Miscarriage – what you might actually see and feel

WARNING — This article contains some graphic descriptions of what you might see during a miscarriage.

A miscarriage requires prompt medical care. If you think you are having a miscarriage, call your doctor or midwife for advice and support. Go to the Emergency Department if:

• you are bleeding very heavily (soaking more than 2 pads per hour or passing clots larger than golf balls)
• you have severe pain in your tummy or shoulder
• you have a fever (a temperature above 38 degrees C)
• you are dizzy, fainting or feel like fainting
• you notice fluid coming from your vagina that smells bad
• you have diarrhoea or pain when you have a bowel motion (do a poo)

Miscarriage is a very unfortunate and sad outcome of pregnancy that takes a significant emotional and physical toll on a woman. It also happens more frequently than many people think. It’s important to recognise that there’s no right or wrong way to feel about a miscarriage.

Despite close to one in 5 pregnancies ending in miscarriage, what actually happens and what a woman needs to know and do when faced with a possible miscarriage are subjects that rarely get discussed.

This article aims to give you an idea of what happens and what a woman needs to know and do at different stages in her pregnancy.

Please call Pregnancy, Birth and Baby on 1800 882 436 if you have any concerns or wish to discuss the topic further.

What might I feel during a miscarriage?

Many women have a miscarriage early in their pregnancy without even realising it. They may just think they are having a heavy period. If this happens to you, you might have cramping, heavier bleeding than normal, pain in the tummy, pelvis or back, and feel weak. If you have started spotting, remember that this is normal in many pregnancies — but talk to your doctor or midwife to be safe and for your own peace of mind.

Later in your pregnancy, you might notice signs like cramping pain, bleeding or passing fluid and blood clots from your vagina. Depending on how many weeks pregnant you are, you may pass tissue that looks more like a fetus, or a fully-formed baby.

In some types of miscarriage, you might not have any symptoms at all — the miscarriage might not be discovered until your next ultrasound. Or you might just notice your morning sickness and breast tenderness have gone.

It is normal to feel very emotional and upset when you realise you’re having a miscarriage. It can take a while to process what is happening. Make sure you have someone with you, for support, and try to be kind to yourself.

What happens during a miscarriage?

Unfortunately, nothing can be done to stop a miscarriage once it has started. Any treatment is to prevent heavy bleeding or an infection.

Your doctor might advise you that no treatment is necessary. This is called ‘expectant management’, and you just wait to see what will happen. Eventually, the pregnancy tissue (the fetus or baby, pregnancy sac and placenta) will pass naturally. This can take a few days or as long as 3 to 4 weeks.

It can be very hard emotionally to wait for the miscarriage because you don’t know when it will happen. When it starts, you will notice spotting and cramping and then, fairly quickly, you will start bleeding heavily. The cramps will get worse until they feel like contractions, and you will pass out the pregnancy tissue.

Some women opt to have medicine to speed up the process. In this case, the pregnancy tissue is likely to pass within a few hours.

If not all the tissue passes naturally or you have signs of infection, you may need to have a small operation called a ‘dilatation and curettage’ (D&C). You may need to wait some time for your hospital appointment. The operation only takes 5 to 10 minutes under general anaesthetic, and you will be able to go home the same day.

While you are waiting for a miscarriage to finish, it’s best to rest at home — but you can go to work if you feel up to it. Do what feels right for you. You can use paracetamol for any pain. If you are bleeding, use sanitary pads rather than tampons.

What might I see during a miscarriage?

In the first month of pregnancy, the developing embryo is the size of a grain of rice so it is very hard to see. You may pass a blood clot or several clots from your vagina, and there may be some white or grey tissue in the clots. The bleeding will settle down in a few days, although it can take up to 2 weeks.

At 6 weeks

Most women can’t see anything recognisable when they have a miscarriage at this time. During the bleeding, you may see clots with a small sac filled with fluid. The embryo, which is about the size of the fingernail on your little finger, and a placenta might be seen inside the sac. You might also notice something that looks like an umbilical cord.

