get you into hospital straight away.

The most concerning causes of bleeding are conditions called “placenta praevia” and “abruption of the placenta”.

Bleeding can also occur if a mother has a bleeding disorder or develops problems in the whole body that mean she is more likely to bleed. This is normally managed throughout pregnancy by joint hospital care between the Obstetric and Haematology teams with a specific care plan made for delivery to keep mother and baby safe.

Placenta Praevia

This affects only about 1 in 200 births.

It means that the placenta (the baby’s connection to the mother in the womb and how it exchanges nutrients, oxygen and waste with the mother) is lower down in the womb than it should be. It is near to, or covering the cervix opening and it would be safer for it to be a little higher. If the placenta remains covering the entire opening late in pregnancy it is called ‘major placenta praevia’ and may mean bed rest or hospital admission from 34 weeks due to the high bleeding risk.

(Placenta praevia is not the same as ‘anterior placenta’ or having the placenta around the front of the womb, which is entirely normal although will need to be monitored especially if a caesarean is likely or has happened in the past.)

Usually at the 20 week or ‘anomaly scan’ if the placenta position is going to be a problem it is noted and the antenatal team will be fully aware. They will follow you up regularly, until term, with further scans (usually one at 32 weeks) to check the position of the placenta. In 90 per cent of women the placenta will naturally rise up higher ‘out of the way of the delivery route’. As the pregnancy progresses, the area where the placenta attaches naturally stretches upwards.

Placenta praevia is graded according to whether it actually covers the os (the baby’s route out of the cervix) or is just coming near to the cervix opening. In most cases the opening is not completely covered.

Placenta praevia risks

You are more likely to have a placenta praevia if you have had one before. Sometimes there is no obvious cause for placenta praevia.

Potential risk factors include:

• mother’s age over 40 years
• previous caesarean section (the risk increases slightly with each one)
• IVF
• smoking or drug misuse
• previous abortion or womb surgery
• multiple pregnancies
• other conditions in the womb, like fibroids taking up space higher up

Signs of placenta praevia

Usually there is a sudden onset of painless, bright red bleeding at any time during the last 3 months of pregnancy.

Due to the position of the placenta the baby may be in a different position in late pregnancy, such as breech, as the placenta is in the way or it may make it difficult for the baby’s head to engage ready for labour.

Similarly this condition might trigger premature labour.

Getty Images

Placenta praevia treatment

There is no treatment per se for placenta praevia when it is diagnosed at a scan, except for careful monitoring. Dependent on the position of the placenta, the mother may have a planned caesarean if this is the safest way to deliver and avoid the placenta. The obstetric team may advise you against penetrative sex if they see a low placenta on a scan during pregnancy and in some cases you will be told to have bed rest either at home or in the hospital towards the end of your pregnancy.

In an emergency scenario, surgery may be necessary to stop the bleeding or an examination under anaesthetic to determine exactly the location of the placenta. See hospital care details below.

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Placental abruption

The placenta is the baby’s major support system. Abruption means that there is bleeding between the placenta and wall of the womb (uterus) and the placenta comes away from the wall of the womb before delivery of the baby. This can involve only part of the placenta or the entire placenta. This cannot be predicted so is always an emergency.

Placental abruption risks

You are more likely to have a placental abruption if you have had one before. There may be no obvious cause.

Potential risk factors include:

• preeclampsia
• extra fluid around the baby (polyhydramnios)
• multiple pregnancy
• infection within the womb
• growth problems with the baby
• smoking or drug misuse
• abruption can arise after trauma or domestic violence.

Signs of placental abruption

Usually there is severe pain in the back or abdomen or both, although this is not always the case. The mother may pass bright red or old dark red blood and there may be clots. Contractions may spontaneously start. The pregnant belly can be very firm and tender to the touch when the midwife or doctor do an examination, or in some women it can just feel like a bruise in one area.

An abruption will often be diagnosed simply from the obvious blood loss but sometimes it can be a ‘concealed abruption where the blood is trapped somewhat between placenta and womb and the pain is what alerts the mother.

Whatever the cause of bleeding the antenatal team’s priority is the safety of the mother and the child. Strict management guidelines work to keep mother safe and deal with delivering baby as safely as possible whether this is immediately or later on.

Placental abruption treatment

Sometimes a small abruption may settle by itself and the mother and baby will be monitored. Sometimes if the growth of baby is compromised but there is no immediate emergency, labour will be induced early. In severe cases immediate induction of labour or an emergency caesarean may be performed.

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Hospitalisation for bleeding late in pregnancy

The experienced multidisciplinary antenatal team will first assess you generally (blood pressure, pulse, temperature etc. ) and set you up with some intravenous fluids and take some blood tests to get a picture of what is going on. They will talk to you to find out what has happened while looking at your antenatal notes and the team will most likely already be aware if you have a diagnosed placenta praevia.

They will gently examine your tummy and may perform an ultrasound to establish the location of the placenta. Sometimes an abruption can be seen on an ultrasound but not always. They may pass a speculum to see what is going on but are less likely to examine you internally if there are concerns it will trigger stronger bleeding or labour. The baby’s heart rate and activity will be assessed by the CTG monitoring around your tummy. The team will decide whether emergency surgery is necessary or if you can be observed and kept stable in the hospital. You will be counselled about blood transfusion, should it become necessary and everyone will work to keep you and baby stable.

Never ignore any worrying signs in pregnancy, especially bleeding or pain and always contact your doctor or midwife.


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Last updated: 20-08-2020

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Spotting and Bleeding During Pregnancy

A break from monthly bleeding is a tiny perk of pregnancy, so it’s definitely unsettling if you spy blood once you’ve conceived. But bleeding isn’t always a sign of something wrong. In fact, up to 25 percent of women experience it in the first trimester and more than half go on to have healthy pregnancies and babies. 

So if you’re noticing light spotting, you can take a deep breath and read on for a probable (and probably reassuring) explanation. Here’s more about the difference between spotting and bleeding, what causes it during pregnancy and how bleeding is treated when you’re expecting.

How can you tell the difference between spotting and bleeding?

The difference between spotting and bleeding while pregnant usually comes down to the shade of the blood and the amount. In terms of color, spotting is often brownish or pink, similar to what you’d expect at the end of your period. And as for amount, you’re probably spotting if the blood is so light that you reach for a panty liner rather than a maxi pad.

On the other hand, bright red blood is considered bleeding, especially if it’s flowing and heavy. If you’re experiencing bleeding during pregnancy, you’ll skip over that box of liners in favor of a sanitary pad to protect your clothes.

What causes spotting during pregnancy?

Light spotting is common and usually benign, and can begin around weeks 3 or 4 of pregnancy. But spotting can happen anytime during these nine months, from the early days of fertilization up to your due date. Here are some of the common causes of spotting during pregnancy:

• Implantation bleeding.  The implantation of the embryo into your uterine wall usually occurs before or around the time you expected your period, or about six to 12 days after conception. Implantation bleeding is lighter than a period, lasts from a few hours to a few days, looks pinkish or brownish and isn’t a sign of something wrong.
• Sex. Your cervix becomes tender and engorged with blood vessels, so any kind of minor bumping like getting busy between the sheets may irritate it and cause light bleeding. This spotting is pretty common, but do tell your practitioner if you’d like extra reassurance.
• Internal pelvic exam or Pap smear. The same type of spotting you might see after sex is also possible when your doctor performs an internal exam or Pap smear.
• Infection of the vagina or cervix. An infection can irritate or inflame the cervix, causing it to bleed a little (though the spotting should disappear once you’re treated).
• Lost mucus plug. This barrier seals your cervix, but later in pregnancy it falls out, indicating the start of labor. It’s usually clear and sticky, but it may also be brown or yellow.
• Subchorionic bleed. Blood accumulates within the folds of the chorion (the outer fetal membrane, next to the placenta) or between the uterus and the placenta itself, causing light to heavy spotting. In most cases, it resolves on its own and isn’t a problem in pregnancy.

What causes bleeding during pregnancy?

Period-like bleeding early in pregnancy, or at almost any time, can signal that something is up. Because heavier bleeding may go hand in hand with any number of pregnancy complications, pinpointing the exact reason is best left to your practitioner. Here are a few possible causes:

• Ectopic pregnancy. This nonviable pregnancy occurs when a fertilized egg implants outside of the uterus, and it requires immediate medical attention. You’ll notice heavier vaginal bleeding and severe sharp abdominal pain, sometimes accompanied by rectal pressure, shoulder pain, lightheadedness, fainting or shock.
• Molar pregnancy. Typically discovered within weeks of conception, a molar pregnancy is when a placenta becomes a mass of cysts accompanied by a malformed or nonexistent embryo. Signs of this rare condition include dark brown to bright red vaginal bleeding with severe nausea, vomiting and cramping. 
• Miscarriage. This early loss happens in about 10 percent of pregnancies and is most often related to a chromosomal or other genetic defect of the embryo, though it may also be due to hormonal or other factors. Heavy vaginal bleeding (possibly with clots and/or tissue) may occur with severe cramping, lower belly or back pain and a sudden, pronounced decrease in early pregnancy symptoms (like breast tenderness and morning sickness) that’s different from the gradual diminishing as the first trimester ends.
• Placenta previa. While usually discovered on a second trimester ultrasound or possibly in the third, this relatively rare complication happens when the placenta implants on the lower part of the uterus and covers part or all of the cervix. (In most women, the placenta moves up and away before birth.) When placenta previa is accompanied by bright red bleeding, your practitioner will likely put you on pelvic rest (meaning no sex) and advise you to relax and avoid strenuous activity or exercise.
• Placenta accreta. If placenta previa is suspected or diagnosed, you may also be monitored for placenta accreta, which occurs when the placenta attaches too deeply in the uterine wall. 
• Placental abruption. This condition, which almost always occurs in the second half of pregnancy and usually in the third trimester, is the early separation of the placenta from the uterine wall. In addition to light to heavy bleeding with or without clots, you may also notice abdominal aching or cramping, uterine tenderness and pain in the back or abdomen. If the separation is slight, there’s usually little danger to you or your baby and you’ll probably be monitored closely and told to take it easy. But if it’s more severe, you may need to be hospitalized — which is why it’s so important to see your doctor regularly.
• Preterm labor. If you go into labor after week 20 and before week 37 of pregnancy, it’s considered preterm. Along with bleeding, it can be accompanied by other labor signs including back pressure, unusual pelvic pressure and regular contractions that intensify and become more frequent even when you change positions. If you suspect labor is starting early, contact your practitioner immediately.
• Uterine rupture. A tear in your uterus during labor is very rare and may occur if you’ve had a prior cesarean birth or other uterine surgery that’s left a scar.

