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Bleeding in sixth month of pregnancy. Second Trimester Pregnancy: Recognizing Normal vs. Concerning Symptoms

What are the common symptoms during the second trimester of pregnancy. How to differentiate between normal discomforts and serious complications. When should you seek medical attention during pregnancy.

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Understanding Second Trimester Symptoms: Pain, Bleeding, and Discharge

The second trimester of pregnancy, typically spanning weeks 13 to 26, is often considered the most comfortable period for many expectant mothers. However, it’s crucial to be aware of various symptoms that may occur during this time. While some discomfort is normal, certain signs warrant immediate medical attention.

Normal Second Trimester Symptoms

  • Mild abdominal pain or discomfort
  • Occasional spotting or very light bleeding
  • Increased vaginal discharge
  • Back pain
  • Headaches
  • Leg cramps
  • Hand pain

These symptoms are generally not cause for alarm but should be monitored and discussed with your healthcare provider during regular check-ups.

Recognizing Emergency Symptoms During Pregnancy

While most second trimester symptoms are benign, some require immediate medical attention. Recognizing these signs can be crucial for the health of both mother and baby.

Symptoms of Miscarriage

A miscarriage is the loss of a pregnancy before the 20th week. Symptoms that may indicate a miscarriage include:

  • Heavy vaginal bleeding (soaking more than one menstrual pad)
  • Severe abdominal or pelvic pain
  • Passing clots or tissue (usually gray or pink)

If you experience these symptoms, seek emergency medical care immediately. If possible, save any passed tissue for medical analysis.

Types of Miscarriage

  1. Threatened miscarriage: Bleeding before 20 weeks with no cervical dilation or fetal expulsion
  2. Complete miscarriage: Full expulsion of fetal parts
  3. Incomplete miscarriage: Partial expulsion of fetal parts before 20 weeks

Women with a history of miscarriage should be particularly vigilant about bleeding or cramping and seek immediate medical attention if these occur.

Ectopic Pregnancy: A Serious Complication

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes. This condition can be life-threatening and requires immediate medical intervention.

Symptoms of Ectopic Pregnancy

  • Cramps and colicky pain with tenderness
  • Pain starting on one side and spreading across the abdomen
  • Pain worsening with bowel movements or coughing
  • Light, brown bleeding or spotting
  • Nausea, vomiting, shoulder pain, weakness, or lightheadedness
  • In severe cases: rapid pulse, clamminess, fainting, and sharp pain

If you experience any of these symptoms, especially in combination, seek emergency care immediately.

When to Call Your Doctor: Non-Emergency Concerns

While some symptoms don’t require emergency care, they still warrant a call to your healthcare provider. Early signs of potential complications include:

  • Cramps and pain in the center of the abdomen with vaginal bleeding
  • Severe pain lasting more than a day (even without bleeding)
  • Bleeding as heavy as a menstrual period
  • Spotting or staining lasting three days or longer

Your doctor can assess these symptoms and determine if further evaluation is necessary.

Understanding Abdominal Pain During Pregnancy

Abdominal pain during pregnancy can range from harmless discomfort to a sign of serious complications. It’s essential to understand the different types and causes of abdominal pain.

Common Causes of Abdominal Pain

  • Ligament and muscle stretching
  • Quick movements causing muscle or ligament “pulls”
  • Scar tissue from previous surgeries or pregnancies
  • Abdominal infections (similar to those in non-pregnant women)

While these causes are often benign, it’s important to report any abdominal pain to your healthcare provider due to the potential for serious complications.

Infections That Can Cause Abdominal Pain

  • Cholecystitis (inflamed gallbladder)
  • Appendicitis
  • Hepatitis
  • Pyelonephritis (kidney infection)
  • Pneumonia

These conditions can be more challenging to diagnose during pregnancy, making it crucial to seek medical advice when experiencing persistent or severe abdominal pain.

Distinguishing Between Normal Discomfort and Serious Complications

One of the challenges of pregnancy is distinguishing between normal discomforts and signs of potential complications. How can expectant mothers make this distinction?

Normal Pregnancy Discomforts

  • Mild, intermittent abdominal pain
  • Occasional spotting
  • Increased vaginal discharge
  • Back pain that improves with rest or position changes
  • Occasional headaches
  • Leg cramps, especially at night

Warning Signs of Complications

  • Severe, persistent abdominal pain
  • Heavy vaginal bleeding
  • Severe headaches that don’t respond to over-the-counter pain relievers
  • Sudden swelling of face, hands, or feet
  • Vision changes or seeing spots
  • Fever over 100.4°F (38°C)

If you experience any of these warning signs, contact your healthcare provider immediately.

The Importance of Regular Prenatal Care

Regular prenatal care is essential for monitoring the health of both mother and baby throughout pregnancy. How does prenatal care help in identifying and managing potential complications?

Benefits of Regular Prenatal Check-ups

  • Early detection of potential problems
  • Monitoring fetal growth and development
  • Addressing maternal health concerns
  • Providing education on pregnancy and childbirth
  • Offering emotional support

Attending all scheduled prenatal appointments allows your healthcare provider to track your pregnancy’s progress and address any concerns promptly.

What to Expect During Prenatal Visits

  1. Blood pressure checks
  2. Urine tests to screen for infections and preeclampsia
  3. Weight monitoring
  4. Fetal heart rate monitoring
  5. Measurements of fundal height (to assess fetal growth)
  6. Discussion of any symptoms or concerns

These regular check-ups provide an opportunity to discuss any symptoms you’re experiencing and receive guidance on managing pregnancy discomforts.

Coping Strategies for Common Second Trimester Discomforts

While some discomfort is normal during pregnancy, there are strategies to alleviate common symptoms and improve overall comfort. What are some effective ways to manage second trimester discomforts?

Managing Abdominal Pain and Ligament Stretching

  • Practice good posture
  • Use a pregnancy support belt
  • Apply heat or cold packs to sore areas
  • Perform gentle stretching exercises
  • Move slowly and carefully to avoid sudden movements

Alleviating Back Pain

  • Use proper lifting techniques
  • Sleep with a pregnancy pillow for support
  • Wear comfortable, supportive shoes
  • Practice prenatal yoga or swimming
  • Consider prenatal massage

Dealing with Headaches

  • Stay hydrated
  • Get adequate rest
  • Practice relaxation techniques
  • Use cold or warm compresses
  • Consult your doctor about safe pain relief options

Remember to always consult your healthcare provider before starting any new exercise regimen or taking any medications during pregnancy.