At 8 weeks

The tissue you pass may look dark red and shiny — some women describe it as looking like liver. You might find a sac with an embryo inside, about the size of a small bean. If you look closely, you might be able to see where the eyes, arms and legs were forming.

At 10 weeks

The clots that are passed are dark red and look like jelly. They might have what looks like a membrane inside, which is part of the placenta. The sac will be inside one of the clots. At this time, the developing baby is usually fully formed but still tiny and difficult to see.

At 12 to 16 weeks

If you miscarry now, you might notice water coming out of your vagina first, followed by some bleeding and clots. The fetus will be tiny and fully formed. If you see the baby it might be outside the sac by now. It might also be attached to the umbilical cord and the placenta.

From 16 to 20 weeks

This is often called a ‘late miscarriage’. You might pass large shiny red clots that look like liver as well as other pieces of tissue that look and feel like membrane. It might be painful and feel just like labour, and you might need pain relief in hospital. Your baby will be fully formed and can fit on the palm of your hand.

After the miscarriage

You will have some cramping pain and bleeding after the miscarriage, similar to a period. It will gradually get lighter and will usually stop within 2 weeks.

The signs of your pregnancy, such as nausea and tender breasts, will fade in the days after the miscarriage. If you had a late miscarriage, your breasts might produce some milk. You will probably have your next period in 4 to 6 weeks.

Remember, it’ll be normal to feel very emotional and upset at this time.

More information

Read more about miscarriage here:

Call Pregnancy, Birth and Baby on 1800 882 436, 7am to midnight (AET), to speak to a maternal child health nurse for advice and emotional support.

9 Reasons for Bleeding And Spotting During Pregnancy

Are you pregnant? Have you experienced some spotting or bleeding and are wondering what it means?

While it can be alarming and distressing to notice blood in the bathroom when you least expect it, there are some rational explanations — and not all of them are as dire as you may be thinking. In fact, while not experienced by every mom, some level of bloody discharge during pregnancy is actually pretty common.

Read on to learn about what bleeding or spotting during pregnancy can mean, what other symptoms to watch for, and when to worry.

The Differences Between Bleeding and Spotting

Any bleeding that occurs outside your normal menstrual period is commonly referred to as breakthrough bleeding ⁽¹⁾.

However, there are different levels of breakthrough bleeding, often differentiated by the terms’ bleeding and spotting.

Spotting:

• Is blood that is visible on your underwear or the toilet paper when you wipe after urinating.
• Appears as light brown or pink spots — as you see at the very beginning or end of your menstrual period.
• Does not require a pad or panty liner.

Bleeding:

• Is bright red.
• Is heavier than spotting, more similar to a menstrual period.
• Requires a sanitary pad to manage.

What Does Bleeding During Pregnancy Mean?

When you experience any amount of vaginal bleeding during pregnancy, your mind always jumps to the worst. We get it.

It’s alarming, it’s unexpected, and it’s scary — especially when you feel so helpless and want to know what’s going on inside your body.

Try To Relax

While bleeding or spotting could indeed signal there is a problem with your pregnancy, rest assured it’s not the only possible explanation.

So before you freak out, remember that a lot of changes are going on in your body. Hormones are shifting, tissues are stretching, and blood flow to your uterus is increasing.

So bleeding during pregnancy can also simply be due to a physiological process.

How Common is Bleeding During Pregnancy?

Bleeding is relatively common during pregnancy. How often it occurs and the reasons behind it differ throughout the trimesters. Up to 30% of women experience bleeding during their first trimester ⁽²⁾ and as many as 20 percent of women — that’s one in five — have bleeding at some point throughout the entire course of their pregnancy ⁽³⁾.

You’re most likely to experience bleeding at certain points along your pregnancy — like toward the beginning to middle of the first trimester, or toward the end of the third. Report to your doctor any bleeding you might notice at any point during pregnancy.

