Blood clots during early pregnancy bleeding: Vaginal Bleeding and Blood Clots During Pregnancy
Pain and bleeding in early pregnancy (totonga hapūtanga)
It is common to have pain and/or bleeding in early pregnancy (totonga hapūtanga). Most people who experience it go on to have a healthy pregnancy and baby. However, it can be a warning sign of a miscarriage or an ectopic pregnancy, so you should talk to your lead maternity carer (LMC) or doctor if it happens to you.
Key points about pain and bleeding in early pregnancy
- Any pain (kōharihari) in the lower part of your tummy and/or bleeding (toto) from your vagina (tenetene) in the first 3 months of pregnancy should be checked out.
- Pain and bleeding in early pregnancy affect about 1 in 4 pregnant people, but most go on to have a healthy pregnancy and baby.
- Common causes include implantation bleeding, cervical bleeding, miscarriage and ectopic pregnancy.
- You may need to have blood tests and an ultrasound scan to find out the cause. Sometimes a cause cannot be found.
- If you feel upset or distressed about this happening, there is support available.
Contact your midwife or GP, or go to the nearest emergency department if you have any of the following symptoms:
What are the causes of pain and bleeding in early pregnancy?
Possible causes of pain and/or bleeding in early pregnancy include the following:
- Implantation bleed – this usually happens around the time your period would have been due. It happens when the developing embryo attaches itself to the wall of your womb. The bleeding is usually light and there is no pain.
- Cervical bleed – your cervix is prone to bleeding in pregnancy due to hormonal changes and increased blood flow to your cervix. This can also happen after sex. This bleeding is usually harmless but if you have had an abnormal cervical smear or are overdue a cervical smear, your cervix must be checked by a doctor to make sure that there is no abnormality on your cervix.
- Miscarriage – this is the loss of the pregnancy before 20 weeks’ gestation. Read more about miscarriage.
- Ectopic pregnancy – this is a pregnancy that occurs outside of your womb. Read more about ectopic pregnancy.
Other causes of pain and/or bleeding not related to pregnancy include:
What should I do if I have bleeding in early pregnancy?
You should see a doctor or midwife if you have bleeding in early pregnancy. How urgently you need to be seen depends on how much bleeding you have.
A few spots of blood on your underwear or toilet paper is known as spotting. With spotting, a panty-liner is enough and you don’t usually need a pad. If you have spotting in early pregnancy, contact or make an appointment with your midwife or GP. It is okay to wait 24–48 hours for this appointment.
Moderate vaginal bleeding
If you soak your pad with 2–4 hours, or you have pain that doesn’t improve with pain relief, you need to contact or see your midwife or GP more urgently, usually on the same day.
Heavy vaginal bleeding
If you have heavy vaginal bleeding, you need to seek urgent medical help. This occurs when you soak your pad in less than an hour or you pass large clots and tissue. Contact your midwife or GP, or go to the after-hours doctors or nearest emergency department.
How is pain and bleeding in early pregnancy diagnosed?
Your midwife or doctor will ask you some questions about your symptoms, including when they started, the date of your last period and about your past pregnancies. Your doctor may also examine your tummy and vagina to work out what is causing your bleeding and/or pain. A vaginal examination will not harm the pregnancy or cause you to miscarry.
You may need some blood tests and an ultrasound scan, depending on what your doctor or midwife thinks is causing your symptoms. The ultrasound scan can be done either abdominally (when the ultrasound probe is on the lower part of your tummy), or vaginally (when the ultrasound probe is inserted into your vagina). In early pregnancy, often a vaginal scan needs to be done in order to get a clear view of your womb. You may also need a urine pregnancy test to confirm your pregnancy if this has not already been done.
Sometimes, it may not be possible to find out the cause of the bleeding and pain.
Your blood group may be checked. If your blood group is Rh(D) (rhesus) negative and you have heavy bleeding you will need to have an injection of Anti-D.
Understanding your test results
Your ultrasound scan and blood tests will help your doctor or midwife to work out what is happening. Your test results may show one of the following:
- No cause is found and your pregnancy is developing and progressing normally.
- You are in the process of having a miscarriage or have had a miscarriage.
- Your blood test showed a high level of pregnancy hormone but no pregnancy could be seen on the ultrasound scan. This can happen when the pregnancy is still too small to be seen, when you have already had a miscarriage or when you have an ectopic pregnancy. This is called a pregnancy of unknown location (PUL). It requires further follow up with blood tests and/or ultrasound scans to find out where the pregnancy is.
- There is a pregnancy sac in your uterus (womb), but the embryo or heart beat could not be seen. This can happen in very early pregnancy or if the pregnancy is not developing properly. You will usually need a follow up ultrasound scan in this situation.
- The pregnancy develops outside of your womb. This is called an ectopic pregnancy.
How is pain and bleeding in early pregnancy treated?
Treatment depends on your test results and the cause of your symptoms. Your midwife or GP will decide and let you know what’s next based on the results of your tests. If you are having a miscarriage or ectopic pregnancy, treatment will focus on the condition. Read more about treatment of miscarriage and ectopic pregnancy.
If you are having heavy bleeding and are unwell, you will need to be admitted to the hospital for emergency care. If your symptoms are not severe, you may be kept in the hospital for observation for a short period of time. If your test results are inconclusive, you will be asked to go back to the hospital for a follow-up in the next few days for repeat scans and blood tests.
It is safe to take paracetamol in pregnancy. You should avoid non-steroidal anti-inflammatories (NSAIDs) such as diclofenac (voltaren) and ibuprofen (brufen), or aspirin if the pregnancy is ongoing. Stronger medicines such as codeine and tramadol can be used in pregnancy but should only be taken after medical advice.
What support is available with pain and bleeding in early pregnancy?
Having pain and bleeding in the early stages of pregnancy can be frightening. It is normal to feel upset and distressed. You can talk through your feelings with your partner, family/whānau and friends to get the support you need. You can also talk to your doctor or midwife.
If you’re feeling anxious and overwhelmed, or just need someone to talk to, free call or text 1737 anytime, 24 hours a day to speak to or text with a trained counsellor. You can also find a counsellor yourself to talk about how you are feeling.
The following links provide further information about pain and bleeding in early pregnancy. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
Pain and bleeding in early pregnancy – information for women Hutt Maternity, NZ
Bleeding in early pregnancy HealthInfo, NZ
Pain and bleeding in early pregnancy The Royal Women’s Hospital, Victoria, Australia
Bleeding and/or pain in early pregnancy NHS Hull Teaching Hospitals, UK
Vaginal bleeding in pregnancy NHS, UK
- Pain and bleeding in early pregnancy Auckland Regional HealthPathways, NZ
- Bleeding in early pregnancy HealthInfo, NZ
- Pain and bleeding in early pregnancy – information for women Hutt Maternity, NZ
|Dr Judy Ormandy is an obstetrician and gynaecologist at Capital & Coast District Health Board and a Senior Lecturer in Obstetrics & Gynaecology at the University of Otago, Wellington. Her areas of interest are medical education and maternal mental health.|
Blood Clots in Pregnancy: Reasons, Signs & Treatment
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Pregnancy is a time of joy, but also one of anxiety, stress and fear. A woman may face a few risky things during her pregnancy, one of which is the threat of blood clots. Even though very few pregnant women face a risk of developing a blood clot, it is a highly critical condition, and can lead to serious complications for the pregnant woman and her unborn baby. The important thing to do is stay calm in the face of pressure, to be able to deal with the many problems of pregnancy. Fortunately, there are several things one you can do to protect yourself and your child from the dangers posed by blood clots during pregnancy.
What Is a Blood Clot?
Your body can be injured in many ways. If your skin experiences a cut or wound, your body will send an army of special blood cells known as platelets to help. Platelets, along with an assortment of clotting factors, stick together to form a seal at the injury site, and stop blood from leaving the body. Clotting in such circumstances is an important bodily process to prevent blood loss. However, if a clot forms inside your veins and is unable to dissolve itself, this can become a dangerous situation.