Emotional Well-being During the Second Trimester

The second trimester isn’t just about physical changes; it’s also a time of emotional adjustment. How can expectant mothers maintain good mental health during this period?

Common Emotional Experiences

  • Excitement and anticipation
  • Anxiety about the pregnancy and upcoming parenthood
  • Mood swings due to hormonal changes
  • Body image concerns
  • Relationship changes

Strategies for Emotional Well-being

  • Practice mindfulness and relaxation techniques
  • Engage in regular physical activity (with doctor’s approval)
  • Maintain open communication with your partner and support system
  • Join a prenatal support group
  • Consider prenatal counseling if experiencing persistent anxiety or depression

Remember that it’s normal to experience a range of emotions during pregnancy. However, if you’re feeling overwhelmed or experiencing persistent negative emotions, don’t hesitate to seek professional support.

Preparing for the Third Trimester

As the second trimester comes to a close, it’s time to start preparing for the final stage of pregnancy. What should expectant mothers focus on as they approach the third trimester?

Physical Preparations

  • Continue regular prenatal check-ups
  • Prepare for increased physical discomfort
  • Start or continue pregnancy-safe exercise routines
  • Begin planning for maternity leave
  • Consider taking childbirth education classes

Practical Preparations

  • Start setting up the nursery
  • Research and choose pediatricians
  • Create a birth plan
  • Pack a hospital bag
  • Consider infant care and breastfeeding classes

By taking these steps, you’ll be better prepared for the challenges and excitement of the third trimester and the arrival of your baby.

The second trimester of pregnancy is a crucial period for both maternal and fetal health. While it’s often considered the most comfortable stage of pregnancy, it’s important to remain vigilant about potential complications. By understanding the difference between normal discomforts and warning signs, maintaining regular prenatal care, and prioritizing both physical and emotional well-being, expectant mothers can navigate this trimester with confidence. Remember, when in doubt, always consult your healthcare provider. They are your best resource for ensuring a healthy pregnancy and preparing for the exciting journey of parenthood ahead.

The Second Trimester of Pregnancy: Pain, Bleeding, and Discharge

Pain, bleeding, and discharge

Some pain or discomfort is normal during the second trimester of pregnancy. Spotting and very small amounts of blood may also be harmless. However, there are certain types of pain, bleeding, and vaginal discharge that you shouldn’t ignore.

Learn how to tell the difference between normal pregnancy problems and serious medical concerns.

Emergency medical symptoms during the second trimester

There are a number of situations during pregnancy that demand medical attention. If you experience the symptoms below, don’t hesitate to call your doctor or seek emergency care.

When to seek emergency medical attention

Always seek emergency care if you are experiencing the symptoms of a miscarriage. Symptoms of a miscarriage include:

  • enough vaginal bleeding to soak more than one menstrual pad
  • severe pain in the abdomen or pelvic region
  • clots or clumps of tissue (typically gray or pink in color) passed from the vagina

If you pass clots or clumps from the vagina, try to save the tissue in a jar or plastic bag to give to the doctor for analysis. They may then determine the cause of the problem.

There are three types of miscarriage.

If a miscarriage has been threatened, there was bleeding before 20 weeks of pregnancy with no cervical dilation and no expulsion of any of the fetal parts.

If a miscarriage has been completed, there was complete expulsion of fetal parts from your body.

If a miscarriage has happened incompletely, there was partial expulsion of the fetal parts before 20 weeks. In the case of incomplete miscarriages, the next step may be to allow the remaining products of pregnancy to pass naturally or perform a dilation and curettage.

Note: If you have miscarried before and notice bleeding or cramping, you should seek emergency medical attention.

Always seek emergency care if you are experiencing the symptoms of an ectopic pregnancy (a pregnancy outside the uterus). Symptoms of an ectopic pregnancy include:

  • cramps and colicky (spasmodic) pain with associated tenderness
  • pain that starts on one side and spreads across the belly
  • pain that worsens with taking a bowel movement or coughing
  • light bleeding or spotting that is brown in color, is either constant or intermittent, and precedes the pain by weeks
  • one of the above symptoms combined with nausea and vomiting, pain in the shoulder, weakness or lightheadedness, or rectal pressure
  • rapid and weak pulse, clamminess, fainting, and sharp pain (these symptoms may arise if the ectopic pregnancy is in the fallopian tube and the tube ruptures, causing septic shock)

When to call your doctor

Emergency care isn’t always necessary. However, some signs require a doctor’s evaluation. Always call your doctor for advice if you’re experiencing signs of miscarriage. Early signs of miscarriage include:

  • cramps and pain in the center of the abdomen with vaginal bleeding
  • severe pain or pain that lasts for more than a day (even without bleeding)
  • bleeding that is as heavy as a period
  • spotting or staining that lasts for three days or longer

Pain

Although you may not experience an emergency, there will probably be times during your pregnancy when you’re uncomfortable or in pain. Many women have pain during the second trimester even when nothing is medically wrong.

Abdominal pain, back pain, headaches, leg cramps, and hand pain don’t always signal a problem. Learning to identify and relieve these normal discomforts will help you throughout your pregnancy.

Abdominal pain

Abdominal pain can either be a normal symptom of pregnancy or a sign of something serious, like preterm labor or ectopic pregnancy. It’s important to tell your doctor when you feel any type of abdominal pain, because of the potential for a serious complication.

When you feel pain in your abdomen during the second trimester, it’s usually related to the tension on the ligaments and muscles in the pelvis. These get stretched as the uterus expands to hold the growing baby.

If you move quickly, you can “pull” a ligament or muscle. This may feel like a painful pang in your pelvis or a cramp down your side that can last for several minutes. This kind of pain isn’t harmful to you or your baby.

Sometimes abdominal pain is related to past pregnancies or surgeries. If you’ve had surgery for infertility or other types of abdominal surgery, you may experience pain from the pulling of the remnants of scar tissue (adhesions).

Pregnant women can also have the same types of abdominal infections that other women develop. Infections that can cause abdominal pain include:

  • cholecystitis (inflamed gallbladder)
  • appendicitis (inflamed appendix)
  • hepatitis (inflamed liver)
  • pyelonephritis (kidney infection)
  • pneumonia (lung infection)

Sometimes these diseases are harder to diagnose during pregnancy because the location of pain characteristic to each has been shifted. This happens when the growing uterus pushes nearby organs out of its way.

If you’re experiencing serious pain that doesn’t feel like it’s in your uterus, show or tell your doctor exactly where the pain is located. If you have one of the above infections, you may need antibiotics or surgery to fix the problem.