9 Causes Of Bleeding or Spotting During Pregnancy

There are many reasons you may experience bleeding or spotting during pregnancy. Some of these are:

1. Implantation Bleeding

When fertilization occurs, it happens in the fallopian tubes — well before the egg reaches the uterus. Meanwhile, the uterine walls have become thick-lined with blood and tissue, preparing for a potential pregnancy should it happen.

If pregnancy does not occur, this uterine lining is shed and is what comprises the menstrual period. If a pregnancy does occur, the fertilized egg needs to burrow its way into the lining, which can cause light bleeding. This is known as implantation bleeding.

About one-third of women experience implantation bleeding. While the timing for women varies based upon their fertility cycles, it typically occurs about 3 to 7 days before an expected period.

For this reason, it can often be mistaken as the start of a woman’s period, although it is usually of a much shorter duration, differs in color and amount.

How Long It Lasts

Implantation bleeding can be a one-time occurrence or last for up to three days.

The bleeding is not heavy and resembles spotting. It is usually pink or dark brown and does not include clots like menstrual blood.

2. Miscarriage

When you notice bleeding or spotting during pregnancy, miscarriage is typically the first thing your mind thinks of — after all, it’s a much-feared worst-case scenario. And while it is a very real possibility, try to remember it’s really not the only possible explanation.

A miscarriage is the loss of a pregnancy within the first 20 weeks of gestation. However, most miscarriages occur within the first three months ⁽⁴⁾.

As many as one out of five pregnancies end in miscarriage, primarily due to genetic abnormalities. Other miscarriages occur for no known reason.

If you do experience a miscarriage, bleeding is one of the primary symptoms. The blood may appear brown or bright red and may be accompanied by clots or tissue ⁽⁵⁾. There may also be a gush of clear or pink fluid or discharge, which is actually amniotic fluid.

If you suspect you are experiencing a miscarriage, your doctor will likely order an ultrasound and a blood test.

The ultrasound will examine the inside of your uterus to try to determine whether there is a fetus and detectable heartbeat. A blood test can measure hCG levels, also known as the “pregnancy hormone”.

The levels of hCG in your bloodstream rise rapidly during early pregnancy, and if a downward trend is detected in your blood, it could indicate a miscarriage. Remember though, hCG levels alone are not an indicator that everything is 100% OK, as they can rise and double as expected even in some cases of ectopic pregnancy. That’s why your doctor will always do an ultrasound too.

It usually takes two hCG levels to diagnose a problem with the pregnancy ⁽⁶⁾. While the absolute value varies greatly from one woman to the next, two tests 48-72 hours apart should show a doubling of the hCG level in the early first trimester.

Sometimes women experience a miscarriage and following the initial symptoms of pain and bleeding and after they notice tissue passing they can start feeling their symptoms disappear and might not want to see their doctor. This can potentially be very dangerous for the woman since there are different types of miscarriages and they can happen due to an ectopic pregnancy, so if this happens you should always see your doctor.

Editor’s Note:

Dr. Irena Ilic, MD

3. Placenta Previa

The placenta is the major organ that delivers blood, oxygen, and nutrients to your baby, and it grows throughout your pregnancy. It is typically attached high in your uterine wall, where it gets the best blood flow and will stay well out of the baby’s way when it comes time to deliver.

Sometimes, the placenta develops close to or directly over the cervix. This is called placenta previa ⁽⁷⁾. There are different types, depending on its position, including partial, low-lying, marginal and major or complete placenta previa.

This is typically detected in an ultrasound during the second trimester and is closely monitored for the duration of pregnancy.

Placenta previa can cause a good amount of vaginal bleeding and must be monitored, but with lifestyle modifications and modern medical procedures, you will more than likely deliver a healthy baby. Also, not all cases of placenta previa will be accompanied by heavy bleeding; it can be minimal to none. As the uterus continues to grow, it’s common for the placenta to shift out of the way of the cervix, leading to a normal delivery.