Early Signs of Pregnancy

When should you worry about spotting or bleeding during pregnancy?

Concern about bleeding during pregnancy is completely normal, but remember that light spotting is as variable as it is common and is usually nothing to worry about. Some women spot on and off for their entire pregnancies, while others spot for just a day or two or a few weeks. Happily, women continue to have healthy pregnancies and healthy babies in most cases.

Still, heavy bleeding that soaks through a pad always warrants a call to your practitioner, especially if it’s accompanied by cramps or pain in your lower abdomen. But it’s not inevitably a sign that you’re miscarrying. Some women bleed, even heavily, for unknown reasons and still deliver healthy babies.

When should I go to the doctor for spotting or bleeding during pregnancy?

If you’re at all concerned, don’t hesitate to talk to your physician. Heavy bleeding at any point in pregnancy should be reported to the doctor immediately, but spotting or light vaginal bleeding during the first trimester that goes away in a day or so can be brought up at your next prenatal checkup.

At this appointment, your doctor may order a blood test to check hCG levels or perform an ultrasound to check and see that your pregnancy is progressing.

But bleeding during the second trimester, even if it’s not much to see, should be discussed with your health care provider the day it happens. And if you spy blood during the third trimester, get in touch with your doctor right away.

What is the treatment for spotting and bleeding during pregnancy?

In addition to an exam and various tests at the doctor’s office, rest and relaxation are often the best treatments for a case of spotting or bleeding during pregnancy. That might include some time away from work, getting help with little ones and chores at home, and skipping sex for a while.

More serious cases of bleeding during pregnancy may require a hospital visit or surgery, depending on the diagnosis. If your blood type is Rh negative, you’ll get an injection of RhoGAM if Rh incompatibility is diagnosed during your pregnancy.

No pregnant woman wants to see vaginal blood of any amount or shade when she’s expecting, but much of the time spotting or light bleeding isn’t a serious problem. Keep track of your symptoms and speak with your doctor at any point for reassurance and guidance.

Bleeding in pregnancy | Tommy’s

What are the causes of bleeding in late pregnancy (after 24 weeks)?

Some women may experience a light bleed later on in their pregnancy. This is may not be from inside the womb, but from the cervix, for example, which can cause bleeding after sex. This may settle and doesn’t necessarily mean there is a problem, but you should contact the hospital maternity unit immediately so you can be checked, just in case.

There are two more serious causes of bleeding in late pregnancy:

Low-lying placenta (placenta praevia) 

The area where the placenta is attached usually stretches upwards away from your cervix. A low lying placenta is when the placenta stays low in your womb, near to or covering your cervix. This may block the baby’s way out. In most cases, this would have been seen at one of your routine ultrasound scans and you will have an extra scan later in your pregnancy to see if the placenta has moved up.   

If the placenta is still low in your womb you may blead heavily during your pregnancy and your baby’s birth. This can put you and your baby at risk. If you have a low lying placenta and you have bleeding you may need emergency treatment – call 999.  

You’re more likely to need a caesarean section if you have a low-lying placenta.

Placental abruption (abruptio placentea)

This is a serious condition in which the placenta starts to come away from the womb wall. It usually causes extreme stomach pain which does not come and go like contractions. It may occur even if there is no bleeding.

Contact your hospital maternity unit immediately if you are bleeding in late pregnancy.

Find out more about placental abruption.

Rhesus negative

During your antenatal care your midwife will find out your blood group and whether you have rhesus positive or negative blood. Knowing which group you are in is important. If you have rhesus negative blood, but your partner has rhesus positive blood, your baby has a chance of having rhesus positive blood too. If this happens, your body might see your baby’s blood as different to yours and develop antibodies. These antibodies can pass across the placenta and attack your baby’s blood cells.

This won’t normally affect your first pregnancy, but it can be very serious in later pregnancies. Because of this, if you have rhesus negative blood your midwife will offer you an injection called anti-D during your pregnancy to protect your baby.

If you have any bleeding or trauma to your bump (for example, if you fall over) contact your midwife or hospital maternity unit immediately. You may need to be checked and possibly have another injection of anti-D.

Talk to your midwife if you have any questions about your and your baby’s blood type.

Where should I seek help for bleeding in pregnancy?

Any bleeding in pregnancy should be investigated even if you are not experiencing any other symptoms. It is important to make contact with a health professional to be seen as soon as possible.

Before 12 weeks pregnant

If you feel generally well and the bleeding is not heavy, then you can call your GP or midwife (if you have one yet) for an appointment who can then assess if they need to refer to the local Early Pregnancy Unit. Sometimes, you can self-refer to a local Early Pregnancy Unit depending on your history and where you live. If you call your local GP surgery they should be able to advise you. 

You can also call NHS 111 if you feel you need urgent medical help but it is not an emergency.

Go to your local A&E if you are experiencing bleeding and:

• it is during the night or at the weekend when a GP is unavailable
• the bleeding is heavy
• the pain is severe
• you feel generally unwell

After 12 weeks pregnant

Go to your local A&E or contact the hospital maternity unit immediately so you can be checked, just in case.

Bleeding During Pregnancy: Types, Risk Factors

Bleeding during pregnancy is relatively common, particularly during the first trimester. As many as one in three people will experience bleeding during their first three months. Minor bleeding generally isn’t serious, particularly if it’s not accompanied by pain.

However, major bleeding and painful bleeding may be signs of a serious problem. Therefore, any bleeding during pregnancy should be evaluated by your healthcare professional.

This article will discuss risk factors for bleeding during pregnancy and possible causes of it during each trimester.

Kemal Yildirim / iStock / Getty Images

Types of First Trimester Bleeding

There are a number of reasons why people experience bleeding during the first trimester. Diagnosing first trimester bleeding usually requires a physical exam, a blood test, and/or sexually transmitted infection (STI) testing.

Repeated blood tests may be used to monitor the changing hCG (human chorionic gonadotropin) hormone levels present during pregnancy to determine if the pregnancy is likely to be viable. The hormone progesterone and Rh factor (Rhesus factor, a protein on the surface of red blood cells giving us a positive or negative blood type) may also be evaluated during the first trimester.

Implantation Bleeding

Implantation bleeding occurs when the fertilized egg attaches to the lining of the uterus. This usually occurs around one to two weeks after fertilization, around 20–24 days into your menstrual cycle.

Implantation bleeding is usually light and may resemble spotting. It may be accompanied by nausea, headache, and other symptoms. Implantation bleeding is normal and is not a risk factor for pregnancy loss.

Miscarriage

Miscarriage is defined as a pregnancy loss that happens before the 20th week of pregnancy. Early pregnancy loss during the first trimester is not uncommon and often reflects chromosomal abnormalities or other problems with the developing fetus. In addition to bleeding, symptoms of miscarriage include strong cramping and passing tissue.

Bleeding during the first trimester does not mean that you will lose your pregnancy. Your doctor will likely perform an ultrasound in addition to testing your blood to see how your pregnancy is progressing.

Ectopic Pregnancy

An ectopic pregnancy occurs when the fertilized egg implants in the fallopian tube or a place other than the uterus. Ectopic pregnancies are not viable. They can lead to severe complications, including death.

Symptoms of an ectopic pregnancy include hCG levels rising more slowly than would be expected for a typical uterine pregnancy. Pregnant people may also experience cramping, shoulder pain, and weakness or dizziness in addition to the expected symptoms of pregnancy.

Ultrasound can be used to diagnose an ectopic pregnancy. Sometimes surgery is needed to examine the fallopian tubes and see where the embryo has implanted. Surgery may also be needed if the fallopian tube has ruptured or is at risk of rupturing. However, many ectopic pregnancies can be managed with medication.

Infection

Sexually transmitted infections and other infectious conditions can cause problems during pregnancy, including bleeding. Diagnosing an infection may require a combination of a physical exam, a vaginal swab, a cervical swab, urine testing, and blood testing.

Types of Second and Third Trimester Bleeding

With certain exceptions, bleeding during the second and third trimesters of pregnancy is more likely to be a concern. One major exception is light bleeding after vaginal intercourse. Changes in the cervix during pregnancy make it more likely to bleed. Therefore, light bleeding after intercourse is not necessarily a concern, but you should still contact your clinician if it occurs.

Placenta Previa

Placenta previa occurs when the placenta—the organ that develops in your uterus to provide oxygen and nutrients to the fetus—covers any portion of the opening of the cervix. It is thought to happen in approximately one out of every 200 full-term pregnancies.