Warning: If you’re experiencing regular or painful contractions in the pelvis or abdomen, call a doctor immediately. These may be a sign of preterm labor.

Back pain

Back pain is very common during pregnancy. Pregnancy hormones cause the joints in the pelvis to become soft and lax in preparation for childbirth. As your uterus gets bigger in the second trimester, your center of gravity changes.

You begin to carry yourself differently to accommodate the weight. In addition, your abdominal muscles may separate as the uterus presses up against them, weakening the abdominal wall. All of these factors can contribute to back pain, strain, and discomfort.

Here’s how you can improve back pain:

  • Practice good posture while standing (shoulders back, pelvis in) and sitting (elevate feet slightly and try to avoid crossing your legs).
  • Get up every once in a while when you’re sitting for long periods.
  • Lift heavy objects by bending at the knees, rather than the waist.
  • Try not to reach for things over your head.
  • Sleep on your left side, bending at your hips and knees, and place a pillow between your legs to reduce pressure on your back.
  • Strengthen your stomach muscles. One of the keys to a strong back is a strong abdomen.
  • Talk to your doctor. You may need to use a back brace or some other form of support to relieve the pressure on your back.

Warning: If you’re experiencing lower back pain accompanied by painful urination, you may have a bladder or kidney infection. Low, dull, consistent back pain may be a sign of preterm labor. Severe back pain coupled with vaginal bleeding or discharge may also indicate a serious problem. Call your doctor immediately if you experience any of these symptoms.

Headaches

Many women experience frequent headaches during pregnancy. You still may be experiencing headaches that started during the first trimester, or they may be just beginning now.

Hormonal changes, tension, fatigue, hunger, and stress are all culprits. Try to relax, stay rested, and eat regularly. You can also try to relieve headaches in the following ways:

  • If you have a sinus headache, apply warm compresses to aches in the sinus areas of your head. These include both sides of the nose, the middle of the forehead, and the temples.
  • If the headache is due to tension, try applying cold compresses to aches along the back of your neck.
  • Learn relaxation exercises, like closing your eyes and imagining yourself in a peaceful place. Reducing stress is a key component of a healthy pregnancy. Consider calling a counselor or a therapist if needed.

Speak with a physician before you begin using pain relievers. This is important even if you took over-the-counter medications for pain before you were pregnant.

Common headache medicines include ibuprofen (Motrin), aspirin (Bufferin), acetaminophen (Tylenol), and naproxen sodium (Aleve).

Acetaminophen is probably the safest option during pregnancy, but don’t take pills during pregnancy unless your doctor has specifically told you to do so.

Warning: Call your doctor if the headache is particularly severe or lasts for more than a few hours. Also note whether your headache comes with a fever, swelling in the face and hands, dizziness, nausea, or changes in vision. These may be signs of preeclampsia or another serious complication.

Leg cramps

Although no one knows exactly what causes them, leg cramps are common in the second and third trimester. Possible causes may be that you don’t consume enough calcium, have too much phosphorous in your diet, or are tired.

It may be that the uterus is pressing on the nerves that go to the legs. Regardless of the cause, you may wake up in the middle of the night with bothersome cramps.

You can avoid or get rid of cramps by:

  • exercising your calves
  • staying hydrated
  • alternating between sitting and standing
  • wearing support hose
  • wearing comfortable, supportive shoes
  • flexing the ankle and toes upward with a straightened knee to stop the cramping
  • massaging or applying a warm compress to the leg that is cramping
  • talking to your doctor about reducing the amount of phosphorous in your diet by cutting down on foods like milk or meat
  • making sure you get enough calcium (by eating fortified cereal or spinach) and magnesium (by eating beans or semisweet chocolate)

Warning: Tell your doctor if the cramps feel particularly painful, fail to go away, cause swelling, feel warm to the touch, or change the skin color of your leg (to white, red, or blue). You may have a blood clot in a leg vein that needs to be treated. This is known as deep vein thrombosis, and without treatment it can be deadly. Consult a doctor immediately.

Pain and numbness in the hand

Numbness and pain in the thumb, index finger, middle finger, and half of the ring finger can be a sign of carpal tunnel syndrome.

Usually this condition is diagnosed in people who regularly perform repetitive tasks such as typing or piano playing, but it’s also common in pregnant women.

During pregnancy, the tunnel that surrounds the nerve to these fingers can become swollen, causing tingling, numbness, and pain. In the evening, after your arm has been dangling by your side all day, your symptoms may worsen due to gravity.

Shaking out your arm when you experience the carpal tunnel symptoms may help. Alternatively, you may want to talk to your doctor about splinting your wrist or taking vitamin B-6.

Numbness and tingling in the hand can also be caused by poor posture. If your shoulders droop and your head is thrust forward, you put pressure on the nerves under your arms, causing tingling.

Practice standing up straight with your head and spine erect. A supportive bra and proper bed rest are also important.

Bleeding

Bleeding can be a scary symptom during pregnancy. In some cases, bleeding can be harmless. It can happen when pregnancy hormones cause you to develop more sensitive, expanded blood vessels.

In other cases, bleeding can indicate a serious problem with the pregnancy. If you experience any bleeding, call a doctor for advice.

Vaginal bleeding

Light bleeding or spotting (which can be brown, pink, or red) during the second and third trimester isn’t usually cause for concern. It typically occurs as a result of interference with the cervix during sex or a vaginal exam.

Pink mucus or brownish discharge may both occur during the second trimester. It’s caused by small amounts of blood leaving your body with normal discharge.

Vaginal bleeding that’s like a period, however, can be a worrisome sign that needs immediate medical attention. Clots of blood or clumps of tissue in the blood may be symptoms of a miscarriage.

For this reason, you should never be the judge of what is normal or abnormal bleeding. Instead, call your doctor.

If the bleeding is heavy or if it’s accompanied by pain, call your doctor immediately. If it’s spotty, you can make the call sometime that day. Serious bleeding is most commonly caused by placenta previa, premature labor, or late miscarriage.

Rectal bleeding and hemorrhoids

Rectal bleeding isn’t as worrisome as vaginal bleeding and is generally a sign of either hemorrhoids or anal fissure. Rectal bleeding could also be a sign of something more serious. You should speak with your doctor if you’re experiencing this symptom.

Rectal bleeding may mean you have hemorrhoids, either external or, less commonly, internal. Hemorrhoids occur in up to half of all pregnant women. They are varicose veins of the rectum and can cause pain, itching, and bleeding, often made worse by constipation.