Women face a much higher risk of developing a blood clot in the uterus during pregnancy than non-pregnant women. This is due to the raised estrogen levels in their blood, which promote the activity of clotting factors. While the clot may not be dangerous in itself, it might cause severe complications, depending on its location. Blood clots can form at any time during the pregnancy, or even for a few weeks after you give birth.
Types of Blood Clots
There are two main kinds of blood clots that form inside the body. They are:
Blood clots that form inside veins or arteries are known as a thrombus. Thrombus clots can also develop inside the heart. A thrombus is a coagulated mass of red blood cells, platelets, and fibrin protein. It can block healthy blood vessels and prevent blood flow, leading to a condition known as thrombosis. Generally, thrombosis occurs in the leg veins, but sometimes can happen elsewhere in the body. Thrombosis in pregnancy is quite common and very dangerous. The two main kinds of thrombosis are:
- Deep Vein Thrombosis: Deep Vein Thrombosis, or DVT, occurs when a blood clot develops in a vein deep within the body, usually in the thigh or calf. It shows itself in the form of inflammation, swelling, pain, and warmth around the area in which it is located.
- Cerebral Vein Thrombosis: Cerebral vein thrombosis, or CVT, is the formation of a blood clot in a vein that is present in the brain. This greatly increases the chances of a stroke.
An embolus is a clump of material that moves through the blood vessels. It is most commonly a thrombus that has dislodged from a blood vessel, but can occasionally be fat or air bubbles. An embolus during pregnancy can also obstruct the flow of blood in various organs in the body, giving rise to a condition known as Venous Thromboembolism (VTE). If it hampers blood flow to the heart, lungs, or brain, it could cause severe damage or even death.
What Causes Blood Clots During Pregnancy?
There are several reasons for the formation of blood clots during pregnancy. Some of them are:
Having cholesterol plaques clogging up your arteries will affect blood flow in that area, making you more susceptible to a thrombus.
2. Lack of Movement
Standing or sitting for long periods can promote the development of blood clots in the leg. Make sure you don’t sit cross-legged for too long, either.
Blood clots can develop in pregnant women who do not stay hydrated by drinking water or juices. Hyperemesis gravidarum is a sickness that could cause dehydration as well.
4. Recovering From Surgery
If you have recently undergone invasive surgeries that involve cutting into arteries and veins, you face a higher risk of blood clots.
5. Damage to Blood Vessels
The increase in the size of your baby during pregnancy will start putting pressure on the veins that lead to the pelvic region. This makes it likely for a clot to form in that region.
Who Is at the Risk of Getting Blood Clots During Pregnancy?
Developing a blood clot is uncommon, but the further you progress in your pregnancy, the higher is the risk, peaking at the first month after your child is born. There are many risks that can cause blood clots during pregnancy. They are:
1. Family History
If there is a history of the development of blood clots in your family, it is likely that you might have inherited that tendency.
2. Certain Medical Conditions
Having illnesses like heart disease, sickle cell anaemia, thrombophilia, high blood pressure, diabetes, or lupus greatly increase your risk of developing blood clots.
Being over 40 makes your blood more likely to clot, so pregnant women above the age of 35 should take extra care.
Smokers or second-hand smokers are at high risk of developing blood clots, as cigarette smoke tends to damage the inner lining of the blood vessels, as well as make platelets stickier.
Having a BMI higher than 30 during pregnancy can cause reduced blood flow in the body, enhancing the formation of clots.
Signs and Symptoms of Blood Clots While Pregnant
As a pregnant woman, you are prone to constantly worrying for both your and your baby’s health. Instead of fretting about another possible danger, just take note of all the signs your body is trying to show you. If you find yourself facing any of the following symptoms, it’s best to seek medical attention immediately:
- Chest ache or tightness
- Bloody coughs
- Difficulty breathing
- Intense fatigue
- Swelling and tenderness in the calf, thighs and lower back
There are several ways in which blood clots can be determined by your doctor. A few commonly used techniques are:
- Pulmonary angiogram to check for any embolus in the lungs
- Ultrasound of the veins to visually check for clots
- D-dimer test, which measures the level of clotting-related proteins to check for the chemical presence of blood clots
- MRI of the veins to locate a thrombus
- Contrast venography, which is one of the best methods to identify clots (but it is quite expensive and invasive)
- A CT scan
Complications of Having Blood Clots in Pregnancy
Thrombosis kills someone every five minutes. As the risks of blood clots during pregnancy are significantly increased, it could cause serious damage to both you and your unborn child. Some of the complications that can emerge in your body from developing pregnancy blood clots are:
1. Pulmonary Embolism
When an embolus moves from its initial location, it is driven around by the bloodstream. If it somehow makes it to the lungs, it is known as a Pulmonary Embolism (PE). PE is a type of VTE along with DVT. This condition can drastically reduce oxygen levels, damaging multiple tissues and organs in the body. The symptoms of PE are shortness of breath, feeling faint, irregular heartbeat and anxiety.
2. Myocardial Infarction
Also known as a heart attack, it can occur if the blood clot obstructs the heart muscles from receiving oxygen and the nutrients it requires. This could lead to the slow death of the heart tissues, causing a heart attack. Heart attacks can cause severe damage to the heart, and are often fatal.
3. Ischemic Stroke
The brain requires a constant supply of blood to function. Cerebral Vein Thrombosis (CVT) can stop blood from reaching the brain, or in extreme cases, result in a bursting of the blood vessel. This is known as a stroke. Symptoms of a stroke are vision loss, dizziness, seizures, lack of feeling on one side of the body, and inability to move or speak. In many cases, strokes can lead to brain damage or fatality.
This is one of the most common conditions that some pregnant women go through, especially in their third trimester. Preeclampsia causes a rise in blood pressure, which affects the functions of the liver and kidneys. These organs may also be damaged if the condition is not treated in time. Some of the warnings signs of preeclampsia are headaches, protein in the urine, and unclear vision.
Can Blood Clots Affect Your Baby?
Blood clots are not only dangerous to your health, but they can also cause severe harm to your unborn child, especially if they travel to the uterus. Blood clots can occasionally form inside the placenta, which will result in a blockage in the foetus’s blood supply. A few of the dangers they can cause to your baby are:
1. Placental Dysfunction
As the placenta is the organ that serves as the pathway for oxygen and food between the foetus and the uterus, blood clots developing in the placenta will block the flow of blood to the foetus. This could put the life of your unborn child in serious jeopardy.
2. Foetal Growth Retardation
If the placenta is unable to function efficiently, oxygen and nutrients will not reach the foetus. This will result in the foetus developing incompletely or abnormally.
Blood clots may also lead to the foetus dying before the third trimester, while still in the uterus.
4. Preterm Birth
Blood clots can also lead to premature birth, which means that the baby is born a week or more before its due date. These babies are underweight and might develop hearing disabilities, vision problems, cerebral palsy, and have lower IQ.
Can It Affect My Labour If I’m at High Risk of Getting DVT?
Deep Vein Thrombosis might be a debilitating condition, but you can still have a successful pregnancy even if you are at high risk. Reducing the risk of developing a clot until birth and for a few months afterwards is crucial. Some of the things you can do in your late pregnancy are:
- Move often as frequent movement will help keep the blood flowing through your body and reduce the chances of clots forming.
- Drink enough water as staying hydrated will prevent your blood from getting thick enough to precipitate clots.
- Aim to have a natural birth, as caesarean surgeries increase the risk of blood clots forming.
How Are Blood Clots Treated in Pregnant Women?