It is more common in people who have had a previous cesarean section (C-section) delivery, as well as those who have had multiple pregnancies, are older, smoke, or have a history of spontaneous or elective abortion.

Symptoms of placenta previa include passing bright-red blood, usually without pain. It is generally diagnosed via ultrasound. A person with placenta previa may require monitoring throughout the pregnancy.

Placental Abruption

Placental abruption is when the placenta starts to separate from the uterine lining before delivery. It is thought to occur in approximately 0.9% of singleton (one fetus) pregnancies in the United States. Common symptoms include bleeding associated with severe abdominal or back pain and contractions.

Placental abruption is more common after trauma and in older pregnant people, those with infections, and those with chronic health problems. The amount of bleeding is not a reliable sign of how serious the separation is. Early delivery is recommended if the fetus is in distress.

Premature Labor

Premature labor is labor that occurs before 37 weeks of gestation. Symptoms of premature labor can include cramps, changes in vaginal discharge, contractions, and ruptured membranes (when the bag of water breaks). There may also be bleeding.

If you are experiencing symptoms of possible premature labor, talk to your doctor. You will likely be examined and given an ultrasound. Several treatment options are available to delay labor and improve the fetus’s outcome after delivery.

Vasa Previa

Vasa previa occurs when unprotected blood vessels supplying the fetus are located too close to the cervix. This puts the vessels at risk of rupturing after the membranes rupture.

Vasa previa is extremely rare, occurring in less than one of 2,500 deliveries. Up to one-third of cases detected during pregnancy will require emergency preterm delivery.

If vasa previa is not detected before labor, it can be devastating or even fatal for the fetus. This is because rupture of the vessels can quickly cause the fetus to bleed out.

The classic presentation of vasa previa is painless vaginal bleeding after membrane rupture, along with signs of fetal distress. Emergency C-section followed by fetal resuscitation may be required.

Invasive Placentation

Invasive placentation is an uncommon cause of vaginal bleeding during pregnancy. However, it is a significant cause of postpartum hemorrhage.

It occurs when the placenta embeds too deeply in the uterus, invading the myometrium, the smooth muscle tissue of the uterus. It is more common in people who have had one or more previous C-sections.

Uterine Rupture

Uterine rupture occurs when the wall of the uterus breaks open. This condition is extremely rare. It affects 0.8% of people with previous uterine surgery. It affects only 0.03-0.08% of all delivering patients.

Bleeding and pain may occur with uterine rupture. The fetus’s body parts may become easier to feel through the abdomen. Immediate treatment is necessary.

Coagulopathy

Over the course of pregnancy, there are many changes within the body. One of those changes concerns blood-clotting. Disseminated intravascular coagulation (DIC) is the technical term for when clotting occurs throughout the body. It can then lead to severe bleeding.

Signs of DIC include bleeding from the vagina as well as other areas, such as the gums, rectum, and skin. People may also experience symptoms of shock. DIC during pregnancy is rare but can be serious and even fatal.

Risk Factors for Bleeding During Pregnancy

Different causes of bleeding during pregnancy have different risk factors. Common risk factors include:

• Older age of the pregnant person
• Previous uterine surgery, including C-section
• High number of previous pregnancies (parity)
• Smoking
• High blood pressure
• History of sexually transmitted diseases
• Chronic health conditions, like diabetes

While some of these risk factors can be modified, others cannot. Still, it’s important to do what you can to manage your health both before and during pregnancy. Part of that includes going in for regular prenatal care. Starting prenatal care early will help your provider manage any issues that could put your pregnancy at risk.

Summary

There are many causes of bleeding during pregnancy. You should always contact your healthcare professional to determine whether it is a benign symptom or a sign of serious risk for yourself or your fetus.

In the first trimester, possible causes include implantation bleeding, miscarriage, ectopic pregnancy, and infection. In the second and third trimesters, among the possible causes are placenta previa, placental abruption, vasa previa, preterm labor, or a coagulation disorder.

A Word From Verywell

Bleeding during pregnancy can be frightening. Although it may be tempting to wait and hope that it will stop, it’s important to discuss any bleeding during pregnancy with your healthcare provider. Many causes of bleeding aren’t serious or can be treated in a straightforward way.

If bleeding during your pregnancy is serious, prompt medical attention is even more important. Early treatment may make the difference between losing a pregnancy and keeping it. It may also save your life. Fortunately, many times bleeding in pregnancy is not life-threatening for you or your baby.

90,000 Abortions: indications, methods, permitted periods

While some women dream of bearing and giving birth to a child, others are looking for ways to terminate an unwanted pregnancy. Modern medicine and pharmacology provides a huge selection of contraceptives to exclude conception, but despite this, the number of abortions performed by doctors is constantly growing. According to statistics, about 20 thousand women a year get rid of unwanted pregnancies. It is difficult to give this act an unambiguous moral assessment, however, from a scientific point of view, the embryo is the first stage in the development of the human body and is fully equated with a newborn child, and abortion is a murder.Morality does not force a woman to follow her interests forcibly, but demands to bear responsibility for her actions, without paying with the life of an unborn person. On the other hand, such a serious medical intervention as abortion always has an extremely detrimental effect on a woman’s body, especially on the organs of the reproductive system. The consequences can be extremely dire, ranging from hormonal imbalance and the development of various neoplasms, ending with infertility. Therefore, if a woman has doubts about this procedure, first of all, it is necessary to consult with a gynecologist who will tell you about all the possible risks.There are certain periods during which the procedure can be carried out by medical workers, and various types of abortions are offered, we will consider them in more detail.

How long can you have an abortion?

Abortion is called artificial termination of pregnancy before 22 weeks. This is a medical procedure, which is not aimed at treatment, but at the termination of the vital activity of a living organism. If we consider pregnancy by week, it is divided into two stages: embryonic (up to 8 weeks) and fetal (from 9 weeks to delivery).In the first case, the embryo is called an embryo, and in the second – a fetus, which is actively developing internal organs and systems. Starting from 5 weeks, the heart is formed, the contraction of which can be heard on an ultrasound examination. Despite this, abortive intervention can be carried out up to 12 weeks and no later than 22 weeks.

According to the regulations of domestic legislation, abortion up to 12 weeks refers to early, any woman can be carried out if desired. After 12 and up to 22 weeks, the procedure is allowed to be performed only for social or medical reasons, among which:

• rape of a woman;
• fetal death;
• ectopic pregnancy;
• severe fetal pathologies that are incompatible with life;
• diseases of the mother, which will not allow to bear and give birth to a healthy child;
• The need for another medical procedure or surgery that is incompatible with pregnancy.

Before carrying out an abortion at a later date, a meeting of the medical commission is held, which decides on the termination of pregnancy, eliminating the risks and possible complications. It is important to understand that early or late abortion can have irreversible consequences for a woman’s health and the doctor must inform about them.

Abortion Methods

To receive a referral for an abortion, a woman must undergo a series of medical examinations, including:

• blood and urine test for hCG level – will help to exclude an ectopic pregnancy;
• Ultrasound of the pelvic organs;
• blood for STDs: syphilis, HIV, hepatitis B and C;
• vaginal swab;
• General analysis of blood and urine.

The results obtained make it possible to obtain an accurate picture of pregnancy, to identify concomitant diseases, and to determine possible disorders in the development of the fetus.

In medical practice, there are different methods of abortion that are used in a particular case. In addition to third-party intervention, interruption can occur on its own – a miscarriage, which is the result of an unfavorable course of pregnancy or the impact of certain factors on the fetus or the woman’s body.

In other cases, we will talk about medabort, which can be carried out in several ways. Abortion happens:

• medication – consists of taking certain hormonal drugs, which are taken according to a strict scheme;
• mini-abortion – using a vacuum aspirator;
• instrumental – scraping of the uterine cavity with vacuum aspiration of the ovum;
• minor cesarean section.

Another method of abortion is saline, which consists of injecting a saline solution into the fetal bladder, it kills the fetus.After 2 days, hormonal drugs are prescribed to stimulate labor. In practice, this type of abortion is not encouraged, since there have been cases when during childbirth, the fetus was alive, but had severe deviations.

Methods of abortion are different, but the choice of the method used remains with the doctor and the woman, depending on the duration of pregnancy, the general state of health of the woman. The shorter the period, the less risks. And do not forget that starting from the 8th week, the fetus develops the nervous system, the heart contractions are clearly audible, and by 16 weeks it already hears sounds, can react to them.Therefore, if pregnancy is undesirable or there is a medical indication for terminating it, you should not waste time.

Medical abortion

Medical termination of pregnancy is recommended up to 7 weeks of pregnancy. It consists of taking certain medications that are prescribed by the doctor individually for each patient. The composition of such drugs contains substances that block the functioning of the hormones progestin and prostaglandin, the deficiency of which causes the termination of pregnancy.In practice, Mifepristone tablets are used more often, followed by Misoprostol. The former lead to the death of the embryo, and the latter cause contraction of the uterus, remove the dead embryo from its cavity. These drugs are dispensed according to a strict doctor’s prescription, since they have many contraindications and side effects. The dosage is determined by your doctor. After an abortion, after 7 days, a woman must undergo an ultrasound of the pelvic organs.

Women believe that medical abortion is one of the safest, does not require mechanical or surgical intervention, but this is far from the case.This procedure has a number of contraindications:

• Ectopic pregnancy;
• more than 49 days since the last menstrual period;
• bronchial asthma;
• adrenal pathology;
• renal failure;
• diseases of the genitourinary system.