Hemorrhoids are caused by progesterone acting on the walls of the rectal veins, causing them to relax and expand. As you advance in your pregnancy and the uterus presses on these veins, blood flow slows down and the veins dilate even more.

Squeezing and constipation can make hemorrhoids worse. Laughing, coughing, straining, and going to the bathroom may cause hemorrhoids to bleed.

If rectal bleeding isn’t caused by hemorrhoids, it may be caused by an anal fissure — a crack in the skin that lines the anal canal. Anal fissures are usually caused by constipation. Fissures are very painful, particularly during the strain of taking a bowel movement.

Hemorrhoids and anal fissures can cause brown, pink, or red bloodstains to appear on your underwear or toilet paper. If the bleeding is heavy or continuous, call a doctor for advice.

If you’re diagnosed with hemorrhoids or an anal fissure, you should do the following:

  • Try to avoid constipation by remaining well hydrated and eating a diet high in fiber.
  • Try to alleviate pressure on the veins in the rectum by sleeping on your side, not standing or sitting for long periods of time, and not taking too long or straining when going to the bathroom.
  • Take warm sitz baths up to two times a day. Sitz baths are basins that fit on your toilet and are filled with warm water in which you can soak your anus.
  • Soothe the hemorrhoids with ice packs or witch hazel, and only use topical medications if your doctor prescribes them. Your doctor may also prescribe stool softeners or a laxative.
  • Practice good hygiene by wiping thoroughly after bowel movements (from front to back) and keeping yourself clean.
  • Use only white, unscented toilet paper.
  • Perform Kegel exercises to improve the circulation to the area.

Warning: Massive rectal bleeding can be a serious problem. It can be caused by ectopic pregnancies or serious internal problems. Seek medical care immediately if you’re bleeding heavily from the anus.

Nosebleeds and nasal congestion

Like many of the complaints of pregnancy, nasal stuffiness and nosebleeds are believed to be due in large part to estrogen and progesterone. These hormones cause increased blood flow and swelling of the blood vessels in the mucus membranes.

Particularly in cold, dry weather, this can mean that you feel more congested than normal. You may also experience nosebleeds more often than you did before getting pregnant.

You may want to try the following to ease your nasal symptoms:

  • Use a humidifier to help with the dryness that can make symptoms worse.
  • Blow your nose gently by closing one nostril while you blow through the other.
  • Curb nosebleeds by leaning forward and applying gentle pressure to the nose. Try squeezing it with the thumb and forefinger for five minutes. Repeat if necessary.
  • Call your doctor if the bleeding doesn’t stop, or is heavy or frequent.
  • Seek emergency medical care if nasal congestion makes it hard to breathe.

The same changes in hormones and blood vessels that cause nasal bleeding can cause sensitive gums. If you experience bleeding when flossing or brushing your teeth, try using a softer toothbrush.

Visit a dentist if you bleed a lot or have a lot of pain when flossing or brushing your teeth. Serious dental problems can be a sign of other health concerns that can complicate pregnancy.

Discharge

Many women experience different types of discharge during the second trimester. Pay attention to the color, smell, amount, and frequency of vaginal or anal discharge. Some types of discharge may indicate an infection that needs medical attention or treatment.

Vaginal discharge

As the pregnancy progresses, you may notice increasing vaginal discharge. Typically, it looks like egg whites and is milky and a bit odorous. It may remind you of premenstrual discharge, only a bit heavier and more frequent.

This discharge is totally normal and is just another change your body goes through in response to the pregnancy hormones and the increased blood flow to the area. You can wear panty liners or change your underwear more often than usual if you find the discharge bothersome.

Though the kind of discharge described above is normal, there are some types of discharge that may mean you have an infection.

Vulvovaginal candidiasis, or yeast infection, is very common during pregnancy. Signs include a thick, cottage cheese-like discharge accompanied by itching, redness, and burning, as well as painful intercourse and urination.

Sexually transmitted infections (STIs) may also occur during pregnancy, and because many of them can affect the fetus, it’s important that they be treated.

You may have a condition that requires treatment if any of the following is true:

  • The discharge looks like pus.
  • The discharge is yellow, green, or has a foul odor.
  • You notice a burning sensation when you urinate.
  • Your labia are red, swollen, or itchy.

Unlike signs of infection, clear or pinkish watery discharge may be a sign of premature rupture of the amniotic sac.

Rupture of the sac may cause a trickle of watery discharge or a rush of lots of watery fluid from the vagina. This is commonly known as having the water break before labor begins.

Warning: If you experience a steady trickle or a rush of watery discharge during the second trimester, call a doctor immediately. It may be a sign of premature labor or a tear in the amniotic sac.

Rectal discharge

In addition to bleeding from the rectum, some women may experience anal discharge during pregnancy. Rectal discharge may be caused by STIs, bowel and gastrointestinal problems, or physical wounds in the rectum. If you’re experiencing rectal discharge, consult a doctor.

Gonorrhea, chlamydia, and other infections that can be transmitted through sexual contact can cause an infection in the anus. These infections can cause lesions or sores that bleed. In addition, they may lead to discharge that’s foul-smelling, green or yellow, and thick.

It may be painful to wipe or go to the bathroom. If you have these symptoms, discuss them with a doctor. Left untreated, they may cause serious problems for the baby. Most STIs can be treated with antibiotics.

Some pregnant women may experience anal discharge due to bowel problems or gastrointestinal disorders. These may result in mucus or watery discharge from the anus.

Certain gastrointestinal problems or food poisoning may also cause frequent diarrhea or fecal matter with unusual colors or textures. Tell your doctor about any unusual characteristics of your bowel movements. Some conditions require immediate treatment.

Finally, if you have a hemorrhoid or anal fissure that has become infected, you may notice unusual rectal discharge. Infected wounds may cause brown, yellow, green, or white discharge.

Such a wound may or may not have a foul smell. Infected sores are often very painful and require medical attention. Consult a doctor for treatment if you experience anal discharge of this nature.

Nipple discharge

Many women experience discharge from one or both nipples during the second trimester of pregnancy. Breast tenderness and changes in nipple color are also common during pregnancy.

Discharge is most common in women who have previously given birth. Nipple discharge is often clear, milky, or yellowish in color.

Discharge from the nipples is normally not a sign of a problem, unless the following symptoms are present:

  • The nipple changes in size or becomes inverted.
  • The nipple is dry, cracked, or painful.
  • The nipple has a rash or new bumps.
  • The discharge is foul-smelling, bloody, green, or brown.