If the doctor observes blood clots in your body during pregnancy, there are several ways with which they can be treated:
1. Treatment With Heparin or Low Molecular Weight Heparin
Heparins are a class of molecules that behave as anticoagulants. They prevent the formation of clots in the blood, and thereby reduce the chances of getting deep vein thrombosis and pulmonary embolisms. This treatment will continue for at least 6 weeks after delivery.
It is an anticoagulant that is very efficient in treating DVT and PE, but is not recommended in pregnant women due to its side-effects, such as internal bleeding and tissue damage. A couple of weeks after you have given birth, your obstetrician can prescribe warfarin until all the blood clots have disappeared.
3. Inferior Vena Cava Filters
New research is showing the promise of a technique which involves surgically inserting a small device into the inferior vena cava of the heart, to reduce the risk of pulmonary embolisms. However, it has been found to increase the occurrence of deep vein thrombosis.
Due to the critical nature of pregnancy blood clots, there are some things that you must compulsorily do to keep them away from you and your child.
1. Stay Active
This is the most important advice. In addition to advancing your cardiovascular health, getting physically active will keep your circulation in peak condition and not give your blood a chance to clot. However, always ask your healthcare provider before you indulge in any kind of exercise while pregnant, especially if you are overweight. If you are medically advised to take bed rest during your pregnancy, anticoagulant medicines can keep the blood clots at bay.
Invest in Compression Pants
Wearing compression clothing will prevent damage to your veins and improve blood flow. This will also lower the chances of DVT.
3. Keep Moving
Even if you have an active lifestyle, try not to remain seated or lying down when you’re at home or at work. Stand up now and then, or take a short walk around the house or the office before getting back to what you were doing. Keep your leg muscles relaxed by giving them regular massages. If you’re travelling, make sure you get up and move around the bus, train, or plane at least every half an hour.
4. Drink Water
This is something crucial to our health, yet we still forget to do it enough. Most people need at least 2 litres of water a day. Pregnant women will do better drinking 3 to 4 litres every day.
5. Maintain a Healthy Lifestyle
Eating a balanced diet of fruits, vegetables, whole grains, and lean meats, is important to stay healthy. Avoid smoking and alcohol, as the former irritates the artery linings, and the latter thins the blood.
Taking precautions against the dangers posed by blood clots is one of the most important things you can do to safeguard the health of your baby and yourself. It’s important to remember to stay calm, and take the necessary measures, such as seeking medical attention, at the right time. Take everything one step at a time, and you will find yourself being able to handle the toughest of decisions. Don’t be afraid to ask for help and support when you need it, as you’ll soon be out of this difficult yet rewarding time.
14 Causes of Breakthrough Bleeding and Spotting
If you feel like you can usually predict your period with military precision—or at least generally know when you can expect it to begin and end—breakthrough bleeding might throw you for a loop. Allow us to help you out if you’re now staring at your screen like, Wait, what is breakthrough bleeding, exactly? Breakthrough bleeding is spotting that happens between your regular periods. It can be pretty common and is often nothing to worry about, Jacques Moritz, M. D., an ob-gyn at New York-Presbyterian and Weill Cornell Medicine, tells SELF. Sometimes, though, breakthrough bleeding may be a sign of a medical issue that requires evaluation and treatment.
That’s why we’re going to make the blanket recommendation that if you are seeing bleeding between periods and aren’t sure why—especially if it’s new or accompanied by pain or other symptoms—you should get in touch with your primary care physician or ob-gyn so they can help you figure out what’s going on. In any case, here are some of the most common breakthrough bleeding causes that people experience. They might give you an idea of what’s up before you go in to see the doctor.
1. You recently started a new birth control pill.
Spotting during the first three months after going on a new birth control pill is considered fairly normal, Dr. Moritz says. “It may take three months for your body to get used to the medicine and the lining of your uterus to adjust to it.”
Spotting can also occur when you switch from a brand name to a generic, Dr. Moritz says. Some gynecologists think that generics may not perfectly match brand-name formulations and that the slight difference may be enough to cause breakthrough bleeding. The United States Food and Drug Administration (FDA) says all generic drugs work the same as their brand-name counterparts but allow for a slight, natural variability that won’t change the main function of the drug. If after three months on a new pill you’re still spotting, or you suddenly start spotting on a pill you’ve taken for longer than that, ask your ob-gyn about switching medications if it’s really bothering you.
2. You’re taking a very low-dose birth control pill.
Many of the newer generations of lower-hormone birth control pills have either very little estrogen or no estrogen at all, relying instead on progestin to regulate your cycle. While many people like these formulations because they experience fewer side effects overall, the super-low hormone dosage makes breakthrough bleeding more likely, even when you’ve been using the same pill for a while. “The pill is making the lining of the uterus so thin that the little blood vessels are fragile and just break because they don’t have enough hormones for support,” Dr. Moritz explains. If the spotting bothers you, ask your ob-gyn about switching to a higher-dose pill and what side effects you can expect if you make the jump.
3. You have an IUD.
Similarly to the pill, a hormonal IUD can cause breakthrough bleeding at first, usually for up to three to six months after insertion. When it comes to the copper IUD, irregular bleeding (and heavier, more painful periods) is relatively common and can go on for quite a while. As SELF previously reported, this is because the device can irritate and inflame the uterus. Although doctors generally recommend giving your body six months or so to adjust, talk to your ob-gyn if you’re miserable.
4. You’re ovulating.
Some people spot during ovulation because the downswing in hormones can cause a little uterine lining to break down too early, causing light bleeding. If your mid-cycle bleeding is accompanied by one-sided pain, you might be dealing with mittelschmerz. This type of ovulation pain occurs when the follicle ruptures and releases its egg, according to the Mayo Clinic.
5. You’re perimenopausal.
Depending on your age, changes in your menstrual cycle are likely to indicate that your body is nearing menopause, which usually begins between ages 45 and 55. The phase before menopause, called perimenopause, can last for several years as hormone levels begin gradually shifting, according to the American College of Obstetricians and Gynecologists (ACOG). Along with periods that are lighter or heavier, shorter or longer, more or less frequent, you may experience breakthrough bleeding during hormone dips.
6. You’ve recently had sex.
Friction from vaginal intercourse can also cause breakthrough bleeding, especially if your vagina wasn’t lubricated enough (because there wasn’t enough foreplay, enough lube, et cetera). If you experience persistent vaginal dryness, it can compound this issue. Vaginal dryness can occur for lots of reasons, including childbirth, taking certain cold medications, and being in perimenopause or menopause. Perimenopause and menopause make you more likely to experience vulvovaginal atrophy, which is a reduction in estrogen that causes symptoms including irritation, soreness, urinary frequency, incontinence, and vaginal dryness. In the event that vaginal dryness during sex is the cause of your spotting, there are over-the-counter vaginal moisturizers that might help you find some relief, and you can always try to find a lubricant that works for you. If nothing is helping, your doctor might be able to offer more guidance.
7. You’re about to become pregnant.
Implantation bleeding is one of the earliest signs of pregnancy, occurring in up to 25% of pregnant people, according to ACOG. One to two weeks after fertilization, when the fertilized egg implants in the uterine lining, a very small amount of blood may flow from the uterus and out the vagina. “It’s just a little spot, not a lot,” Dr. Moritz says.
8. You had vaginal intercourse while pregnant.
During pregnancy, the cervix gets very sensitive, and if it’s irritated during penetrative sex, it can bleed a lot, Dr. Moritz says. Additional blood vessels are developing there, according to ACOG, so bleeding a little after intercourse is no big deal. “It’s totally fine,” he says. It doesn’t mean anything has happened to the baby—having penetrative sex doesn’t harm the fetus.
9. You’re pregnant and have a subchorionic hematoma.
A subchorionic hematoma is essentially a blood clot that can occur when the outermost membrane surrounding the embryo (the chorion) separates a little from the uterine wall, allowing some blood to pool in that space between the two. Sometimes that blood flows out of the vagina, but sometimes it doesn’t. In any case, it’s painless and very common, Dr. Moritz says. These usually aren’t a major cause for concern, and research isn’t really conclusive about whether or not subchorionic hematomas definitively increase a person’s risk of miscarriage or how factors like the size of the hematoma and when it occurs may influence that risk.