What Placenta Previa Means For Your Pregnancy

Women with placenta previa will probably have to go on pelvic rest during the rest of their pregnancy, which means they can’t have sex, vaginal exams, and may have to avoid vigorous exercise. If it doesn’t resolve by the end of your pregnancy, you will have to deliver your baby by C-section since the placenta is blocking your baby’s exit from the womb. Also, after the delivery you might experience more bleeding than usual or bleeding which is harder to control, so your doctor will monitor you closely.

Placenta previa is relatively common, occurring in 1 of 200 pregnancies. Most of these, up to 90%, resolve by the time of delivery. It’s more likely to occur if this is not your first pregnancy, if you’re pregnant with multiples if you had any previous procedures on your uterus.

4. Placental Abruption

Placental abruption occurs when the placenta separates from your uterine wall before your baby is born ⁽⁸⁾. It is a serious condition as it affects your baby’s oxygen and blood supply, and there is no medical treatment to reattach the placenta. It usually happens in the third trimester.

Placental abruption usually develops suddenly and is accompanied by abdominal and back pain, along with heavy bleeding. However, occasionally it occurs slowly over time which can result in a light, occasional bleeding. This can be the case with chronic placental abruption, and in these cases, the baby’s growth progress might be slowed down.

If you have occasional bleeding, your doctor will also monitor your amniotic fluid levels and your baby’s rate of growth to determine how the condition is affecting your pregnancy.

It’s important to note the severity of your bleeding does not always directly correlate with the severity of your placental abruption. This means that even if sometimes there is little blood seen on the outside, there could be more blood trapped inside the uterus. Your doctor will examine your uterus and order an ultrasound to diagnose your placental abruption and its severity.

When

If you have any signs or symptoms of placental abruption you should call your doctor right away.

If you have a placental abruption, you may have to deliver your baby immediately if you are near the end of your pregnancy. If you are earlier in your pregnancy and your bleeding stops, you will be closely monitored for the duration of your pregnancy as there is a risk of premature labor.

5. Hematoma

Between your placenta and the uterine wall is a membrane called the chorion. Sometimes, blood collects in the folds of the chorion and results in a condition called subchorionic bleeding, or subchorionic hematoma ⁽⁹⁾. They can be of different sizes, with larger causing heavier bleeding, but with smaller being the most common.

If you experience bleeding during pregnancy, your doctor will likely order an ultrasound to screen for the presence of a hematoma. However, some hematomas are accidentally detected through routine ultrasounds with no accompanying bleeding.

There is no specific treatment for subchorionic hematoma except possible pelvic rest depending on the severity of your condition, and the good news is that it frequently resolves on its own. Your doctor might also start you on medication to prevent miscarriage.

However, in more severe cases if it does not resolve, it may result in a placental abruption, which can be a serious threat to your pregnancy.

If you are diagnosed with a subchorionic hematoma, you will likely be monitored more closely by your doctor, and have more frequent ultrasounds. You should avoid standing for long periods of time, having sex and doing exercise, and make sure to follow your bed rest instructions.

The Bottom Line

Subchorionic hematoma is found in up to 11% of pregnancies and is more common after IVF ⁽¹⁰⁾, but with a timely diagnosis, most women go on to have healthy pregnancies and normal deliveries.

6. Vaginal Infection

The cervix is considered a blood-rich organ, which means it can easily bleed if inflamed or irritated. An infection, such as a yeast infection or bacterial vaginosis, can cause cervical irritation and bleeding.

These conditions are completely unrelated to pregnancy, but with the increased blood flow to your reproductive organs and cervix during this time, bleeding may be a symptom you don’t experience as frequently when you’re not pregnant.

Your vaginal bleeding may be due to an infection if it’s accompanied by foul-smelling or abnormal discharge, if you have redness, itching or irritation of the vaginal walls, or if you are experiencing a burning sensation when you pee ⁽¹¹⁾.

What To Look For

The bleeding you experience as a result of infection is most similar to spotting and will not likely be bright red or heavy.