If you aren’t sure whether your nipple discharge is normal, call a doctor to discuss your symptoms.

The Second Trimester of Pregnancy: Pain, Bleeding, and Discharge

Pain, bleeding, and discharge

Some pain or discomfort is normal during the second trimester of pregnancy. Spotting and very small amounts of blood may also be harmless. However, there are certain types of pain, bleeding, and vaginal discharge that you shouldn’t ignore.

Learn how to tell the difference between normal pregnancy problems and serious medical concerns.

Emergency medical symptoms during the second trimester

There are a number of situations during pregnancy that demand medical attention. If you experience the symptoms below, don’t hesitate to call your doctor or seek emergency care.

When to seek emergency medical attention

Always seek emergency care if you are experiencing the symptoms of a miscarriage. Symptoms of a miscarriage include:

  • enough vaginal bleeding to soak more than one menstrual pad
  • severe pain in the abdomen or pelvic region
  • clots or clumps of tissue (typically gray or pink in color) passed from the vagina

If you pass clots or clumps from the vagina, try to save the tissue in a jar or plastic bag to give to the doctor for analysis. They may then determine the cause of the problem.

There are three types of miscarriage.

If a miscarriage has been threatened, there was bleeding before 20 weeks of pregnancy with no cervical dilation and no expulsion of any of the fetal parts.

If a miscarriage has been completed, there was complete expulsion of fetal parts from your body.

If a miscarriage has happened incompletely, there was partial expulsion of the fetal parts before 20 weeks. In the case of incomplete miscarriages, the next step may be to allow the remaining products of pregnancy to pass naturally or perform a dilation and curettage.

Note: If you have miscarried before and notice bleeding or cramping, you should seek emergency medical attention.

Always seek emergency care if you are experiencing the symptoms of an ectopic pregnancy (a pregnancy outside the uterus). Symptoms of an ectopic pregnancy include:

  • cramps and colicky (spasmodic) pain with associated tenderness
  • pain that starts on one side and spreads across the belly
  • pain that worsens with taking a bowel movement or coughing
  • light bleeding or spotting that is brown in color, is either constant or intermittent, and precedes the pain by weeks
  • one of the above symptoms combined with nausea and vomiting, pain in the shoulder, weakness or lightheadedness, or rectal pressure
  • rapid and weak pulse, clamminess, fainting, and sharp pain (these symptoms may arise if the ectopic pregnancy is in the fallopian tube and the tube ruptures, causing septic shock)

When to call your doctor

Emergency care isn’t always necessary. However, some signs require a doctor’s evaluation. Always call your doctor for advice if you’re experiencing signs of miscarriage. Early signs of miscarriage include:

  • cramps and pain in the center of the abdomen with vaginal bleeding
  • severe pain or pain that lasts for more than a day (even without bleeding)
  • bleeding that is as heavy as a period
  • spotting or staining that lasts for three days or longer

Pain

Although you may not experience an emergency, there will probably be times during your pregnancy when you’re uncomfortable or in pain. Many women have pain during the second trimester even when nothing is medically wrong.

Abdominal pain, back pain, headaches, leg cramps, and hand pain don’t always signal a problem. Learning to identify and relieve these normal discomforts will help you throughout your pregnancy.

Abdominal pain

Abdominal pain can either be a normal symptom of pregnancy or a sign of something serious, like preterm labor or ectopic pregnancy. It’s important to tell your doctor when you feel any type of abdominal pain, because of the potential for a serious complication.

When you feel pain in your abdomen during the second trimester, it’s usually related to the tension on the ligaments and muscles in the pelvis. These get stretched as the uterus expands to hold the growing baby.

If you move quickly, you can “pull” a ligament or muscle. This may feel like a painful pang in your pelvis or a cramp down your side that can last for several minutes. This kind of pain isn’t harmful to you or your baby.

Sometimes abdominal pain is related to past pregnancies or surgeries. If you’ve had surgery for infertility or other types of abdominal surgery, you may experience pain from the pulling of the remnants of scar tissue (adhesions).

Pregnant women can also have the same types of abdominal infections that other women develop. Infections that can cause abdominal pain include:

  • cholecystitis (inflamed gallbladder)
  • appendicitis (inflamed appendix)
  • hepatitis (inflamed liver)
  • pyelonephritis (kidney infection)
  • pneumonia (lung infection)

Sometimes these diseases are harder to diagnose during pregnancy because the location of pain characteristic to each has been shifted. This happens when the growing uterus pushes nearby organs out of its way.

If you’re experiencing serious pain that doesn’t feel like it’s in your uterus, show or tell your doctor exactly where the pain is located. If you have one of the above infections, you may need antibiotics or surgery to fix the problem.

Warning: If you’re experiencing regular or painful contractions in the pelvis or abdomen, call a doctor immediately. These may be a sign of preterm labor.

Back pain

Back pain is very common during pregnancy. Pregnancy hormones cause the joints in the pelvis to become soft and lax in preparation for childbirth. As your uterus gets bigger in the second trimester, your center of gravity changes.

You begin to carry yourself differently to accommodate the weight. In addition, your abdominal muscles may separate as the uterus presses up against them, weakening the abdominal wall. All of these factors can contribute to back pain, strain, and discomfort.

Here’s how you can improve back pain:

  • Practice good posture while standing (shoulders back, pelvis in) and sitting (elevate feet slightly and try to avoid crossing your legs).
  • Get up every once in a while when you’re sitting for long periods.
  • Lift heavy objects by bending at the knees, rather than the waist.
  • Try not to reach for things over your head.
  • Sleep on your left side, bending at your hips and knees, and place a pillow between your legs to reduce pressure on your back.
  • Strengthen your stomach muscles. One of the keys to a strong back is a strong abdomen.
  • Talk to your doctor. You may need to use a back brace or some other form of support to relieve the pressure on your back.

Warning: If you’re experiencing lower back pain accompanied by painful urination, you may have a bladder or kidney infection. Low, dull, consistent back pain may be a sign of preterm labor. Severe back pain coupled with vaginal bleeding or discharge may also indicate a serious problem. Call your doctor immediately if you experience any of these symptoms.

Headaches

Many women experience frequent headaches during pregnancy. You still may be experiencing headaches that started during the first trimester, or they may be just beginning now.