10. You have noncancerous growths on your ovaries, uterus, or cervix.
There are a number of abnormal but typically benign growths that can occur on your reproductive organs, including ovarian cysts, uterine fibroids, uterine polyps, and cervical polyps. Localized pain to varying degrees may come along with all of these, along with other symptoms, but it really depends on what you’re dealing with. Bleeding doesn’t necessarily occur with all of them. For example, it’s much more common to see bleeding with uterine polyps than with ovarian cysts, Dr. Moritz says.
Symptoms of molar pregnancy | Gestational trophoblastic disease (GTD)
A molar pregnancy occurs when the fertilisation of the egg by the sperm goes wrong and leads to the growth of abnormal cells or clusters of water filled sacs inside the womb. It is a type of gestational trophoblastic disease.
Vaginal bleeding is the most common symptom of a molar pregnancy. Bleeding can happen during a normal pregnancy too and is not always serious, but you should tell your doctor or midwife straight away if you have any bleeding.
Women with a molar pregnancy are more likely to pass blood clots or have a watery brown vaginal discharge. Some women pass pieces of the molar tissue, which can look a bit like small bunches of grapes. Bleeding caused by a molar pregnancy usually begins between weeks 6 and 12 of pregnancy.
Less common symptoms
The following symptoms are uncommon. This is because most molar pregnancies are found during routine ultrasound scans carried out in early pregnancy.
In some women who have a complete molar pregnancy the abdomen might get bigger more quickly than in a normal pregnancy. So your doctors or your midwife may say that you are large for your dates. In women with a partial molar pregnancy, the womb and abdomen might be smaller than expected for the stage of pregnancy.
Feeling and being sick
Feeling and being sick are common in a normal pregnancy. But with a molar pregnancy the sickness can be more severe and might happen more often. This is called hyperemesis.
Anaemia (low red blood cells)
Anaemia means that you have a low number of red blood cells in your body. Red blood cells carry oxygen around your body. If you’re losing blood because of vaginal bleeding, your red blood cell count may get low. Being anaemic can make you feel tired and breathless.
Pre eclampsia is a complication that can occasionally happen in the last 3 months of a normal pregnancy. The main symptoms are high blood pressure and protein showing in your urine. Rarely, with a molar pregnancy you can get pre eclampsia much earlier on.
This is a rare symptom of molar pregnancy. The medical term for this is hyperthyroidism.
Cancer Research UK nurses
For support and information, you can call the Cancer Research UK information nurses. They can give advice about who can help you and what kind of support is available.
Freephone: 0808 800 4040 – Monday to Friday, 9am to 5pm.
Bleeding and Spotting During Pregnancy
Not much can make you worry more during pregnancy than seeing some blood in your underwear. Does spotting during pregnancy mean you’re having a miscarriage, bloody show, or something else? This guide to spotting and bleeding during pregnancy will help you know what’s going on, and what to do about it for peace of mind.
The Difference Between Spotting and Bleeding
Spotting is defined as colored vaginal discharge that’s enough to leave some marks on a pad or panty liner, but not enough to soak it through. Spotting can range from pink-tinged discharge, to brown or bright red. Bleeding on the other hand is when there’s enough fluid to soak through a panty liner or pad, and its often bright red, though not always.
Spotting During Early Pregnancy
The American Pregnancy Association estimates about a third of women experience what’s called implantation bleeding. This happens after conception, when the fertilized egg burrows into the uterine lining. Implantation bleeding occurs about 10 to 14 days after ovulation and is often mistaken for a missed period.
Implantation bleeding is typically light pink to brown and only lasts a few hours to a few days. It is much lighter than a usual period, which is heavier bleeding that continues for about a week.
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Is Spotting Normal During Pregnancy?
An estimated 20% of women will report having spotting during the first trimester, according to the American Pregnancy Association, about the same amount that will also have implantation bleeding. Another statistic says that about 50% of mamas will have bleeding or spotting at some point in their pregnancy, so it’s not uncommon. Heavy bleeding however is always a cause for concern and should be checked out as soon as possible by your midwife or doctor.
Bright Red Spotting During Pregnancy
There are several different issues that can cause bright red spotting during pregnancy, some more benign than others. Some lesser reasons for bright red spotting include recent vaginal irritation from intercourse, from checking your cervix or a pap smear. When the discharge is bright red, it means that the blood is fresh. Here are some other possible reasons for bright red spotting:
Placenta previa is when the placenta partially or fully covers the cervix and can cause bleeding, usually bright red, later in the pregnancy. This condition is usually detected early by ultrasound, before bleeding occurs. Most cases of placenta previa will resolve themselves by delivery, as it only occurs in about 1 in every 200 deliveries. However, placentas that don’t migrate up where they belong can cause bleeding in the second or third trimester, necessitating further interventions.
Placental abruption is when the placenta separates from the uterus. It usually occurs during the last 12 weeks of pregnancy. This event is rare and occurs in about 1% of pregnancies according to the American Pregnancy Association. Placental abruption is accompanied by light to heavy bleeding, with or without clots.
Make sure to contact your midwife or doctor for any bleeding during the second half of your pregnancy.
A molar pregnancy is also known as gestational trophoblastic disease (GTD). In the case of molar pregnancies, a placenta is created, giving a positive pregnancy test result, but because of a lack or overabundance of chromosomes, there will either be a cluster of cells and no fetus present or an embryo which is severely malformed. Bleeding is dark brown to bright red and may be accompanied by nausea, vomiting and cramping. Molar pregnancies are rare, and only happen in 1 out of 1,000 pregnancies. If you suspect a molar pregnancy, see your health care professional immediately for treatment as it could lead to a rare form of cancer.
Is it a Miscarriage?
Bright red spotting or bleeding in the first trimester can indicate a miscarriage. It is estimated that half of all pregnancies end in miscarriage, though often it’s so early that it isn’t noticeable. If an ultrasound shows a normal heartbeat between seven and 11 weeks, then there’s more than a 90% chance of not miscarrying, according to a study in the U.S. National Library of Medicine.
Bleeding during pregnancy can be classified either as a threatened miscarriage or an inevitable miscarriage. A threatened miscarriage will present with spotting or bleeding and often abdominal pain, but the cervix is still closed upon examination. An inevitable miscarriage however means that the cervix is dilated, bleeding is heavy and a miscarriage is almost certain to occur. Someone who is may be miscarrying could experience some or all of the following symptoms during pregnancy.
Symptoms of Miscarriage
- White/pink mucus discharge
- Brown or bright red bleeding
- Abdominal cramping and pain
- Blood clots
- Lower backache
How to Prevent a Miscarriage
While you can’t prevent a miscarriage if your body isn’t meant to carry the embryo, there are ways to prevent a full miscarriage if you suspect you may be having a threatened miscarriage. Note that if the cervix is already dilated and the bleeding is heavy, then it’s likely an imminent miscarriage and probably can’t be stopped. If you suspect a miscarriage, contact your midwife or doctor right away. Your health care provider will be able to examine you and let you know what’s going on.
In a threatened miscarriage, the cervix is still closed, so there’s still a chance that the baby will stay put for a while. Your midwife or doctor will be able to give you guidance, but the following tips can be helpful at preventing a threatened miscarriage from becoming an imminent miscarriage. The most important thing is to relax and reduce stress.
- Put your feet up and relax
- Don’t lift anything over 10 pounds
- Bed rest
- Stay calm
- Try forest bathing
- Repeat positive affirmations. The brain is a powerful tool!