Vaginal infections are easily treated with antibiotics, and your doctor will prescribe those safe to use in pregnancy.

7. Sex

Sex is safe during pregnancy, so unless you’ve been given explicit instructions from your doctor to avoid it, enjoy getting your groove on while you’re expecting.

However, the act of sex has the potential to irritate the cervix — especially if the penis bumps up against it. This can cause you to notice some very light bleeding the next day, most likely so light that you’ll only notice it on toilet paper after going to the bathroom.

This does not indicate there is a problem and is completely normal.

Don’t be shy about discussing sex during pregnancy with your partner and with your healthcare provider. There are some cases when your doctor might suggest you should avoid sex, such as having an incompetent cervix, placenta previa, unexplained bleeding. Even then, 9 months will pass soon and in the meantime, there are other ways for maintaining intimacy with your partner so don’t feel discouraged.

Editor’s Note:

Dr. Irena Ilic, MD

8. Losing Your Mucus Plug

During pregnancy, your body develops a mucus plug at the opening of your cervix. Sounds lovely, I know, but it has a very important purpose. It helps protect your baby and uterus from bacteria ⁽¹²⁾.

Toward the end of your pregnancy, as your cervix begins to open, this mucus plug will release, and you may experience spotting in your underwear. It looks different from typical spotting, however, in that it’s mixed with stringy or thick mucus.

Some women experience the loss of their mucus plug throughout several days and may notice it as pink-tinged bloody spots or streaks on the toilet paper when they wipe after going to the bathroom. Other women experience the loss of their mucus plug all at once. In this case, the volume of blood will be greater and the loss of the mucus plug will be more noticeable. It can also happen without you noticing it. But, if you see discharge which might or might not be your mucus plug, and it is bright red in color and not just a few drops you should contact your doctor right away, especially if you are feeling any pain.

The loss of the mucus plug usually signals that labor is imminent, though it can be up to two weeks before labor begins. Some women don’t lose their mucus plug until they’re actually in active labor. It is also known as bloody show.

If you are near the end of your pregnancy and start seeing blood in your underwear or on toilet paper, don’t panic — especially if it is mixed with discharge. It is a normal part of your body preparing for labor.

On the other hand, if you’re not nearing your due date and notice some blood-tinged mucus, contact your doctor. They will check your cervix to see if it is opening too early. If it is, you may be going into premature labor or have an incompetent cervix ⁽¹³⁾.

If either of these are diagnosed, they can be treated with labor-stopping medications or a cerclage.

9. Unknown Reasons

On rare occasions, some women will experience heavy breakthrough bleeding — almost like a regular period — intermittently throughout the entire course of their pregnancy with no known medical cause.

While this is not considered normal, if you are experiencing regular, heavy bleeding your doctor will work with you to rule out all severe causes that may threaten the life of your baby and the viability of your pregnancy.

If this happens to you regularly, track the occurrences of breakthrough bleeding to see if you can notice a pattern and help your doctor identify the cause.

Cover Your Bases

Ask your doctor if you should take an additional iron to compensate for the regular loss of blood, but don’t up your iron intake without your doctor’s guidance.

When Should I Seek Medical Help?

You should always mention any type of bleeding or spotting to your doctor at your next pregnancy appointment. If you want to get their opinion as to whether or not they’d like to see you sooner you can call them between appointments.

If you experience any of the following symptoms along with your bleeding or spotting, either ask your doctor for an immediate appointment or head to the local emergency room if they can’t fit you in:

• Severe, painful cramping.
• Bright red, heavy bleeding that soaks a pad.
• A rush of fluid in addition to blood.
• Severe nausea, vomiting, and dizziness.
• Chills and high fever (100.4 degrees Fahrenheit or higher).

If you are experiencing heavy bleeding, use a sanitary pad to manage it until you can be seen by the doctor. If you do not have a pad on hand, you can stuff a baby diaper in your underwear or a washcloth. Never use a tampon while pregnant.