The danger lies in the fact that after medical abortion there is a high risk of uterine bleeding, as well as excessive contraction of the uterus, vomiting, nausea, heart rhythm disturbances and other complications.With a high risk of complications, taking drugs for abortion should be carried out under the supervision of a doctor in a hospital setting.

Vacuum abortion

Mini-abortion (vacuum abortion) – a procedure to terminate an unwanted pregnancy, refers to sparing operations, since it does not involve surgical intervention. Lasts up to 12 weeks, consists of vacuum suction of the embryo from the uterus using a suction catheter. The procedure excludes damage to the mucous membranes, does not cause isthmic-cervical insufficiency or injury to the cervix.If the woman has not given birth before, it is performed using anesthesia. It takes no more than 1 hour in time. 7 days after the procedure, an ultrasound scan is prescribed, which will help to exclude incomplete removal of the ovum.

Vacuum abortion is contraindicated at:

• • ectopic pregnancy;
  • period is more than 12 weeks;

poor blood clotting;

• inflammation of the pelvic organs.

After performing the procedure, a woman may be bothered by pain in the lower abdomen, menstrual irregularities, hormonal imbalance.A mini-abortion prohibits re-conception earlier than 6 months later, so the doctor prescribes hormonal contraceptives for the woman, which will exclude re-conception.

Surgical abortion

Surgical abortion allows you to terminate a pregnancy up to 22 weeks. During the procedure, the contents of the uterus are physically scraped together with the ovum, which excludes the further development of the embryo. Despite the 100% result, this type of abortion is performed when other methods are ineffective.

During an abortion, the cervix is ​​opened with special instruments, with the help of a curette, the fetus is scraped out, forceps can be used. If it is not possible to completely remove the embryo, it is removed in parts. Instrumental abortion is the most reliable, but also the most dangerous. It is performed under general anesthesia in a hospital setting.

Thanks to the capabilities of modern surgery, during the operation, a hysteroscope can be used, which is inserted into the uterine cavity, eliminates the risk of damage to the endometrium, and is a guarantee that after the operation, no fragments of the embryo remain in the uterus.

The operation takes from 20 to 30 minutes, but after it is carried out, the woman must spend several hours in the hospital under medical supervision. Normally, there should be no severe bleeding, nausea, vomiting or severe pain in the lower abdomen.

Surgical abortion has some contraindications, including:

• poor blood clotting;

90,011 infections of the pelvic organs;

• inflammatory processes.

After termination of pregnancy by the instrumental method, the risk of complications is quite high, it may be associated with a medical error or the internal state of health of the woman herself.Common consequences include:

• violation of the menstrual cycle;
• adhesive processes;
• obstruction of the fallopian tubes;
• hormonal imbalance;
• benign tumors;
• infertility;
• depressive states.

Complications after surgical termination of pregnancy may appear immediately after the abortion procedure or after a certain period of time. Therefore, doctors recommend that after the operation be careful about your health, and at the first ailments, contact a specialist for help.

What is the safest abortion

There are no safe types of abortion, since any technique has its own contraindications and side effects. But if there is a need for carrying out, it is better to terminate pregnancy up to 7 weeks. The longer the gestation period, the higher the risks of complications and adverse effects on the body.

In the early stages, preference is given to medical or vacuum abortion, and later – to surgery. Regardless of the method chosen, a woman after the procedure should follow a number of rules that will help the body recover faster and reduce the risk of complications:

• taking antibiotics to reduce the risk of inflammation;
• taking oral contraceptives to normalize hormonal levels;
• proper and healthy nutrition;
• in the first days after an abortion to exclude physical and mental stress.

If after an abortion there is severe pain in the lower abdomen, bleeding, vomiting, nausea, you should immediately seek medical help, do not self-medicate or wait for an improvement in well-being.

Consequences of abortion

Any type of abortion is stress for the body, which is already preparing for the preparation of bearing a fetus, therefore there are consequences of such a procedure, and they do not always pass without leaving a trace for a woman. Common complications include:

• uterine bleeding;
• secondary infection;
• mechanical damage to the uterine wall;
• high risk of developing endometritis;
• infertility;
• systematic pain in the lower abdomen;
• menstrual irregularities;
• the need to remove the uterus if it is severely damaged;
• hormonal imbalance.

Women believe that the most formidable complication of abortion is infertility, but this is not entirely true, since other diseases are no less dangerous. A large percentage of women are unable to bear a child, and even if they are pregnant, they face constant miscarriages.

Pregnancy after abortion

Many women who had to have an abortion think about pregnancy and childbirth, but how quickly can you get pregnant and how long will the body need to recover?

If the process of artificial termination of pregnancy was successful, there are no complications, you can get pregnant a few weeks after the abortion, but doctors strongly advise against doing this, prescribe oral contraceptives to be taken for several months.

How quickly pregnancy occurs depends on the characteristics of the female body. Some can conceive a child almost immediately, while others cannot feel the joy of motherhood for several months or years.

Doctors gynecologists advise adhering to some recommendations:

• 6 months before the desired conception, exclude the use of hormonal contraceptives;
• Strengthen the body – give up bad habits, revise the diet, eat only healthy and fortified foods;
• active lifestyle;
• to exclude heavy physical labor;
• undergo a comprehensive examination;
• to be observed by a gynecologist.

Doctors do not recommend getting pregnant too quickly, as there is a high risk of fetal abnormalities, miscarriage and other unpleasant consequences. The body needs to be given time to recover, otherwise the process of conception may be delayed. Psychologists recommend maintaining a positive attitude while preparing for pregnancy, spending more time outdoors, communicating with pleasant people, and avoiding stress and depression.

If you cannot get pregnant, do not despair – monitor the state of your body, visit a doctor on time, eat only healthy food, keep your spirits, and everything will definitely work out!

90,000 Bleeding during pregnancy – alarming symptom – Twój Lekarz

Vaginal bleeding during pregnancy occurs at different times and has different causes.

Bleeding for up to 20 weeks occurs in 20-30% of pregnant women, in about half of these cases, a miscarriage develops. If the pregnancy is not interrupted, then in the future there is a risk of premature birth, intrauterine fetal death, and low birth weight. All bleeding carries risks for the woman herself. From conception to 12 weeks, bleeding is usually not associated with any pathology, but is a sign of placentation.

Causes of bleeding in the first trimester:

• Embryo implantation and placental development;
• ectopic pregnancy;

90,011 miscarriage;

• molar pregnancy or hydatidiform mole;
• cervical infections or other diseases.

Warning signs: pain, dizziness, fainting, heart palpitations, fever, purulent discharge.

Causes of bleeding in the second and third trimester:

• Premature dilatation of the cervix;
• miscarriage or intrauterine fetal death;
• placenta previa – low placenta, other features;

90,011 uterine rupture;

• infections and pathology of the cervix;
• premature birth.

In later stages, slight bleeding may be the norm – when the cervix softens, the mucous plug begins to move away, which may be accompanied by the appearance of blood in the discharge.

In any case, a woman should inform her doctor about bleeding as soon as possible. It is necessary to assess the blood loss – the number of pads used. An extremely alarming symptom is severe cutting pain in the abdomen, especially when turning and breathing deeply. In this case, it is better to immediately call an ambulance.During the examination, in addition to the examination, the woman’s blood group and Rh factor, hemoglobin level are determined; in the early stages – the concentration of chorionic gonadotropin, an ultrasound examination is performed to assess the fetus and the uterine cavity.

The tactics are very different and depend on the cause of the bleeding and the condition of the woman. With light bleeding, which consists in a small, drip discharge of blood, as well as with bleeding that has ended within two hours, rest and home mode can be shown.With an ectopic pregnancy, miscarriage, the threat of premature birth, the woman will be hospitalized, possibly surgery.

The prognosis of bleeding during pregnancy depends on its duration, as well as the profusion of blood loss. Sometimes this condition can threaten a woman’s life, so you should not ignore the appearance of blood during pregnancy.

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90,000 Anna Starobinets on how late termination of pregnancy is arranged in Russia

I am registered in the antenatal clinic, but I was observed for all sixteen weeks at the V.F. Snegireva, which is on Elansky Street, next to Bolshaya Pirogovka. Observed for a fee. And she was going to give birth there and also paid. It seemed to me that it would be safer. In my first pregnancy, I did not leave the feeling that there, inside, everything is kept on snot. They constantly wrote to me: “the threat of miscarriage”, I lay on the shelf. Badger the Younger was born nevertheless on time, but I decided that the second time I would approach the matter wisely. Consultation – what is consultation? There are queues, there are all irritated, stupid. Better paid.More qualified doctors, better equipment and all that. In this second pregnancy, my pulse was over 120, but there was no threat of termination. Badger Senior was still joking that this child had grabbed me tightly and was not going anywhere.

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100%

Now we know what’s going to go. Such children, if they do not die in the womb, are born with huge bellies. Their bellies are made up mostly of kidneys. And the kidneys are from cysts. Their bellies are so large that it prevents them from moving through the birth canal and requires a cesarean section.Their lungs are undeveloped – due to the pressure of the kidneys and due to the compression associated with the lack of water. They cannot breathe. They live from a few minutes to several months on an artificial respirator. They have high blood pressure. They have a “Potter face” – not to be confused with your favorite hero. Potter’s face is shaped by the lack of water. A flattened nose, wide-set narrow eyes, deformed auricles.

But our daughter is so beautiful. She is very beautiful.

I am calling the doctor who consulted me at the V.F. Snegireva. I’m talking about huge kidneys and about polycystic disease. And about the fact that I may have to terminate the pregnancy.