Hormonal changes, tension, fatigue, hunger, and stress are all culprits. Try to relax, stay rested, and eat regularly. You can also try to relieve headaches in the following ways:

  • If you have a sinus headache, apply warm compresses to aches in the sinus areas of your head. These include both sides of the nose, the middle of the forehead, and the temples.
  • If the headache is due to tension, try applying cold compresses to aches along the back of your neck.
  • Learn relaxation exercises, like closing your eyes and imagining yourself in a peaceful place. Reducing stress is a key component of a healthy pregnancy. Consider calling a counselor or a therapist if needed.

Speak with a physician before you begin using pain relievers. This is important even if you took over-the-counter medications for pain before you were pregnant.

Common headache medicines include ibuprofen (Motrin), aspirin (Bufferin), acetaminophen (Tylenol), and naproxen sodium (Aleve).

Acetaminophen is probably the safest option during pregnancy, but don’t take pills during pregnancy unless your doctor has specifically told you to do so.

Warning: Call your doctor if the headache is particularly severe or lasts for more than a few hours. Also note whether your headache comes with a fever, swelling in the face and hands, dizziness, nausea, or changes in vision. These may be signs of preeclampsia or another serious complication.

Leg cramps

Although no one knows exactly what causes them, leg cramps are common in the second and third trimester. Possible causes may be that you don’t consume enough calcium, have too much phosphorous in your diet, or are tired.

It may be that the uterus is pressing on the nerves that go to the legs. Regardless of the cause, you may wake up in the middle of the night with bothersome cramps.

You can avoid or get rid of cramps by:

  • exercising your calves
  • staying hydrated
  • alternating between sitting and standing
  • wearing support hose
  • wearing comfortable, supportive shoes
  • flexing the ankle and toes upward with a straightened knee to stop the cramping
  • massaging or applying a warm compress to the leg that is cramping
  • talking to your doctor about reducing the amount of phosphorous in your diet by cutting down on foods like milk or meat
  • making sure you get enough calcium (by eating fortified cereal or spinach) and magnesium (by eating beans or semisweet chocolate)

Warning: Tell your doctor if the cramps feel particularly painful, fail to go away, cause swelling, feel warm to the touch, or change the skin color of your leg (to white, red, or blue). You may have a blood clot in a leg vein that needs to be treated. This is known as deep vein thrombosis, and without treatment it can be deadly. Consult a doctor immediately.

Pain and numbness in the hand

Numbness and pain in the thumb, index finger, middle finger, and half of the ring finger can be a sign of carpal tunnel syndrome.

Usually this condition is diagnosed in people who regularly perform repetitive tasks such as typing or piano playing, but it’s also common in pregnant women.

During pregnancy, the tunnel that surrounds the nerve to these fingers can become swollen, causing tingling, numbness, and pain. In the evening, after your arm has been dangling by your side all day, your symptoms may worsen due to gravity.

Shaking out your arm when you experience the carpal tunnel symptoms may help. Alternatively, you may want to talk to your doctor about splinting your wrist or taking vitamin B-6.

Numbness and tingling in the hand can also be caused by poor posture. If your shoulders droop and your head is thrust forward, you put pressure on the nerves under your arms, causing tingling.

Practice standing up straight with your head and spine erect. A supportive bra and proper bed rest are also important.

Bleeding

Bleeding can be a scary symptom during pregnancy. In some cases, bleeding can be harmless. It can happen when pregnancy hormones cause you to develop more sensitive, expanded blood vessels.

In other cases, bleeding can indicate a serious problem with the pregnancy. If you experience any bleeding, call a doctor for advice.

Vaginal bleeding

Light bleeding or spotting (which can be brown, pink, or red) during the second and third trimester isn’t usually cause for concern. It typically occurs as a result of interference with the cervix during sex or a vaginal exam.

Pink mucus or brownish discharge may both occur during the second trimester. It’s caused by small amounts of blood leaving your body with normal discharge.

Vaginal bleeding that’s like a period, however, can be a worrisome sign that needs immediate medical attention. Clots of blood or clumps of tissue in the blood may be symptoms of a miscarriage.

For this reason, you should never be the judge of what is normal or abnormal bleeding. Instead, call your doctor.

If the bleeding is heavy or if it’s accompanied by pain, call your doctor immediately. If it’s spotty, you can make the call sometime that day. Serious bleeding is most commonly caused by placenta previa, premature labor, or late miscarriage.

Rectal bleeding and hemorrhoids

Rectal bleeding isn’t as worrisome as vaginal bleeding and is generally a sign of either hemorrhoids or anal fissure. Rectal bleeding could also be a sign of something more serious. You should speak with your doctor if you’re experiencing this symptom.

Rectal bleeding may mean you have hemorrhoids, either external or, less commonly, internal. Hemorrhoids occur in up to half of all pregnant women. They are varicose veins of the rectum and can cause pain, itching, and bleeding, often made worse by constipation.

Hemorrhoids are caused by progesterone acting on the walls of the rectal veins, causing them to relax and expand. As you advance in your pregnancy and the uterus presses on these veins, blood flow slows down and the veins dilate even more.

Squeezing and constipation can make hemorrhoids worse. Laughing, coughing, straining, and going to the bathroom may cause hemorrhoids to bleed.

If rectal bleeding isn’t caused by hemorrhoids, it may be caused by an anal fissure — a crack in the skin that lines the anal canal. Anal fissures are usually caused by constipation. Fissures are very painful, particularly during the strain of taking a bowel movement.

Hemorrhoids and anal fissures can cause brown, pink, or red bloodstains to appear on your underwear or toilet paper. If the bleeding is heavy or continuous, call a doctor for advice.

If you’re diagnosed with hemorrhoids or an anal fissure, you should do the following:

  • Try to avoid constipation by remaining well hydrated and eating a diet high in fiber.
  • Try to alleviate pressure on the veins in the rectum by sleeping on your side, not standing or sitting for long periods of time, and not taking too long or straining when going to the bathroom.
  • Take warm sitz baths up to two times a day. Sitz baths are basins that fit on your toilet and are filled with warm water in which you can soak your anus.
  • Soothe the hemorrhoids with ice packs or witch hazel, and only use topical medications if your doctor prescribes them. Your doctor may also prescribe stool softeners or a laxative.
  • Practice good hygiene by wiping thoroughly after bowel movements (from front to back) and keeping yourself clean.
  • Use only white, unscented toilet paper.
  • Perform Kegel exercises to improve the circulation to the area.

Warning: Massive rectal bleeding can be a serious problem. It can be caused by ectopic pregnancies or serious internal problems. Seek medical care immediately if you’re bleeding heavily from the anus.