- Take magnesium to relax, or use a topical magnesium oil or lotion
- Recline in the bathtub with some soothing Epsom salts (which are magnesium)
- Get help if needed. Have family or friends help out with household tasks or taking care of the kids.
Brown Spotting During Pregnancy
A brown discharge during pregnancy is from blood that’s older and not as recent as red blood. Miscarriage, molar pregnancy and bloody show can all be a reason for brown spotting. The most common reason for brown spotting during pregnancy though is from vaginal irritation.
During pregnancy, the number of blood vessels in the cervix increase. Sex or vaginal exams can cause irritation in this delicate area, and the increased blood flow may cause spotting. The spotting can be brown, pink or red. If the discharge continues and isn’t occasional, then it could be a cause for concern and should be reported to your health care professional.
Other Reasons for Spotting During Pregnancy
There are many other reasons other than miscarriage for spotting during pregnancy that could cause red or brown spotting. Some possible causes are:
This condition is when blood accumulates in the folds of the outer fetal membrane next to the placenta or between the uterus and placenta. Usually these resolve themselves, but sometimes it can increase the risk for preterm labor or other complications. A subchorionic hemorrhage causes light to heavy spotting and can be brown, dark blood possibly accompanied by blood clots. The blood clots are either absorbed by the body or expelled from the vagina. Even though this issue may not be serious, it still requires prompt medical attention.
STDs and Infections
Most providers will routinely test for the sexually transmitted diseases chlamydia and gonorrhea during pregnancy, as these can cause health issues for the baby. Group B Strep bacteria is also routinely screened for, as it can cause bladder or uterine infections or complications in newborns. Both STDs and infections can irritate the cervix and cause spotting. You can learn more about natural GBS treatments here.
The blood is sometimes accompanied by mucosal discharge. If you have a fever, painful urination, nausea or vomiting along with spotting, be sure to contact your health provider right away. This could indicate a urinary tract infection or other illness, and needs addressed promptly.
Cervical Polyp or Fibroid
Fibroids are growths that can occur in the uterine lining. If the placenta embeds itself in a uterine fibroid, it can cause some bleeding. Bleeding can also occur if there is a polyp on the cervix. A polyp is an abnormal growth that often occurs as a result of elevated estrogen levels during pregnancy. Combined with an increased number of blood vessels in the cervix, the cervix is more likely to bleed if there is polyp present. Note that polyps are usually benign are not cause for concern. But any continual spotting or bleeding should be brought up to your health care provider just to be safe.
An ectopic pregnancy is when the embryo is lodged outside of the uterus, typically in a fallopian tube. This is sometimes called a tubal pregnancy, which can rupture the fallopian tube as the embryo grows. According to the American Pregnancy Association, ectopic pregnancy occurs in about 1 of 50 pregnancies and almost always results in the loss of the pregnancy. The blood can range from spotting to bleeding, and is usually brown or red.
Ectopic pregnancy is a serious complication and should be addressed immediately as it can also result in severe health complications for the mother. Be sure to tell your health care provider right away if you experience any of the following symptoms along with the spotting or bleeding:
- Pain in the shoulders
- Pain in the pelvis or abdominal muscles
- Severe sharp pain on one side of the lower abdomen
- Rectal pressure
- Lightheadedness or fainting
Spotting or Bleeding During the Third Trimester
Once you are in your third trimester, spotting or bleeding could indicate the beginnings of labor, so it’s important to pay attention to your body and contact your health care provider immediately if you experience any pre-labor symptoms or unknown bleeding. Some possible causes for bleeding the the third trimester include the loss of your mucus plus and what’s known as the “bloody show,” which isn’t nearly as messy as it sounds.
Losing the Mucus Plug
As your body prepares for your baby’s arrival, it will usually include the loss of your mucus plug. The mucus plug can vary in color from clear to white, or even be green, pink or brown. However, it is often clear with streaks of pink or brown. You will usually lose your mucus plug sometime during or after your 37th week of pregnancy, as it is usually a sign that your cervix is softening and/or dilating in preparation for labor. This may be accompanied by the bloody show.
This event occurs at the tail end of pregnancy and is the result of tiny capillaries bursting in the cervix as it prepares for labor. First time moms usually have bloody show a few days before labor begins, while others usually don’t experience it until the cervix is dilating for active labor. The bloody show is a minimal amount of discharge that can range from brown, to pink, to the most common, bright red. It’s a sign that baby is on the way soon and there nothing to worry about. Bloody show may be accompanied by the loss of the mucus plug before active labor, or maybe not.
Premature labor could also be a reason for spotting or bleeding in your third trimester. Premature labor is defined by the CDC as labor that starts before 37 weeks. But it’s important to understand the differences in contractions and symptoms to know whether your body is ready to have a baby.
Braxton Hicks contractions can often be mistaken for premature labor. However, Braxton Hicks contractions are small, practice contractions your body makes as it prepares for actual labor and they usually don’t involve any other symptoms.
Prodromal labor on the other hand feels like real contractions that even increase in frequency and intensity, but it also doesn’t result in baby’s appearance. Read more about Braxton Hicks contractions and prodromal labor symptoms.
Unlike Braxton Hicks contractions or prodromal labor, premature labor does result in the birth of the baby. Let your midwife or doctor know right away if you’re having the following symptoms, as premature labor requires prompt care for you and baby:
- Vaginal discharge
- Cervical dilation (you may or may not be able to feel that this has happened)
- Pelvic pressure as baby descends or pushes down
- Abdominal and/or uterine cramps
- Lower back pain that’s dull
- Loss of mucus plug or bloody show
When to Call Your Midwife or Doctor
Anytime you experience heavy bleeding in pregnancy, or the discharge is bright red, be sure to contact your provider promptly. It’s usually recommended to wait and report light spotting during office hours, as it’s usually not an emergency. While the information here can help point you toward what may be going on in your body, self-diagnosis has its limits. If you’re unsure or just feel uneasy about any vaginal discharge, it’s better to be safe than sorry and let your provider know right away.
How to Talk to Your Provider
Certain types of spotting during pregnancy aren’t really a cause for concern, while others are emergency situations. It can be hard to gauge what is what, so anytime you’re unsure, it’s best to err on the side of caution. If you notice spotting or bleeding, it helps to wear a panty liner or pad to better gauge of the color, the amount of discharge and if it’s accompanied by mucus. You don’t need to bring the pad in with you to an appointment, but take note of what it looks like and any other symptoms so you can pass the information along.
What Will Your Provider Do if There’s Spotting or Bleeding?
If the spotting is minimal and your symptoms point to an issue that isn’t serious, your midwife or doctor may choose to wait it out. Frequent spotting however can be due to a hormonal imbalance, and in this case your provider may check your HcG and progesterone hormone levels. It really depends on the specific discharge and symptoms you’re experiencing, but your provider may also do one or more of the following:
- Perform a vaginal exam to check the cervix and vagina
- Perform an ultrasound to monitor the baby
- Use a doppler or fetoscope to check the baby’s heartbeat
- Recommend abstaining from sex
- Check for a UTI or other infection
The Most Important Thing to Remember
Stress makes any situation worse, so remember to relax! Spotting or bleeding during pregnancy is fairly common, and often has an easy solution. Let your doctor or midwife know what’s going on, and take some deep breaths, mama.
What About You?
Did you experience spotting or bleeding during pregnancy? How did you and your health care provider handle the situation?
Spotting During Early Pregnancy? It’s Usually Nothing to Worry About.
By Lindsay Meisel | Published | Last updated ✓ Fact checked
Spotting during pregnancy causes many women to panic that they might be having a miscarriage or chemical pregnancy, but most of the time, it’s no cause for alarm. There are a variety of reasons why you might experience spotting, brown discharge—or even heavy bleeding with clots—during pregnancy. But the statistics around spotting and pregnancy outcomes are reassuring.