“This is a very serious diagnosis,” he says. “And interruption is a serious procedure.
– Yes, I know. What should I do? When should I come to you?
– I don’t see much point in coming to me now. You could consult with perinatologists. For example, in the Filatovskaya hospital. But in general, if the diagnosis is confirmed, then the prognosis for life is unfavorable.I would advise you to contact the antenatal clinic as soon as possible. Now time is working against you. The term is long. The antenatal clinic gives permission to interrupt.
– If I get this permission, will I be able to terminate the pregnancy at your clinic?

So far, he has spoken to me in a gentle and compassionate manner. After this question, something in his tone changes. As if I suggested that he do something dirty and perverted together with me.

– No, we don’t. We don’t do that kind of thing.

I call a few more clinics and maternity hospitals with a good reputation, paid and free. They don’t do that kind of stuff either. “And what kind of” such “?” – “How what? Long-term abortions! ” – “But this is according to medical indications!” – “So contact the antenatal clinic.” And I also ask if they are pregnant with such defects. On a paid basis. If I, for example, decide to inform the child. But they don’t do that sort of thing either. In one of the clinics they tell me indignantly:

– Are you a woman ?! How do you imagine that? We have pregnant women here! Looking at you, they will freak out!

They have pregnant women here.Pregnant women. They are here to deal with pregnant women and their babies, and not with any pathological abomination. They control their weight and the composition of their blood and the beating of their hearts. But if something goes wrong, if the work of the primary cilia in the cells of the epithelium of the renal tubules is impaired, if the parenchyma degenerates into cysts, if the prognosis is unfavorable, if such children do not survive, then the paunch turns into a fetus with a defect, into a rotten pumpkin; the pregnant woman turns into a rat. All these clinics. With balloons, with magazines “Your Baby”, with photographs of babies, with bras for expectant mothers.They are not for rats.

Let the rats go through the back door. Let the rats swarm in the basement. The one who is waiting for the baby comes in through the front door. The expectant mother comes in through the front door.

And I’m not waiting, I’m not expecting anyone.I’m just a rat. And my future is spelled out in the instructions of the Sanitary and Epidemiological Surveillance.

The advantage of a pregnant journalist over a pregnant non-journalist is that a pregnant journalist is able to quickly gather information, even when he is in complete despair and is covered with snot. In just a couple of hours of research, I find out that late termination of pregnancy is done in strictly specialized institutions for medical or social reasons. That these institutions are mainly obstetric and gynecological hospitals at certain hospitals.Such hospitals accept pregnant and non-pregnant women, including those with viral infections, with purulent-septic lesions, with inflammatory diseases of the genital tract, with chronic urogenital infection, after undergoing clandestine abortions, without registration, without an exchange card, without a fixed place of residence. Late abortion for social reasons is a case of women suffering from drug addiction, alcoholism, mental disorders, financially needy, “without a breadwinner”.Late abortion for medical reasons is my case. Threat to the mother’s life or severe malformations of the fetus. You can get a referral to such an institution only at the antenatal clinic at your place of residence.

In Moscow, “such an institution” is, for example, an obstetric hospital at the 36th city hospital. It is located in the Sokolinaya Gora region. If you are a man or a woman who has never been in a position, you may not know that Falcon Mountain loves to scare negligent pregnant women.”Here you come irregularly, here we will not fill out an exchange card for you, and you will give birth on Sokolinaya Gora with homeless people.” In my first pregnancy, they told me so in the antenatal clinic. True, in the second pregnancy, which needs to be terminated, they will tell me something completely different. That there, in the hospital on Sokolinaya Gora, specially trained doctors, professionals and masters of their craft. They and only they are able to terminate a pregnancy for a long time. This requires real skill. After all, it’s a dangerous business. Suddenly something goes wrong.Bleeding. Or the uterus will have to be removed.

And of course, what a research without reading reviews and discussions on the forums. I’ve read hundreds, maybe thousands. It’s a whole world.

These are the rat king’s troops who lost the battle. The mutilated, bleeding, retreating with a hiss and cry into their underground burrows …

Lyolya When on July 20 I experienced an artificial birth on honey. My boy’s testimony was diagnosed with Arnold Chiari Syndrome, I learned what PAIN is.When it is scary to close your eyes, when it is impossible to look at other children, you become like an open wound that constantly bleeds. I had a long period of 26 weeks, I was stimulated for 7 days, kelp was inserted, injections were injected. the son was alive and kicked very hard. When the bladder was pierced and the water receded, my stomach took its shape and I could feel the heartbeat of the fetus with my hand. Then I began to lose a lot of blood, I don’t know why the labor activity stopped altogether, and then it was decided to carry out an abortion.He was cut into pieces alive inside me and removed.

Guest moms who do such terrible things are just bitches … …

Olga Thank God I did not go through this horror, but I can say with confidence that a child should live as long as God gave him! not doctors. Let him live 1 hour, 1 minute, but you will know that you did not kill him

From an article on the website “Female Doctor”: For interruption, the hormone prostaglandin is taken, which causes contractions and slow dilatation of the cervix.This process is very long and painful. Much more often in the later stages, “artificial childbirth” is carried out using the drug mifepristone and a prostaglandin analog. Another method of “artificial childbirth” is saline abortion, or “filling” *. Liquid is pumped out of the fetal bladder with a needle and saline is injected. After a while, the fetus dies from chemical burns and cerebral hemorrhage. Over the next two days, the dead body is removed from the woman’s body. Sometimes it happens that a child is born alive, in which case he is given an injection of potassium chloride, which causes cardiac arrest.

* As far as I know, “filling” is not used now in Russia – at least in large cities. Nevertheless, this is a very common “scarecrow” both on the Internet and in antenatal clinics.

From an article on Allwomans.ru : Doctors call such a fruit “candy”, since the child’s skin becomes thinner and bright red under the influence of a saline solution. The dead fetus is removed after 24–48 hours.

Maxim In my life I would not agree to this! Some women cannot have children, while others do such atrocities! Poor children, not yet born, already exhausted and dead!

Katya L. I am 20 years old, the pregnancy was desired. I don’t drink. I don’t smoke. vices incompatible with life spina bifida, fluid accumulates in the brain, the body is a banana, a split in the dorsal sacral region, and something with one foot. I lost the meaning of life, went to the hospital and put pills every 3 hours. They started from 9 in the morning at 17, unbearable pains began, they said to put candles so that the uterus would weaken, and they only carried me from the ward at 21:20, they took me from the ward to give birth, they pierced a bubble of water, they moved away and gave birth to a girl (she was dead) and the placenta itself was born then anesthesia I don’t know why.GOD DON’T GIVE anyone to go through this I sit reading and roar the psyche is very disturbed there is no one who does not want to communicate wants to die.

olga A common thread runs through the phrase: “What have I experienced …”, notice the emphasis on the word I! You do not want to let your “inferior” child live, because first of all you yourself do not want to experience suffering to see and understand that he will die! But at the same time, let it be hard, but agree with the decision to dissolve it inside yourself in a saline solution … You regret, first of all, Yourself!

Saturnina I cannot respect those who killed living children.Want more kids? And what kind of mothers will you be to them? With you there will be only condemnation and shame that killed their children.

For several hours I plunge headlong into this black obstetrician-gynecological subspace. And even then, when I seem to emerge, I am drawn back all the time. Nothing in the world interests me more than these pathological reports from hell. In our everyday vocabulary with the Elder, the expression “read about horrors” even appears.

– Are you reading about horror again?
– Yes.
– Why?
– To know.

I am reading about the possible consequences of “artificial childbirth” for health (this is a whole bunch, from infections and bleeding to complete loss of fertility in the future).

I read about “cleaning”, which is also called “scraping” – both words are disgusting. Cleaning is done at the very end, under anesthesia, regardless of whether there are any fragments of the placenta left in the uterus, just in case. Cleaning is sometimes done several times, because they clean it with a curette blindly, without ultrasound control, and something still remains.I’m afraid of anesthesia. I’m afraid of scraping. I’m afraid of the curette. I’m afraid of all these words. I don’t want to be scraped and cleaned with a sharp curette.

I read about saline abortions and candy babies.

I read stories of women who held the dead bodies of their belly-dwellers in their hands.

I read stories of women whose families fell apart after “artificial childbirth”.

I read stories of women who never find peace.

I read the questions “for what?”, And “how to live now?”, And “is it possible that this is a mistake of doctors?”

I read condolence comments and angry denunciations.

I read confessions and sermons.

I do not know why I am reading all this, because I already have a sea of ​​information. Probably, I just want to constantly receive confirmation that I am not the only one. That there is a whole huge basement of the same rats like me, and they all squeal in pain and fear.

Trolls are imprisoned together with the rats in the basement. Those who write about infanticide, and about a barrel of brine waiting in hell, and about God, who alone decides who lives and who dies.

In general, God in such forums exists in two persons. The punishing God is the one who will plunge everyone into sodium chloride for such things in due time – and the God of the Expert Class. The God of the Expert Class (as well as his deputies – matronushka, father) is able to correct poor ultrasound results, heal chromosomal abnormalities and refute diagnoses.

Of course, in a situation where there is only hope for a miracle, turning to a higher authority is quite natural. Personally, I am an agnostic, but if I were a believer, if I had no doubt that someone upstairs hears me, prayer would bring me relief.Belief in a miracle is natural. Prayer is natural. It is unnatural when prayer and medicine, diagnosis and faith interchange each other. When advice regarding fetal malformations comes from the father. “Doctors send for an interruption; the child has no brain. How can I help the baby?” – “Do not listen to the doctors, go to the matronushka …” This is how desperate and maddened you have to go.