The Bottom Line

While experiencing bleeding during pregnancy is alarming, rest assured that most often it occurs due to a condition that is treatable, and that most women can go on to deliver healthy babies.

However, because it may also signal a more severe condition, it’s always important to mention any level of vaginal bleeding or spotting to your doctor so they can evaluate you.

Miscarriage: the signs and what really happens

It’s probably the biggest pregnancy anxiety but sometimes miscarriage is shrouded in myth and secrecy. Here are the facts you need to know.

Some women have no obvious signs of a miscarriage and only have it diagnosed during a scan. Other women have symptoms that can be intense, including bleeding or spotting, with or without stomach pain or cramps (NHS Choices, 2018a; Miscarriage Association, 2018a). Some pass clots or ‘stringy bits’.

“When symptoms do occur, they don’t always result in a miscarriage and might be part of a normal pregnancy. So if you get them, try not to panic.”

Miscarriage symptoms and signs: bleeding

Bleeding can vary from light spotting or brownish discharge to heavy bleeding and bright red blood (Miscarriage Association, 2018a). It might come and go over several days.

Try to remember that light vaginal bleeding is relatively common during the first trimester (the first 12 weeks) and definitely isn’t a sure sign that you’re having a miscarriage. One study found that in the first 20 weeks of pregnancy, 21% of the women experienced vaginal bleeding and 12% had a miscarriage after that (Everett, 1997). This means about half of the women who had vaginal bleeding continued having a healthy pregnancy.

Bleeding could be caused by any of the following:

• Implantation: In early pregnancy, you might get some harmless light bleeding (spotting), when the developing embryo plants itself in the wall of your womb. This often happens when your period would have been due.
• Cervical changes: Pregnancy can cause changes to the cervix, and this may cause bleeding, for example after sex.
• Ectopic pregnancy: When a fertilised egg implants outside the womb, such as in the fallopian tube, it can’t develop properly. Symptoms are: a sharp, sudden and intense pain in your tummy, feeling very dizzy or fainting, and feeling sick or looking very pale. Call 999 or go to your nearest accident and emergency (A&E) department if you get a combination of those symptoms.

  (NHS Choices, 2016; NHS Choices, 2018b)

If you start bleeding during pregnancy, contact your GP, midwife or the early pregnancy unit at your local hospital as soon as possible. If your symptoms are not severe and your baby is not due for a while, you’ll be monitored. Some women may have to stay in hospital for observation (NHS Choices, 2018b).

How will I know what’s causing my bleeding?

You may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests to check your hormone levels. Your doctor will also ask you about other symptoms but sometimes it might not be possible to find out what’s caused the bleeding.

Miscarriage symptoms and signs: stomach pain

Stomach pain might be due to an upset tummy or constipation. Some women experience lower stomach cramps because of the recent implantation of the fertilised egg in the wall of the uterus. You can also get cramps in the early weeks because your womb is stretching and growing (Marcin, 2017).

If you have bleeding or spotting as well as pain, that may be a sign of miscarriage (Miscarriage Association, 2018a). Contact your GP or early pregnancy unit.

If you have sharp abdominal or one-sided pain or pain in your shoulders, and/or pain when you poo, go to A&E. They’ll give you an emergency scan. It’s especially important to get help if you have had an ectopic pregnancy before (NHS Choices, 2018a; Miscarriage Association, 2018a).

If pregnancy symptoms go away, is that a sign of miscarriage?

The sudden disappearance of pregnancy symptoms like nausea or cravings can also sometimes be a sign of miscarriage. But this doesn’t necessarily mean there is a problem. Some women don’t get many pregnancy symptoms anyway.

If you’ve been having strong pregnancy symptoms that suddenly reduce or stop well before you’re 12 weeks pregnant, your hormone levels might be dropping. You may want to do another pregnancy test and/or talk to your GP about a scan (Miscarriage Association, 2018a).