Vaginal bleeding in early pregnancy is relatively common, affecting 10 – 15 percent of women. While it’s considered a risk factor for miscarriage, preterm delivery, and low birth weight, many sources suggest that the increased risk of these issues is slight, and most women who experience spotting go on to have healthy, full-term pregnancies.
What Causes Spotting During Early Pregnancy?
Sometimes spotting happens without any identifiable cause. It’s just one of those unexplainable pregnancy things. Other times, there is an explanation for the spotting or bleeding, and it’s usually nothing bad. Here are some of the common causes of spotting or bleeding during pregnancy:
Irritation to the Cervix
The cervix may be more sensitive and prone to bleeding during pregnancy. Anything that irritates the cervix—like sexual intercourse, transvaginal ultrasound, or progesterone suppositories—might lead to bleeding.
No Known Cause
It’s frustrating, but sometimes spotting or bleeding can happen during pregnancy without any identifiable cause.
Implantation Bleeding? It’s a Myth.
Many women believe that when spotting occurs in very early pregnancy, it is implantation bleeding. However, there is no medical evidence that implantation bleeding exists. Spotting in the luteal phase is fairly common in both pregnancy and non-pregnancy cycles. When spotting occurs in early pregnancy, it usually does not occur on the day of implantation (one study found that most bleeding began at least five days after implantation).
Subchorionic hematoma is the accumulation of blood within the folds of the outer fetal membrane, or between the uterus and the placenta. Sometimes there is no bleeding, and sometimes there is light to heavy spotting. Most of the time, subchorionic hematoma resolves on its own, and does not impact the health of the pregnancy.
Infections (such as bacterial vaginosis) can irritate the vagina or cervix and cause light bleeding or spotting. Seek treatment for the infection and the spotting should resolve.
Seeing blood during pregnancy is scary, but it doesn’t usually mean that you’re having a miscarriage or chemical pregnancy. One study found that of all pregnancies with bleeding, 14 percent miscarried, compared to nine percent miscarrying in pregnancies without bleeding. And the majority of pregnancies that miscarried had no bleeding in early pregnancy.
How do you know if spotting is benign or a sign of something bad? Unfortunately, there’s no foolproof way to tell. Sometimes vaginal bleeding can be heavy with clots, and everything is fine. Other times, light spotting can signal a miscarriage. There isn’t a hard and fast way to map spotting type to pregnancy loss risk. However, one study found that bleeding that stops and then resumes later may be more ominous. There were two women who experienced this bleeding pattern in the study, and they were the only two women with bleeding who went on to miscarry[4.ibid].
An ectopic pregnancy occurs when the fertilized egg implants somewhere other than the uterus—most commonly, in the fallopian tubes. Often, ectopic pregnancies come with vaginal bleeding that can be anywhere from light spotting to period-like flow. Other symptoms of ectopic pregnancy include one-sided pain and weakness or dizziness. An ectopic pregnancy is a serious medical condition that requires treatment. If you suspect you have one, you should contact your medical provider immediately.
By Lindsay Meisel |
What causes nosebleeds in pregnancy, and tips to manage them | Your Pregnancy Matters
Even when you aren’t pregnant, you’re more likely to get a nosebleed with a cold, sinus infection, or allergies. But approximately 20% of women experience pregnancy rhinitis – inflammation and swelling of the mucous membranes in the nose.
Pregnancy rhinitis causes congestion, postnasal drip, and runny nose. And when you’re constantly blowing your nose, you’re more susceptible to having a bloody nose.
Certain medical conditions such as high blood pressure or clotting disorders can cause nosebleeds as well.
You may also get a nosebleed if the membranes in your nose dry out and crack due to cold weather, dry air, or intense air conditioning.
Pregnancy tumor: A rare cause of nosebleeds
Also known as a pyogenic granuloma, a pregnancy tumor is a noncancerous, rapidly growing mass of capillary blood vessels that bleeds easily. Research suggests the masses form due to the influx of hormones during pregnancy.
Approximately 5% of pregnant women develop pregnancy tumors, which typically form in the gums between the teeth but can also form in the nose. The masses can appear anywhere on the body and generally disappear after the baby is born.
Treatment usually consists of either a medicated gel or nasal spray, which helps control bleeding. Some women need to have the tumor removed if it is causing breathing problems or excessive nosebleeds. The exact procedure to remove the tumor depends on where the tumor is located. For pregnancy tumors of the nose, most can be removed endoscopically without any external incisions or stitches.
Related reading: 5 weird pregnancy symptoms you might not know about
How can I prevent nosebleeds during pregnancy?
While it’s not possible to prevent all nosebleeds, there are few things you can do to avoid irritating the sensitive blood vessels in your nose.
● Moisturize the inside of your nose: Use a bit of saline nasal gel to lubricate dry or irritated nasal passages.
● Use a humidifier: Because dry air increases the risk of nosebleeds, adding a little moisture to the air can do wonders.
● Drink plenty of fluids: This keeps your mucous membranes well hydrated and less likely to dry out and crack.
● Treat colds and allergies: Talk to your doctor about which over-the-counter medications may be best.
Be especially gentle after a nosebleed. Your nose needs to heal, so don’t blow it too hard or stuff tissues in the nostrils, which can prolong bleeding.
How to stop a nosebleed and when to see your doctor
90,000 Discharge during pregnancy | What discharge during pregnancy? | Blog
In the absence of menstruation, girls usually suspect that conception has occurred. However, during pregnancy, the female body can continue to secrete secretions of different colors and nature. We recommend that you closely monitor everything that happens so as not to miss the development of adverse events. We will tell you how to recognize problem situations during pregnancy in the article.
What discharge can be at conception
Many women note that immediately after a delay and at a later stage, the nature of secretion changes.It could be:
- With or without smell.
- Depending on the color – transparent, white, cream, yellow, greenish, bloody.
- By consistency – thick, liquid, curdled.
- As a symptom for assessing the state of health – threatening, safe.
During ovulation, the ovum leaves the ovary, its membrane is deflated, a small amount of fluid is released – so it becomes ready for fertilization.At this time, the thick mucus filling the cervical canal of the cervix becomes less viscous. This makes it easier for sperm to penetrate and further move into the tubes for fertilization. At this time, you may notice an abundance of clear mucous secretions.
After the fusion of the egg with the sperm, movement into the uterus begins, which should end with implantation into the inner layer. During penetration, a slight detachment of it may occur – this causes damage to the blood vessels that profusely penetrate the muscle layer of the uterus.You can make out a light brown discharge, which happens a lot during pregnancy. The color is explained by the fact that the blood has time to clot.
Sometimes the discharge is brightly colored, and some women mistake it for menstruation that started ahead of time. But in this case, short-term is characteristic, a different shade (dark or scarlet), a slight trace on the linen.
With some structural features of the female genital organs (for example, with a bicornuate uterus), after implantation of the embryo in one part, in another, endometrial rejection may begin, as is usually the case with menstruation.This rarely happens.
Characteristics of discharge in case of a threat of miscarriage
Spontaneous abortion is the rejection of an embryo in the early stages after conception. If at the first signs of pregnancy, you notice bloody discharge, there is a high probability that a miscarriage begins.
Miscarriage symptoms also include:
- pulls or presses on the lower abdomen, sacrum, lower back;
- the muscles of the uterus are tense.
A woman may experience cramping spasms.This continues constantly or periodically. Scarlet or brown discharge comes from the vagina during pregnancy, which was previously confirmed. Sometimes the term may be still short, and the first signs did not have time to appear.
After 22 weeks, this is called preterm labor. In this case, the child is still weak, the organs are not sufficiently developed, and the chances of survival are small.
The following factors increase the risk of miscarriage:
- various diseases;
- progesterone deficiency;
- nervous and physical stress;
- pathologies in the genitals;
- fetal developmental defects.
To confirm the diagnosis, the doctor prescribes an ultrasound scan. If it shows that the fetal heart rate is disturbed, the tone of the uterus is increased, its size differs from normal for this period, hospitalization will be recommended to preserve the pregnancy.