Guest Go to the priest and ask whether to terminate the pregnancy or not.

alfina shouted to the entire clinic that I would hang myself.I’m going to kill my child, myself! she was in pain, very painful. I didn’t feel her anymore … I go to the gencologist for an appointment and, oh GOD, do not clean up, again the hospital. cleanup. tears. no patience. just a walking corpse. then there will still be a cyst, but how did I want? kill the child and that’s it? live peacefully on?

Mikhailovna You are murderers, my girls. This is the same murder as going up to a sick child, an old man on the street and nailing him down – which suffers and infects others. Any alcoholic with many children is better than you.Instead of delivering your blood, your pain, giving birth, doing everything possible to save the crumbs, christening, or, God forbid, close his eyes and bury him in a Christian way, you give him to the organs and to rejuvenating creams for aging ladies. No wonder the nurses treat you with disdain. I would sterilize you. P.S. And you yourself will visit the barrel with the salt brine. At the end of this life.

What, again, is the peculiarity of a journalist with a pathology of pregnancy, and not, say, an artist – a Russian-speaking basement with rats is not enough for him, and for a complete picture he also needs to get into an English-speaking one.I’m climbing.

… On the English forums, of course, there is also God, but he is a little different. Not a punishing and not an expert, but something like a cozy warm cat – or, in extreme cases, a mother. He is at home, he comforts and, by virtue of his abilities, shows concern. You can even be offended or angry with him for the fact that he performed his functions poorly. On the forums dedicated to developmental disabilities, there are even separate topics like “Our relationship with God after the loss.”

In addition to God, another character constantly appears there – a psychologist.As a matter of course for such a situation. And not as a last resort, which you resort to, only if you finally go crazy.

In general, English-language thematic forums are much less like a basement. First of all, because an amazing order reigns there, all suffering, as well as mutations, are clearly arranged on the shelves. There is, for example, a popular site with the monstrous soap opera name A Heartbreaking Choice . The left column contains a list of various developmental disorders: anencephaly, congenital brain defects, congenital heart defects, hydrocephalus, Potter’s syndrome (including my case), spina bifida, trisomy 13, trisomy 18, trisomy 21 (down), etc.You click on the right one – you read heartbreaking stories on the topic. There are tons of websites dedicated exclusively to one particular violation. Do you want to “talk about it”? – you go to the discussion section on the site. And you follow certain rituals and rules.

The main rule: if you are, for example, a religious fanatic, a network troll, or you just have your own personal opinion about the inadmissibility of a late abortion, or you accidentally discovered that there is a direct connection between a pregnancy termination on medical grounds and a hell of a fire, – you politely, in large print, warn you not to speak out on the forum.Because here are women who are experiencing loss and who are in pain, and they should not be upset. Because you will be immediately banned anyway – and at best, everything will be limited to that. In the worst case, you will be sued for causing psychological harm. Do you want to go to court? Create your own Fiery Gehenna Discussion Club and enjoy life.

I have never met a single aggressive idiot with his own opinion in the genre of “mother-killers” in any thematic English-language forum.Not because there are no aggressive idiots in the USA, Canada or Australia – there are no less of them than here – but because there are rules.

Therefore, “their” discussion of malformations and abortion is a form of psychotherapy. And “ours” are a form of self-torture.

Well, about rituals. One of the obligatory rituals on English-speaking forums: any personal outpouring in response to someone else’s outpouring is preceded by one simple phrase: I am sorry for your loss. I sympathize with your loss.

Maybe you don’t really sympathize with anyone.Maybe you only think about your head of grief. But you still take and drive in a simple phrase. Just to avoid feeling like a rat in the basement.

90,000 37-40 weeks of gestation

37th week of pregnancy for a baby

At the 37th week of pregnancy, the baby’s height is approximately 48 cm, and its weight is 2,600 g. Outwardly, the fetus hardly differs from the newborn, all facial features are developed, and cartilaginous tissues are pronounced.The accumulation of subcutaneous fat during this period of pregnancy makes the outline of the body softer and rounder. The baby’s skin is gradually smoothed, it is no longer as pink as in the previous weeks of intrauterine development, the integument gradually lightens. The baby’s body is still abundantly covered with grease, but the amount of the cannon is noticeably reduced, the cannon hair remains only on the shoulders and back, in some babies it disappears almost completely.

The accumulation of fatty tissue continues this week.It reaches a maximum rate of 15% of the child’s total body weight. It is difficult to overestimate the importance of adipose tissue for newborns, it is it that protects the child from overheating or hypothermia, since the baby’s thermoregulation system after childbirth is not yet sufficiently formed and continues to develop in the first months of a small person’s life.

At this time, not only the volume of subcutaneous fat increases, muscles and skeleton also develop intensively. The child constantly moves his arms and legs.This kind of workout helps to increase muscle mass. Also, the baby makes rhythmic breathing movements that strengthen the intercostal muscles and the diaphragm, prepare the respiratory system for childbirth.

Pregnant woman at 37 weeks

As the due date approaches, pregnant women begin to notice the appearance of their precursors, that is, certain signs, changes that occur under the influence of hormones. The woman’s body is preparing to give birth to a child, progesterone gives way to the dominant role of the hormone of childbirth estrogen, the state of health of the pregnant woman changes.

From the 37th week, expectant mothers can observe the following changes:

• slight decrease in body weight;
• reduction in the volume of the abdomen;
• the appearance of training or “false” contractions and the increase in their intensity;
• discharge of mucus from the cervix.

The character of the stool changes, it loosens, aching lower back pains of varying intensity may appear, the fundus of the uterus sinks. The woman notes some signs on her own, others are observed by the gynecologist during a routine examination.

Harbingers do not appear in all women. Some expectant mothers note only some of the symptoms listed above, while others observe signs of an impending birth not two or three weeks before their date, but just a few hours. Both the appearance of precursors at the 37th week, and their absence is a variant of the norm and depends on the individual characteristics of the woman’s body.

This week there is an intensive preparation of the female body for the birth of a child. If the fetus is positioned correctly, head down, it gradually descends, goes to the lower part of the uterus, presses against the body and bends the limbs, intuitively taking the most comfortable position for passing the birth canal.The consequence of the movement of the fetus is the lowering of the fundus of the uterus. The abdomen drops, the pressure on the diaphragm is significantly reduced, the pregnant woman can breathe easily, the shortness of breath that had followed her in the previous weeks disappears. The pressure on the stomach also decreases, heartburn, a feeling of heaviness after eating and other unpleasant sensations disappear. Moving the baby can put pressure on the bowels and bladder. A pregnant woman at this time often has the urge to urinate, may suffer from frequent loose stools.The reason for frequent bowel movements is not only the mechanical effect of the uterus on it, but also an increase in the content of estrogens in the body, hormones that contribute to the excretion of fluid. At the 37th week, the expectant mother can empty the intestines up to 3-4 times a day and at the same time observe a significant liquefaction of feces.

38th week of pregnancy: development of the unborn baby

At the 38th week, the fetus is fully formed, so childbirth at this time is no longer dangerous for both the mother and the baby.The weight of the fetus is about 3 kg, however, this indicator can differ significantly for different babies, the weight depends on the individual characteristics of the mother and child, the characteristics of the body structure and other factors. The body length of a newborn is approximately 50 cm.

All organs and systems for a period of 38 weeks are distinguished by physiological and morphological maturity, they are completely ready for work. At this time, the child prepares for childbirth, makes breathing movements and prepares the intercostal muscles for breathing.The tissues of the lungs are washed with amniotic fluid, which helps to maintain the correct level of surfactant that covers the lungs of the infant from the inside. All elements of the respiratory system are ready for use. With the first breath after birth, the alveoli begin to transfer oxygen from the air to the blood, gas exchange occurs, the respiratory and circulatory systems begin to work intensively.

Pregnant woman

The body of a pregnant woman continues to actively prepare for the birth of a baby, the content of estrogen is rapidly increasing, and the level of progesterone is significantly reduced.Changes in hormonal levels contribute to the softening of the tissues of the birth canal and cervix. Throughout pregnancy, the lumen of the cervical canal is closed by a plug of thick mucus, which protects the baby from infection, and the uterine cavity protects against the penetration of microorganisms dangerous to health. In the last weeks of pregnancy, the consistency of mucus changes, it becomes more liquid and begins to gradually flow out. In some women, mucus leaves gradually, while in other women in labor at the same time.The discharge resembles in its consistency and appearance a colorless egg white. Sometimes the mucus is pinkish, brownish, or yellow. Removal of the plug is painless, a woman may experience a slight feeling of discomfort in the lower abdomen. More abundant vaginal discharge than during the entire pregnancy can signal the passage of the plug.

A woman should carefully monitor the color and volume of discharge, since too abundant colorless discharge can indicate not only the passage of the cork, but also act as one of the symptoms of amniotic fluid leakage.Indicator strips and amniotests or test strips can help determine the cause of the discharge. Pads are sold in many pharmacies and can be easily used at home. If leakage of amniotic fluid is confirmed, you should immediately consult a doctor.

After the mucous plug comes off, you should refuse to visit the pool and swim in open reservoirs, since the risk of infection of the child significantly increases. It is also necessary to exclude sexual intercourse.

39th week of pregnancy: what happens to the fetus?

At the 39th week, the child’s weight reaches 3,100-3,500 g, and his height is 50-52 cm. Growth and weight indicators are very relative and can differ significantly. The kid is rapidly preparing for the most important test in his life – birth, which requires endurance and considerable effort. During this period of pregnancy, the size and weight of the child’s adrenal glands, that is, the glands of the endocrine system, which are responsible for the human body’s response to stress factors, increase.It is the hormones adrenaline and norepinephrine produced by the adrenal glands that help the child adapt as quickly as possible to new temperature conditions, tactile, sound and light impulses.