Miscarriage: How do you know for certain?

Miscarriage is usually diagnosed or confirmed with an ultrasound scan. It may take more than one scan to confirm it for definite.

In later (second trimester) pregnancy, bleeding, pain and passing a recognisable pregnancy sac or delivering a baby often confirms what has happened without a scan.

Miscarriage: What happens afterwards?

If there’s no pregnancy tissue left in the womb, no treatment is required. If there is, your options to remove the tissue are as follows:

• Wait 7 to 14 days after a miscarriage for the tissue to pass naturally. If the pain and bleeding don’t start within that time or are getting worse, you should get another scan and discuss your options.
• Take medication if you don’t want to wait or if waiting hasn’t worked. This might involve using mifepristone first, followed 48 hours later by misoprostol.
• Have tissue surgically removed. This may be advised if you have continuous heavy bleeding, infected pregnancy tissue, or if waiting and medication hasn’t enabled the tissue to pass.

  (NHS Choices, 2018c)

Discuss your options with the doctor in charge of your care and read more about available treatments on the NHS Choices website

If your blood group is rhesus negative (RhD negative), you should be offered injections of a medication called anti-D immunoglobin afterwards. This prevents rhesus disease, which is a condition where antibodies in a pregnant woman’s blood destroy her baby’s blood cells (NHS Choices, 2018d).

Contact your hospital immediately if your bleeding becomes particularly heavy, you develop a high temperature, or you experience severe pain.

You should be advised to take a home pregnancy test after three weeks. If you’re still pregnant, you may need further tests to make sure you don’t have a molar pregnancy (an abnormal fertilised egg implanted) or an ectopic pregnancy (NHS Choices, 2016; Miscarriage Association, 2018b).

This page was last reviewed in April 2018

Further information

Our support line offers practical and emotional support in many areas of pregnancy, birth and early parenthood: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

For more help and advice on all pregnancy loss, contact The Miscarriage Association

You can read more about miscarriage in our range of articles.

Bleeding in early pregnancy: what’s normal and what’s not?

Vaginal bleeding in early pregnancy is, obviously, almost always worrying. But studies suggest it happens to up to 24% of us in the 1st 12 weeks of pregnancy and to a much smaller number from 12 to 24 weeks – and, though you should always get it checked out, it doesn’t necessarily mean the worst.

“Bleeding in the 1st trimester is pretty common,” says Patrick O’Brien, consultant obstetrician at University College Hospital, London. “Many women fear it’s going to lead to a miscarriage but that’s not necessarily the case. It can do, of course, but, for most women, the bleeding will settle down and stop.”

Why am I bleeding?

There are lots of possible causes of bleeding in early pregnancy, ranging from the minor to the more serious. Here’s a rundown of what it could be…

It could be… implantation bleeding

Some (but not all) pregnant women experience a small bleed 6 to 12 days after conception – so often just before the time your period would have been due. This happens as your fertilised egg implants in the lining of your womb and usually appears as light, brownish spotting.

It could be… hormonal bleeding

Hormonal or ‘breakthrough’ bleeding can happen at about 4 to 8 weeks into pregnancy (so round about the time your period would have been due), and is pretty common. It’s caused by early-pregnancy changes in your levels of oestrogen and progesterone. It is usually light.

It could be… cervical erosion

This is a lot less serious than it sounds. Cervical erosion, sometimes called cervical ectropion or ectopy, is the medical term for when the blood supply to your womb and cervix is increased, as a result of your pregnancy. As these cells are soft, they can bleed more easily (though harmlessly and painlessly). This can result in spotting or light bleeding – either for no apparent reason or after sex.

It could be… a vaginal polyp

A polyp is a harmless growth. And if it’s in your vagina, it can cause harmless bleeding at any stage in your pregnancy.

It could be… an infection

Any infection of your vagina or cervix (including sexually transmitted diseases, such as genital herpes, chlamydia or gonorrhoea) can cause bleeding. (And will, obviously, need to be treated.)