What discharge during pregnancy is considered normal
Does not pose a threat to health such secretion:
- without unpleasant odor;
- mucous membrane;
- without itching, burning, redness of the genitals.
Transparent liquid on underwear – a symptom of ovulation. During pregnancy, the activity of the processes taking place in the body increases, so the volume of secreted secretion may increase. However, a violation of the norm is the leakage of amniotic fluid. You can determine the problem with the help of special diagnostic tests that the doctor will prescribe if he has any suspicions.
White color, small amount, homogeneous structure should also not be a cause for concern.The increased volume of fluid in this case is associated with increased hormonal activity.
One of the variants of the norm is mucous discharge, which smells of slight sourness. If there is no pain, discomfort, there is nothing to worry about.
Yellow discharge, signs of pregnancy are present, there is no unpleasant odor – you are all right. Some women had this color before conception, only they did not pay attention. Now there are more of them, therefore, more noticeable.
Sometimes a woman observes that the laundry gets wet and the smell of urine appears.This may indicate incontinence due to the constant pressure of the growing uterus. In this case, it is recommended to go to the toilet more often, change panties twice a day.
What discharge during pregnancy is considered a sign of infection
By the nature of the secretion, one can suspect the presence of inflammatory diseases in the woman’s body.
White discharge during pregnancy with a curdled structure is a symptom of thrush (candidiasis). In pregnant women, it is diagnosed quite often – the reason is a change in hormonal levels.The disease is accompanied by itching, redness of the vulva, strong sour odor. Sometimes external manifestations are not detected, then the treatment is not carried out.
Infection is indicated by pain, stinging, skin irritation, ulcers, the smell of rot or fish, gray or green color, the frothy nature of the secreted fluid, increased nervousness, large inguinal lymph nodes. The reason may lie in sexually transmitted infections. This includes syphilis, gonorrhea, trichomoniasis, chlamydia, and others. They are dangerous in that they cause premature birth and fetal defects.
What discharge during pregnancy should you pay special attention to and should you see a doctor?
The fact that pregnancy is at risk is evidenced by:
- Severe pain in the perineum, bleeding, difficulty defecating, convulsions – these can be injuries to the vaginal mucosa.
- Nausea, profuse vomiting, edema, headaches, cough, hypertension, bright red secretion are symptoms of cystic drift (abnormal development of the embryo).
- A drop in blood pressure, pallor, weakness, sweating, pulling sensations, bleeding during pregnancy against the background of a lack of hCG growth in the blood – this is how ectopic attachment manifests itself.
- Discharge of clots, sharp pain, vomiting, diarrhea may indicate a frozen fetus.
If you experience any of the listed symptoms, consult a doctor immediately.
It is also necessary to go to the clinic if you were physically abused, had rough sex, had an accident, fell, or hit. The likelihood that the situation will be resolved successfully is much higher if you do not delay the visit, listen to the symptoms and take good care of your health.
Remember, despite the fact that pregnancy is a normal state of health of the female body, the diagnosis and treatment tactics are still different, due to the many restrictions on manipulations and medications during pregnancy. That is why diagnosis and treatment during pregnancy should be carried out only under the supervision of a physician. Ignoring the symptomatology or self-medication, a pregnant woman risks not only her own health, but also the health of the child.
Doctors of the Leleka Maternity Hospital conduct pregnancy of any complexity, including those burdened by infections, pathologies, and the threat of termination.Our own diagnostic laboratory allows us to accurately and as soon as possible get the test results. Thanks to constant medical supervision throughout the entire period, the chances of a successful delivery are greatly increased.
Entrust the life and health of your child to the doctors of “Leleka”, and we will make sure that you are satisfied.
90,000 blood clots during early pregnancy – 25 recommendations on Babyblog.ru
This is my first entry on bb! There were a lot of thoughts and deeds, there was not much time) I am 32 years old, I am a wife and a mother, my son is growing up 2.10 for us now) My husband and I have always dreamed that our family would have at least two children, or even more! But, as they say, if you want to make God laugh, tell him about your plans.Before the birth of my son, I had an ST at an early stage. The doctor said that now almost every second woman is pregnant for the first time, do not worry too much, rest for half a year and again into battle) The pregnancy was desired, but alas … In general, six months later we tried again and, thank God, everything worked out! During pregnancy, I was only toned several times, nothing else bothered me) The birth was more than wonderful) We were on GV, did not use contraception, since both were not against the addition of more.But the coveted B never came, only by the age of 1.7 I saw the cherished two stripes! But my happiness did not last long, at 7-8 weeks it swept, I ran on ultrasound, again ZB, hospital, cleaning … PPI is normal, hormones are also normal, spermogram is good … And again, doctors say, well, it happens, try again … Exactly half a year later, the striped test again, hCG is growing! But this time even on ultrasound it was already scary to go (((who went through this will understand me well… And I never got to the ultrasound, with severe bleeding they took me to an ambulance … a miscarriage … They didn’t even clean it … They prescribed an OK and sent me to the “miscarriage room”. The doctor ordered an additional blood test from a Hemostasiologist: a semi-quantitative d-dimer and a sail test to begin with …. And then there were also lupus anticoagulants, genetics … The diagnosis was made: genetic thrombophilia! The tendency of blood to form clots. Specifically, in my case, these clots are small, but sufficient to disrupt the blood flow at the stage of attachment to the uterine wall, which causes the developmental arrest and death of the embryo.They promise that pregnancy is possible, but only with the support of the drug (I did not understand yet if the names could be written). It needs to be injected from the month of planning pregnancy until the very birth! In the best case, it will be 10 months, I really hope that it will be so with me! 🙏🏻 I left the doctor full of hope and flew home. But my ardor was cooled by the price of the drug … He is injected every day, starting from the 5th day of the MC. Those. On average, the amount comes out about 10tr per month. Thanks to my husband for driving the blues away from me and saying, we must, then we must! 😊
Today is the 5th day since I inject myself with these injections and hope for the best I really want another little baby! I used to think that there would be another girl))) now it’s all the same, if only he was born and healthy! By the way, injections are given in the stomach at the same time, after the first two I had bruises, now I have adapted to them like) from tomorrow I catch ovulation
I am not losing hope, and I do not advise you!
90,000 Publications in the media
Abortion – termination of pregnancy before the term when the fetus becomes viable (i.e.e., able to exist outside the uterus). Spontaneous abortion (miscarriage) – expulsion of an embryo or fetus with membranes without medical or mechanical intervention. A fetus born not earlier than 22 weeks of gestation with a body weight of at least 500 g is considered potentially viable.
Statistics • In 40% of cases after fertilization of the egg, spontaneous abortion occurs • Most of spontaneous abortions are not detected because the expulsion of the fertilized / implanted egg occurs in early pregnancy (before the onset of amenorrhea and other clinical signs of pregnancy) • Approximately 10-15 % of all diagnosed pregnancies end in clinically diagnosed spontaneous abortion • Intrauterine devices (IUDs) and abortion: The spontaneous abortion rate is about 50% if the IUD is left in place.With the onset of pregnancy, it is recommended to remove the IUD to avoid infection. When the IUD is removed early in pregnancy, the spontaneous abortion rate is approximately 20–30%. The pregnancy rate with the use of an IUD is 2–3 cases per 100 women per year. Prevailing age • Young (under 15) • Women over 35 have a 3 times higher risk of spontaneous abortion than women under 30.
Classification of abortion. Early (up to 12 weeks of gestation) and late (12–22 weeks of gestation) miscarriages are distinguished.In the case of fetal death in the first 7 days after childbirth, which occurred at 22–28 weeks of gestation, a late spontaneous miscarriage is noted.