All senses of the child are developed at 39 weeks. Within a few moments after birth, the baby can focus his gaze, he reacts to bright light and moving objects, many scientists say that newborns distinguish colors, see the faces of parents and doctors. The baby’s hearing in the last weeks of intrauterine life is also fully developed; after birth, he reacts to loud sounds and noise.A newborn baby is able to identify the main shades of taste, recognize sour, bitter, sweet and salty.

In the womb, the baby is in an aquatic environment that minimizes contact. Immediately after birth, the baby experiences many tactile sensations, in contrast to intrauterine life, he feels the touch of his mother’s hands and diapers, towels, dressings and other materials. Babies especially like the touch of skin to skin, therefore, in a modern maternity hospital, newborns are necessarily laid out on their mother’s belly even before the umbilical cord is cut.The child adapts more easily to the new environment, feels protected. Laying out the child has not only a psychological aspect, since it promotes the colonization of microorganisms from the mother’s skin to the skin and mucous membranes of the baby, and increases his immunity.

Pregnant woman

In the last weeks of pregnancy, the expectant mother seeks to prepare the apartment or house as much as possible for the appearance of a new family member. Scientists call this sign of impending labor the nesting syndrome.Many women observe signs of the syndrome from the thirtieth week of pregnancy, however, nesting reaches its maximum point at 39-40 weeks. Pregnant women strive to do general cleaning and repairs, re-glue the wallpaper and acquire many new things that, in their opinion, are simply necessary in the house. After giving birth, many purchases are perplexing. The reason for this behavior is an increase in the level of adrenaline and norepinephrine in the body. These hormones are produced by the adrenal glands, they are necessary not only for the woman, but also for the baby to prepare for the upcoming birth.

40th week of pregnancy: how is the baby developing?

40 weeks – full-term pregnancy. The weight of a child who was born at this time ranges from 2,600 g to 4,400 g, and his body length is 48-53 cm. These indicators are very conditional, since at a period of 40 weeks, miniature babies weighing 2,600 g and real heroes are born, whose body weight is approaching 5000 g. The body length of newborns can also vary from 45 to 55 cm.

Most women give birth at 40 weeks.At this time, the baby is completely ready for birth, he meets all the parameters of a full-term baby. Before giving birth, the child closely presses the arms and legs to the body, flexes the head as much as possible and presses against the exit from the uterus. This position allows you to make it possible to pass the birth canal with the narrowest part of the skull. In the course of labor activity, with each contraction, the child gradually moves downward, he does not move in a straight line, but makes helical-translational movements, as if screwing into the birth canal of the mother.In the course of the advancement of the newborn, the complete ptosis of its head, the cervix of the uterus fully opens. This is followed by attempts, that is, contractions of the uterus, which move the child along the birth canal. Gradually, the baby’s head is shown, followed by his torso. Childbirth is a complex mechanism that is aimed not only at the safe passage of the birth canal by the child, protecting him from accidental injuries due to increased pressure, but also at preventing rupture of the woman’s soft tissues.

Pregnant woman

The long wait for a meeting with your unborn child is nearing the end, it is the 40th week of pregnancy that turns out to be the last for most women.Every day, the anxiety of the expectant mother increases, a long wait affects her mood and well-being. Women strive to give birth to a child as soon as possible so that pregnancy and painful contractions are a thing of the past. Every pregnant woman dreams of meeting her baby, wants to press him to her breast and stroke the delicate head.

Many women, especially primiparous women, fear that labor will begin imperceptibly, but such cases are extremely rare.A woman feels the onset of labor, feels regular contractions, which are repeated at regular intervals and gradually increase, the time interval between them decreases.

Contractions may be preceded by prenatal rupture of amniotic fluid, which occurs in a certain percentage of women in labor. After the water has drained away, the contractions may be quite weak or completely absent. Regardless of the intensity of contractions, the outpouring of water is one of the signs of the onset of labor and requires immediate treatment to specialists, hospitalization of a woman in a maternity hospital or hospital, since when the water flows out, the integrity of the bladder is violated and the risk of microorganisms that are dangerous to the child’s health increases.It is important that after the water has passed, the baby is born within a maximum of 10-12 hours.

A pregnant woman should properly tune in to childbirth, concentrate on the desired result and believe in her own strength, to fulfill the task assigned to her by nature. The correct psychological attitude and theoretical knowledge will help a woman become a mother, successfully go through all stages of childbirth and press the long-awaited child to her heart.

90,000 Unsafe abortion

Abortion is safe when performed by suitably qualified personnel using WHO recommended methods appropriate for gestational age.This termination of pregnancy can be done with medication (medical abortion) or a simple outpatient procedure.

Abortion is unsafe if it is performed either by unskilled persons, conditions that do not meet minimum medical standards, or both. The personnel, qualifications and medical standards considered safe for induced abortion are different for medical abortion (which is carried out exclusively with medication) and surgical abortion (which is performed using a manual or electric aspirator).In addition, the qualifications and medical standards required to conduct a safe abortion depend on the duration of pregnancy and scientific advances.

• Abortion is less safe if it is performed with outdated methods, such as curettage, even if staff are appropriately qualified, or if women using medication do not have access to adequate information or the ability to consult a qualified professional when needed.
• Abortion is dangerous or least safe if it is associated with the ingestion of caustic substances, or if unskilled personnel use dangerous methods, such as the introduction of foreign objects or the use of concoctions prepared according to recipes of traditional medicine.

Women, including adolescent girls, who have an unplanned pregnancy often resort to unsafe abortion if they do not have access to a safe abortion. Barriers to safe abortion include:

• restrictive laws;
• limited choice of services;
• high cost;
• stigma;
• Belief-dictated refusal by health-care providers to perform abortion;
• unnecessary requirements such as mandatory waiting periods, mandatory counseling, misleading information, third party authorization, and medically unnecessary tests delaying medical care.

Magnitude of the problem

According to data for 2010-2014, about 45% of all abortions in the world were unsafe (2).

One third of all unsafe abortions were performed in the least safe conditions, that is, by unskilled persons using hazardous and invasive methods (2).

In Latin America and Africa, most (about 3 out of 4) abortions are unsafe.

An estimated 7 million women per year in developing countries alone were treated in hospitals for complications of unsafe abortion in 2012 (4).

From 4.7% to 13.2% of annual maternal deaths may be associated with unsafe abortion (3). In developed parts of the world, it is estimated that for every 100,000 unsafe abortions, there are 30 female deaths. That number stands at 220 deaths per 100,000 unsafe abortions in developing regions and 520 deaths per 100,000 unsafe abortions in sub-Saharan Africa.

In Africa, almost half of all abortions are performed in the least safe conditions.In Africa, the death rate of women from unsafe abortion is disproportionately high. While this continent accounts for 29% of all unsafe abortions, it accounts for 62% of all deaths associated with unsafe abortion (2).

Who is at risk?

Any woman with an unplanned pregnancy who is denied access to a safe abortion is at risk of an unsafe abortion. Unsafe abortion is more likely to threaten women living in low-income countries and women from disadvantaged backgrounds.Mortality and injury rates are higher when unsafe abortion is performed late in pregnancy. The proportion of unsafe abortions is higher where access to effective contraception and safe abortion is limited or impossible.

Complications of unsafe abortion that require urgent medical attention

After unsafe abortion, women can experience a range of negative consequences that affect their well-being and quality of life, and some women develop life-threatening complications.The most serious and life-threatening complications of the least safe abortion include bleeding, infections, and trauma to the genital tract and internal organs. In particular, unsafe abortions performed in the least safe conditions can lead to the following complications:

• incomplete abortion (incomplete removal or expulsion of the ovum from the uterus)
• bleeding (profuse blood loss)
• infection
• uterine perforation (caused by uterine lancing) with a sharp object)
• Damage to the genital tract and internal organs due to the introduction of dangerous objects into the vagina or anus, such as rods, knitting needles or glass shards.

Signs and symptoms

Careful initial assessment is critical to ensure proper treatment and prompt referral for complications from unsafe abortion. Critical signs and symptoms of complications that require immediate action include:

• Abnormal vaginal bleeding
• Abdominal pain
• Infection
• Shock (collapse of the circulatory system).

Complications of unsafe abortion can be difficult to diagnose. For example, women with an ectopic or ectopic pregnancy (abnormal development of a fertilized egg outside the uterus) may experience symptoms similar to those of incomplete abortion. Therefore, it is very important that health workers are ready to refer these women to specialists and arrange for their transportation to a facility where a definitive diagnosis can be made and the necessary medical care quickly provided.

Treatment and care

Complications of unsafe abortion and their treatment include the following situations:

• Bleeding: It is imperative to stop the profuse blood loss in a timely manner, as delay can be fatal.
• Infection: immediate antibiotic treatment and removal of the remains of the ovum from the uterus.
• Injuries to the genital tract and / or internal organs: If suspected, women should be referred to the appropriate level of care as soon as possible.

Access to treatment for complications of abortion

Health care providers have a responsibility to provide life-saving care to all women who develop abortion-related complications, including treatment for complications from unsafe abortion, regardless of the legal status of the abortion. However, in some cases, abortion complications are only treated if the woman provides information about the person (s) who performed the illegal abortion.

The practice of obtaining confessions from women seeking emergency medical care in connection with the consequences of illegal abortion endangers their lives. The legal requirement for doctors and other health workers to report women who have had an abortion results in delays in health care and increases risks to women’s health and lives. UN human rights standards call on countries to ensure that treatment is provided promptly and unconditionally to everyone who seeks emergency medical care (7).