Nosebleeds and nasal congestion

Like many of the complaints of pregnancy, nasal stuffiness and nosebleeds are believed to be due in large part to estrogen and progesterone. These hormones cause increased blood flow and swelling of the blood vessels in the mucus membranes.

Particularly in cold, dry weather, this can mean that you feel more congested than normal. You may also experience nosebleeds more often than you did before getting pregnant.

You may want to try the following to ease your nasal symptoms:

  • Use a humidifier to help with the dryness that can make symptoms worse.
  • Blow your nose gently by closing one nostril while you blow through the other.
  • Curb nosebleeds by leaning forward and applying gentle pressure to the nose. Try squeezing it with the thumb and forefinger for five minutes. Repeat if necessary.
  • Call your doctor if the bleeding doesn’t stop, or is heavy or frequent.
  • Seek emergency medical care if nasal congestion makes it hard to breathe.

The same changes in hormones and blood vessels that cause nasal bleeding can cause sensitive gums. If you experience bleeding when flossing or brushing your teeth, try using a softer toothbrush.

Visit a dentist if you bleed a lot or have a lot of pain when flossing or brushing your teeth. Serious dental problems can be a sign of other health concerns that can complicate pregnancy.

Discharge

Many women experience different types of discharge during the second trimester. Pay attention to the color, smell, amount, and frequency of vaginal or anal discharge. Some types of discharge may indicate an infection that needs medical attention or treatment.

Vaginal discharge

As the pregnancy progresses, you may notice increasing vaginal discharge. Typically, it looks like egg whites and is milky and a bit odorous. It may remind you of premenstrual discharge, only a bit heavier and more frequent.

This discharge is totally normal and is just another change your body goes through in response to the pregnancy hormones and the increased blood flow to the area. You can wear panty liners or change your underwear more often than usual if you find the discharge bothersome.

Though the kind of discharge described above is normal, there are some types of discharge that may mean you have an infection.

Vulvovaginal candidiasis, or yeast infection, is very common during pregnancy. Signs include a thick, cottage cheese-like discharge accompanied by itching, redness, and burning, as well as painful intercourse and urination.

Sexually transmitted infections (STIs) may also occur during pregnancy, and because many of them can affect the fetus, it’s important that they be treated.

You may have a condition that requires treatment if any of the following is true:

  • The discharge looks like pus.
  • The discharge is yellow, green, or has a foul odor.
  • You notice a burning sensation when you urinate.
  • Your labia are red, swollen, or itchy.

Unlike signs of infection, clear or pinkish watery discharge may be a sign of premature rupture of the amniotic sac.

Rupture of the sac may cause a trickle of watery discharge or a rush of lots of watery fluid from the vagina. This is commonly known as having the water break before labor begins.

Warning: If you experience a steady trickle or a rush of watery discharge during the second trimester, call a doctor immediately. It may be a sign of premature labor or a tear in the amniotic sac.

Rectal discharge

In addition to bleeding from the rectum, some women may experience anal discharge during pregnancy. Rectal discharge may be caused by STIs, bowel and gastrointestinal problems, or physical wounds in the rectum. If you’re experiencing rectal discharge, consult a doctor.

Gonorrhea, chlamydia, and other infections that can be transmitted through sexual contact can cause an infection in the anus. These infections can cause lesions or sores that bleed. In addition, they may lead to discharge that’s foul-smelling, green or yellow, and thick.

It may be painful to wipe or go to the bathroom. If you have these symptoms, discuss them with a doctor. Left untreated, they may cause serious problems for the baby. Most STIs can be treated with antibiotics.

Some pregnant women may experience anal discharge due to bowel problems or gastrointestinal disorders. These may result in mucus or watery discharge from the anus.

Certain gastrointestinal problems or food poisoning may also cause frequent diarrhea or fecal matter with unusual colors or textures. Tell your doctor about any unusual characteristics of your bowel movements. Some conditions require immediate treatment.

Finally, if you have a hemorrhoid or anal fissure that has become infected, you may notice unusual rectal discharge. Infected wounds may cause brown, yellow, green, or white discharge.

Such a wound may or may not have a foul smell. Infected sores are often very painful and require medical attention. Consult a doctor for treatment if you experience anal discharge of this nature.

Nipple discharge

Many women experience discharge from one or both nipples during the second trimester of pregnancy. Breast tenderness and changes in nipple color are also common during pregnancy.

Discharge is most common in women who have previously given birth. Nipple discharge is often clear, milky, or yellowish in color.

Discharge from the nipples is normally not a sign of a problem, unless the following symptoms are present:

  • The nipple changes in size or becomes inverted.
  • The nipple is dry, cracked, or painful.
  • The nipple has a rash or new bumps.
  • The discharge is foul-smelling, bloody, green, or brown.

If you aren’t sure whether your nipple discharge is normal, call a doctor to discuss your symptoms.

causes and treatment by an obstetrician-gynecologist at the Proxima Medical Center (Sochi)

Bleeding during pregnancy is an obstetric symptom characterized by discharge from the vagina of various volumes of bloody discharge, the cause of which can act as pathological conditions, and natural physiological changes in the female body. Every fifth pregnant woman faces this symptom. Bleeding occurs predominantly in the first and third trimesters of pregnancy. Bloody discharge from the vagina should be a reason for urgent medical attention, as in some cases this condition can pose a threat to the mother and fetus.

Causes of bleeding during pregnancy

In the first trimester of pregnancy the most common cause of bleeding is spontaneous miscarriage. Approximately at 6 obstetric weeks, spotting is characteristic of ectopic attachment of the fetal egg, fetal fading, or an Rhesus conflict between the fetus and mother.

In the second trimester of pregnancy bleeding is observed much less frequently, in no more than 10% of cases. In most cases, it is due to pathological causes, including isthmic-cervical insufficiency, intrauterine fetal death, late spontaneous abortion.

In the third trimester of pregnancy bleeding is always indicative of pathology of gestation. Usually spotting is a consequence of placenta previa, its premature detachment. In the latter case, there is a real danger to the life of the fetus. The most rare, but the most dangerous cause of bleeding in late pregnancy is uterine rupture (usually occurs with multiple pregnancies, large fetuses, polyhydramnios, and if there is a scar on the myometrium).

In the presence of benign neoplasms (polyps, mimoma), bleeding can occur at any stage of embryogenesis. Blood discharge is often observed in women suffering from cervical erosion. The likelihood of developing this pathological symptom increases with high physical exertion, too active sexual intercourse, the presence of cardiovascular pathologies, accompanied by a weakening of the endothelium.