According to the clinical course, the following stages of spontaneous abortion are distinguished: threatening abortion, abortion in progress, abortion in progress, incomplete abortion, complete abortion, failed abortion (for more details, see Clinical Presentation).
Etiology • In most cases, the cause of spontaneous abortion is unknown. Most often, spontaneous abortion is caused by chromosomal abnormalities (in the conceptus / embryo / fetus) • Defective implantation of a fertilized egg • Endocrine disorders • Infectious diseases • Poisoning (including drug and alcohol) • Placental insufficiency • Sperm defect • Traumatic • Therapeutic or criminal interventions.
Genetic aspects. Chromosomal abnormalities in the fetus (less commonly in a pregnant woman) significantly increase the incidence of spontaneous abortion.
Risk factors • Chromosomal abnormalities in the fetus (100-fold increase in the frequency of spontaneous abortions) • Pathology of the uterus • Alcohol / drugs • Excessive consumption of caffeine (more than 2 cups of coffee a day) significantly increases the risk of abortion • The age of the pregnant woman is over 35 years old • Somatic diseases (eg diabetes mellitus [DM], thyroid disease) • Infection with certain viruses or bacteria.
Clinical picture (with a previously diagnosed uterine pregnancy) • Bleeding from the genital tract (discharge of pink or brownish color) • Uterine contractions • Dilation of the cervix • Violation of the integrity of the membranes • Isolation of the ovum, its parts or an unviable fetus • Fever • Possible shock • Soft enlarged uterus • Features of the clinical picture depending on the stage of abortion •• Threatening abortion is manifested by pain and heaviness in the lower abdomen, bleeding and uterine contractions without opening the cervix •• The abortion that begins is accompanied by bleeding due to a slight detachment of the ovum from the walls of the uterus , contractions of the myometrium, dilatation of the cervix •• On-the-go abortion – dilatation of the cervix, violation of the integrity of the membranes and release of the ovum or its parts during bleeding •• Incomplete abortion – part of the tissue remains in the uterine cavity.Incomplete spontaneous abortion occurs more often after 10 weeks of pregnancy; the placenta and fetus are expelled separately. The placenta can be preserved in whole or in part, which leads to prolonged bleeding (sometimes profuse) •• Complete abortion – complete expulsion of the embryo, fetus, membranes •• Failed abortion – the dead ovum is in the uterine cavity for a long time (at the same time, an increase in the size of the uterus is observed) …
Laboratory tests • Bacterial culture for group B streptococci, gonococci and chlamydia • Blood: a decrease in hemoglobin (Hb) and hematocrit (Ht) • Chorionic gonadotropin (HCT) •• HCT – a marker of suspected pregnancy •• HCT (or its
b -subunit) can be detected in urine or blood plasma by qualitative and quantitative methods •• Test systems for early diagnosis of pregnancy can detect HCT in concentrated urine during the first 2 weeks after ovulation •• Study of blood plasma for b -cGT subunit allows you to presumably diagnose pregnancy (if implantation has occurred) a week after ovulation and a week before the expected menstruation •• HCT is a criterion for the state of the embryo / fetus.The concentration of this hormone in blood plasma rapidly increases from 2 to 9 weeks of pregnancy. If the content is stable or declining, the viability of the fetus and the normal course of pregnancy are questionable. • Progesterone. In the normal course of uterine pregnancy, the progesterone content is> 25 ng / ml, with ectopic pregnancy and non-viability of the embryo / fetus, the concentration is lower. A progesterone content of less than 5 ng / ml is an indisputable sign of ectopic pregnancy or non-viability of the embryo / fetus.
Special studies • Pathomorphology: fragments of the embryo in the discharge from the uterine cavity • Ultrasound •• To exclude ectopic pregnancy and determine the viability of the embryo / fetus •• Using ultrasound, you can confirm the diagnosis of uterine pregnancy, starting from 4 or 5 weeks • Examination in the mirrors to determine the source of bleeding. Obtaining bacterial cultures for the detection of group B streptococci, gonococci and chlamydia. Bacterial culture of urine taken from a catheter • Bimanual vaginal examination to assess the size and consistency of the uterus, the degree of dilatation of the cervix.Assessment of the size and sensitivity of the uterine appendages.
Differential diagnosis • Ectopic pregnancy • Polyps, neoplasms and inflammatory processes localized in the cervix • Vesiculate drift • Dysmenorrhea.
Signs of pregnancy • Reliable – registration of fetal heart sounds (usually an additional Doppler study is performed, but not earlier than 9 weeks of pregnancy) and imaging of the fetus / placenta by ultrasound • Probable – an increase in the size of the uterus with a simultaneous increase in the size of the abdomen, softening of the cervix , amenorrhea, soreness and swelling of the mammary glands, an increase in the content of HCT in urine and blood.
TREATMENT • With the threat of termination of pregnancy and the onset of abortion, hospitalization, bed rest, psychotherapy, sedatives, antispasmodics, vitamin E, endonasal galvanization, acupuncture, pathogenetic therapy, depending on the identified etiological factor • Under the control of the level of hormones, replacement is performed – after 8 weeks of pregnancy, progesterone for 7 days, it can be combined with misoprostol 0.0125-0.025 mg / day abortion consists in the removal of the ovum or its residues and blood clots • In case of cervical insufficiency and the threat of abortion, cervical cerclage is performed • To prevent bleeding after spontaneous abortion or curettage of the uterine cavity: •• Oxytocin 10 U / m •• Methyl ergometrine 0.2 mg IM • Analgesics if necessary spines • Rh0- (anti-D) -Ig, if the woman’s blood is Rh-negative • Agonists of
b -adrenoreceptors in threatened abortion to relax the myometrium • Progesterone in case of its insufficient content in the blood plasma.
Complications • Complications of curettage of the uterine cavity: perforation, infection of the uterus and uterine bleeding • Repeated spontaneous abortion • Depression with a feeling of guilt (psychotherapy may be necessary).
Course and prognosis • In the case of threatened abortion, if the bleeding has stopped and the examination results indicate a normal course of pregnancy, the prognosis is favorable. Bleeding in the first trimester of pregnancy can lead to premature birth, the birth of a low birthweight fetus (even with urgent delivery) and an increased risk of neonatal fetal death habitual spontaneous abortion, the prognosis for pregnancy is less favorable.
Prevention • Any bleeding from the genital tract in a woman with a suspected or proven uterine pregnancy should be considered a symptom of an incipient abortion until this diagnosis is ruled out. Vaginal bleeding in the early stages of pregnancy occurs quite often, the cause of bleeding is rarely identified. In the case of a habitual spontaneous abortion, material isolated from the uterine cavity is sent for karyotyping. To determine further medical tactics, it is necessary to establish the cause of the habitual abortion. • In case of a habitual abortion due to the pathology of the cervix, a surgical reconstruction of the cervix is performed.
ICD-10 • O03 Spontaneous abortion
Notes • It is recommended to abandon the term “miscarriage” because with the advent of ultrasound and other diagnostic methods, it became possible to determine the diagnosis more accurately (for example, cystic drift, intrauterine fetal death, etc.). If the term is still used, it means a delay in the uterine cavity of parts of the embryo / fetus for 8 weeks or more after the death of the embryo / fetus • Failed abortion – death of the fetus or embryo without labor and its expulsion from the uterine cavity. Management tactics – see abortion in progress
Habitual abortion (habitual miscarriage) – a spontaneous abortion that occurred after 2 consecutive spontaneous abortions or more. Although repeated spontaneous abortions are often accidental, in such cases it is recommended to conduct a study of the karyotype of the parents and an examination of the woman to identify abnormalities (eg, cervical incompetence, uterine abnormalities, infections, hormonal disorders, chromosomal aberrations) • Conceptus.It is believed that the embryo is a community of cells or a creature that forms at the stage of the primary streak, but not earlier; the product of differentiation of the zygote to the stage of the primary stripe cannot be called an embryo.