Prevention and control

The means of preventing unsafe abortion include:

• comprehensive sex education;
• Prevention of unplanned pregnancy with effective contraception, including emergency contraception; and
• providing safe legal abortion.

In addition, the number of deaths and disabilities due to unsafe abortion can be reduced by providing timely emergency treatment for complications (6).

Economic Impact

In addition to death and disability from unsafe abortion, there are significant social and financial costs to women, families, communities and health systems. An estimated US $ 553 million was spent in 2006 to treat the serious consequences of unsafe abortion (4). An additional US $ 375 million will be required to fully meet the unmet need for treatment of complications of unsafe abortion (4).

WHO work

Evidence-based resources

WHO provides global technical and policy guidance on the use of contraception to prevent unintended pregnancy, provide safe abortion and manage complications of unsafe abortion.In 2012, WHO published updated technical and policy guidance on safe abortion. The WHO guidelines for safe abortion are contained in the following publications:

An interactive online database containing comprehensive information on abortion legislation, policy, health standards and guidelines for all countries, available at: https: //abortion-policies.srhr .org.

Provide technical support to countries

Upon request, WHO provides technical support to countries to adapt sexual and reproductive health recommendations to their specific conditions, and to strengthen national policies and programs related to contraception and safe interruption services pregnancy.

Research

WHO is a co-founder of the UNDP / UNFPA / UNICEF / WHO / World Bank Special Program for Research, Development and Research Training in Human Reproduction, which carries out research in clinical care and implementation research on community and health system prevention of unsafe abortion. In addition, WHO monitors the global burden of unsafe abortion and its consequences.

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(1) Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C, Kwok L, Alkema L. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Glob Health. 2020 Sep; 8 (9): e1152-e1161. doi: 10.1016 / S2214-109X (20) 30315-6.

(2) Ganatra B, Gerdts C, Rossier C, Johnson Jr B R, Tuncalp Ö, Assifi A, Sedgh G, Singh S, Bankole A, Popinchalk A, Bearak J, Kang Z, Alkema L.Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. The Lancet. 2017 Sep

(3) Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun; 2 (6): e323-33.

(4) Singh S, Maddow-Zimet I. Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries.BJOG 2015; published online Aug 19. DOI: 10.1111 / 1471-0528.13552.

(5) Vlassoff et al. Economic impact of unsafe abortion-related morbidity and mortality: evidence and estimation challenges. Brighton, Institute of Development Studies, 2008 (IDS Research Reports 59).

(6) L Haddad. Unsafe Abortion: Unnecessary Maternal Mortality. Rev Obstet Gynecol. 2009 Spring; 2 (2): 122-126.

(7) Human Rights Committee; Committee against Torture; Committee on the Elimination of Discrimination against Women.

Uterine fibroids during pregnancy

Uterine fibroids during pregnancy is a voluminous benign neoplasm that develops in the tissue of the uterine wall – the myometrium. The tumor looks like one or more round white balls with a hard rubber texture.

Why a neoplasm occurs

According to most gynecologists, the predisposing factors for the onset of this disease are:

• heredity.Most of the women diagnosed with fibroids before the age of 30 have a burdened heredity, and their mothers were diagnosed with a tumor during menopause;
• hormonal disruptions. An imbalance of sex hormones, which is observed in diseases of the ovaries (cysts, adnexitis), endocrine disorders (type 1 and 2 diabetes, thyroid pathologies), overweight, can provoke tumor growth;
• Post-traumatic changes in the fibers of the smooth muscles of the uterus after abortion, surgery, diagnostic curettage often cause pathological activity of myometrial cells;
• Other growth factors – early onset of menstruation, use of contraceptives, vitamin D deficiency in the body, smoking, beer abuse.

Uterine fibroids during early pregnancy can grow significantly, the cause of which is a change in the level of sex hormones in the first 8 weeks of pregnancy. Psychological reactions can play a role, especially in nervous and suspicious women.

Symptoms and effects on pregnancy

Often, the disease proceeds completely without symptoms, and a woman learns about it only during a routine examination by a gynecologist. In the presence of a large tumor, a pain syndrome may appear, especially during intercourse, a feeling of discomfort and heaviness in the lower abdomen.Frequent urination, swelling of the legs, constipation, the appearance of hemorrhoids, which many women associate with their position, can also be a manifestation of a neoplasm.

Is pregnancy possible with uterine fibroids is a question that worries every woman who finds out about her diagnosis. A large tumor on the outer surface of the uterus can interfere with the passage of the egg through the tubes, and the woman will not become pregnant. If the neoplasm is small, it does not affect the possibility of conception.

Attention! Even if the detected fibroid is very small, it is possible that when the level of hormones changes in the early stages of pregnancy, it can begin to grow and provoke a miscarriage. Therefore, when planning to give birth to a child, it is better to undergo a course of treatment.

While waiting for the baby, fibroids can cause complications. It all depends on how large the node is and where it is located. In the first trimester, the tumor can grow significantly and create problems for the mother and fetus.The size of uterine fibroids during pregnancy can range from a pea to the size of a 9-month-old fetus.

It is interesting! Uterine fibroids after pregnancy can significantly decrease or completely disappear due to the normalization of hormonal levels.

Complaints of pregnant women, which may be associated with the presence of a neoplasm:

• pain in the abdomen, back, or pelvic area. Their cause may be uterine fibroids;

• frequent painful urination;

• constipation and bloating.

Fibroids of the cervix can block urination and cause urinary retention and kidney failure.

According to gynecologists, in the early stages of fibroids can provoke miscarriage, bleeding, placental abruption. At a later date, cause premature birth.

Therefore, it is better not to risk it, but to carry out a course of treatment. You will minimize the risks for yourself and your unborn child.

Treatment of a tumor in pregnant women

It is best to complete your treatment a few months before planning to conceive. Hormone therapy is usually given to reduce the swelling. If it does not work, an alternative would be myomectomy – removal of the tumor. Pregnancy after removal of uterine fibroids occurs without problems and proceeds without complications.

It is good to be treated in advance, but you cannot foresee everything. What if you found out about your disease during a routine examination, already being pregnant?

If the tumor is causing problems, symptomatic therapy is given.Pain syndrome is eliminated with non-steroidal anti-inflammatory drugs. Removal of uterine fibroids during pregnancy is an extreme measure that they are trying to avoid.

For the treatment of fibroids before and while waiting for the child, you do not need to go to the capital’s clinics. It is now available in your area as well. Qualified doctors of the 100med center will help you!

90,000 Is it safer to induce labor immediately or wait if the mother has high but not persistent high blood pressure after 34 weeks of pregnancy?

What is the problem?

Women with high blood pressure (hypertension) during pregnancy or if they develop preeclampsia (high blood pressure with protein in the urine, or other organs and organs involved, or both) can develop serious complications.Possible complications in the mother are worsening of preeclampsia, development of seizures and eclampsia, HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count), placental abruption, liver failure, renal failure, and breathing problems due to fluid accumulation in the lungs …

Childbirth usually prevents an increase in hypertension, but a baby born prematurely has other health problems, such as breathing problems due to immaturity of the lungs.Inducing labor can lead to overstimulation of contractions and fetal distress syndrome. Another option is to wait for a natural birth, carefully observing the condition of the mother and child.

Why is it important?

Since there are benefits and risks to both planned early delivery and expectant management, where the mother has high blood pressure towards the end of pregnancy, we wanted to know which tactic is the safest.We reviewed clinical trials comparing planned early labor by induction of labor or caesarean section versus expectant management.

What evidence have we found?

We searched for evidence as of January 12, 2016 and found five randomized trials involving 1819 women. The two studies were large and high quality, involving 704 women with hypertension during pregnancy, mild preeclampsia or worsening existing hypertension at 34-37 weeks, and 756 pregnant women with hypertension or mild preeclampsia at 36-41 weeks …Few women who had planned early births experienced serious adverse outcomes (1,459 women, high-quality evidence). There was insufficient information to draw any conclusions about the number of infants born in poor health conditions and there was a high level of variability between the two studies (1495 infants, low quality of evidence). No difference was found between early planned labor and delayed labor in terms of the number of caesarean sections (four studies, 1728 women, moderate quality evidence), or length of hospital stay for mothers postpartum (two studies, 925 women, moderate quality evidence) (or child (one study, 756 infants, moderate quality of evidence).

Most of the children born prematurely had respiratory problems (respiratory distress syndrome, three studies, 1511 infants) or were admitted to the neonatal ward (four studies, 1585 infants). A small number of women who gave birth prematurely developed HELLP syndrome (three studies, 1628 women) or severe kidney problems (one study, 100 women).

Two studies compared women with preterm labor at 34-36 weeks and 34-37 weeks with a comparison group that was observed up to 37 weeks, when labor was induced artificially if it did not start spontaneously.Three studies compared women with induced labor with normal or near-normal gestation at 37 completed weeks and between 36 and 41 weeks and women followed up to 41 weeks when induced labor was they did not start spontaneously. Inclusion and exclusion criteria also differed across the five studies.

Information regarding which study group the women belonged to was not hidden from both women and clinicians.Women and staff were aware of this intervention, which could have implications for care and decision-making. Most of the evidence was of moderate quality, so we can be relatively confident in the results.

What does this mean?

Overall, if labor was triggered immediately after 34 weeks of gestation, the risk of complications for the mother was lower and overall there was no obvious difference in the incidence of complications for the baby, but information was limited.