Symptoms

Symptoms of bleeding during pregnancy may vary depending on the cause of bleeding. So, if bleeding is due to spontaneous miscarriage, then the pregnant woman may also be disturbed by pain in the lower abdomen, manifested in the form of spasms, deterioration in well-being and increased weakness. Dizziness, nausea, and a slight rise in body temperature may also occur. In this case, bleeding can have different intensity, and the discharge itself can be of a different color, from bright scarlet to crimson.

With placenta previa, a pregnant woman usually does not have any symptoms other than bleeding. Pain in most cases is not observed, and the tone of the myometrium is within the normal range. With placental abruption, a woman experiences severe pain, and there is also an increase in myometrial tone.

Methods of treatment

Treatment tactics for bleeding during pregnancy depends on the cause of bleeding from the genital tract, the amount of blood lost, the general condition of the patient and the fetus. If the bleeding is due to the natural physiological state of the woman, in the absence of pathological changes, then, as a rule, medical assistance in such cases is not required. It is recommended to comply with all previous doctor’s prescriptions, refrain from active sex life and increased physical activity. In some cases, hemostatic therapy may be indicated.

Similar recommendations are given in the presence of polyps, fibroids and erosion of the cervix, which caused bleeding during pregnancy. In such cases, expectant tactics are preferred. Cauterization of erosion is carried out after the birth of the child. In rare, exceptional cases, qualified gynecologists recommend removing polyps during pregnancy.

Bleeding during pregnancy, which occurred against the background of placenta previa or due to the threat of spontaneous abortion, requires emergency hospitalization of the woman in an obstetric hospital and further drug therapy under the constant supervision of doctors. In order to reduce uterine tone, tocolytics, sedative drugs are prescribed. With threatening abortions in obstetric practice, antispasmodics, coagulants and progesterone preparations are used. Physiotherapeutic treatment methods are also successfully used: electroanalgesia, endonasal galvanization. After normalization of the condition, the patient goes home and must observe the prescribed bed rest and complete sexual rest for a certain time. The introduction of pregnancy in such cases takes place under the close supervision of specialists.

In some cases, bleeding during pregnancy requires surgical procedures. We are talking about the following situations:

  • miscarriage , completed spontaneous abortion – in this case, surgical removal of the remnants of fetal tissues is indicated.
  • attachment of the ovum outside the uterine cavity . An emergency removal of the fetal egg is carried out. The method used to stop bleeding can be different, which depends primarily on the woman’s well-being and the intensity of bloody discharge. In case of massive blood loss, ligation of the uterine arteries is indicated.
  • placental abruption . In moderate and severe forms of pathology, operative delivery (caesarean section) is indicated. After extraction of the fetus and subsequent separation of the placenta, clots are removed and, if necessary, in the presence of pronounced changes in the uterus, a hysterectomy is performed.
  • isthymic-cervical insufficiency . During surgery, sutures are placed on the cervix to prevent its premature opening. Surgery is performed at less than 28 weeks’ gestation, and stitches are removed at 37 weeks. After surgical treatment, drug therapy based on hormonal drugs is indicated.

After the operation, the woman is prescribed a course of antibiotics to prevent the development of an infectious process. Also obligatory for compliance with the condition of postoperative rehabilitation is the observance of sexual rest and the requirements of personal hygiene.

Prognosis and prevention

Bleeding during pregnancy in most cases is characterized by a favorable prognosis. Timely qualified medical care ensures the preservation of the life of a pregnant woman and her fetus. Lethal outcome is extremely rare.

Preventive measures come down, first of all, to carrying out preconception preparation for conception. So, a woman should undergo a comprehensive examination, which allows timely identification and treatment of pathologies that can negatively affect the course of pregnancy. This is especially true of benign neoplasms, which can cause bleeding.

Along with this, a woman is recommended to register in the early stages of pregnancy and undergo all examinations and analyzes prescribed by a gynecologist. In the event of complications in early pregnancy (for example, bloody spotting, uterine tone), complex treatment is necessary, including hormone therapy, sedatives, bed rest, sexual rest and a special diet. Also follows:

  • avoid stressful situations, emotional overstrain;
  • exclude high physical activity;
  • to eat properly and in a balanced way;
  • give up bad habits;
  • take vitamin complexes prescribed by a doctor;
  • avoid violent sexual intercourse.

In severe pregnancy, bed rest and minimal physical activity are recommended to prevent bleeding.

Early and late pregnancy and bleeding

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Bleeding during early and late pregnancy

Bleeding at various stages of pregnancy is a pathological symptom. Its appearance requires additional research methods aimed at clarifying the cause and selecting therapy.

Causes of bleeding during pregnancy

The only physiological cause of bleeding in the early stages may be the manifestation of implantation of the ovum in the uterine cavity. Pathological causes will depend on the gestational age.

In the early stages bleeding can be caused by:

  • Complete or partial detachment of the ovum.
  • Placenta previa.
  • Fetal death.
  • Pathology of hemostasis or Rhesus conflict.

Second trimester bleeding is rare. The reasons may be:

  • Placenta previa.
  • Spontaneous fetal death.
  • Isthmic-cervical insufficiency.

In the third trimester bleeding occurs as a result of:

  • Premature detachment of a normally located placenta.
  • Offers placenta.

Diagnosis

To clarify the cause of bleeding during pregnancy, it is necessary to find out the patient’s complaints, the conditions for their occurrence, as well as possible provoking factors. The doctor evaluates the nature of menstrual and reproductive function.

After a vaginal examination, additional examination methods are prescribed, which include:

  • Examination of the hormonal profile with the determination of the level of human chorionic gonadotropin, as well as progesterone. A discrepancy between the level of v-hCG and the term may indicate fetal death or an ectopic pregnancy.
  • Blood test for Rh factor, as well as the determination of antibodies. With a negative Rh mother, a threat may develop due to increasing antibodies against the fetal organism.
  • Coagulogram. The evaluation of the coagulation system is carried out in order to exclude pathologies of hemostasis.
  • Ultrasound . A non-invasive method is used to visualize the placenta, fetus, and determine the blood flow between the mother and fetus. With the help of ultrasound, it is possible to set the exact date, as well as exclude fetal growth retardation or malformations, and calculate the heart rate.
  • Cardiotocography. A non-invasive test is ordered to evaluate fetal vital signs by recording heart rate.

Treatment

If the disease is caused by fetal death, curettage of the uterine cavity or induction of labor is performed.