It could be… an ectopic pregnancy

Bleeding, or brown, watery discharge, in the first 12 weeks that’s accompanied by strong, painful cramping in your lower tummy and maybe also a pain in the tip of your shoulder may signal an ectopic pregnancy – which happens when your fertilised egg remains stuck in 1 of the Fallopian tubes that connect your ovaries to your womb. It’s a potentially dangerous condition but it is also very rare (affecting about 2% of pregnancies).

It could be… the start of a m

iscarriage

Yes, blood loss in early pregnancy can be a sign of miscarriage, especially if the blood’s red and the flow is heavy or you’re also cramping and in pain. If you are also passing clots of pink or grey material, it’s very likely to be a miscarriage.

What should I do if I’m bleeding in early pregnancy?

Any bleeding in the 1st 24 weeks of pregnancy should be checked out – with a call to your midwife or GP.

As we’ve see above, there is quite a range of potential reasons for your bleeding but “as a general rule,” says Patrick O’Brien, “the heavier the bleeding, the more worrying it would be”.

When you call, try to give as much information as you can about how you’re bleeding. Try to include details about:

• how heavy the blood flow is
• how light/thick the blood is
• what colour the blood is
• whether you’re seeing any clots or other bits of tissue along with the blood

If it’s very early on in your pregnancy (before 6/7 weeks) and you’re not in pain, you may be told to wait to see if the bleeding stops of its own accord. Unfortunately, there is little doctors can see on an ultrasound scan at this point that will tell them – and you – whether your baby is OK.

This is what happened to Jaxxy who posts on our MadeForMums Chat forum. “I’m 5 weeks and 5 days pregnant today. I’ve had bleeding – admittedly not loads but enough to make me think it could be miscarriage. Spoke to the doctors and they’ve just said I’ve got to ride it out.”

This is very typical of a lot of women’s experiences at this stage of pregnancy – and we know how difficult it can be. You may find it helps to share your experience with others on our MadeForMums Chat forum or you could call the Miscarriage Association‘s helpline on 01924 200799 (open Monday to Friday, 9am to 4pm). They also run a Facebook page and an online Live Chat.

If, as result of your call, you’re asked to go in to see your GP or midwife or to visit your local Early Pregnancy Unit, it’s a good idea (if you can) to save any underwear or pads with blood on them, so that you can show them what your bleeding looks like.

Once you’ve arrived, your doctor or midwife will want to examine you or refer you to be examined – with an (internal) ultrasound scan and some blood tests, and maybe a vaginal swab, if an infection is suspected.

It may well be that nothing concerning is found, and you will be sent home and told only to return if the bleeding gets heavier and/or the pain gets worse. You may, at this point, hear the term ‘threatened miscarriage’: this means that, although you’re bleeding or have been bleeding, there is no sign – right now – that you’ve having a miscarriage. Many women who have a ‘threatened miscarriage’ go on to have a healthy baby.

If, however, doctors find evidence that something is wrong with your baby, then, unfortunately, this is a ‘confirmed miscarriage’ and doctors will talk you through your options about what happens next.

About our expert: Patrick O’Brien

Patrick O’Brien has been a Consultant & Honorary Senior Lecturer in Obstetrics and Gynaecology at University College London Hospitals since 1999. He is also the Divisional Clinical Director for Women’s Health. He specialises in Maternal Medicine and high-risk obstetrics and has a particular interest in medical complications of pregnancy.

Read more…

Pulmonary embolism in pregnancy: Know the symptoms, risks of blood clots | Your Pregnancy Matters

Pregnancy causes many changes in your body, from belly to blood.

In fact, pregnant women are five times more likely to develop blood clots than non-pregnant patients because during pregnancy, the body increases production of blood factors that promote normal clotting. The growing uterus also impedes return of blood in veins in the lower part of the body. Most of the time, these changes result in superficial problems like varicose veins.

Sometimes, increases in clotting factors along with decreased flow in the veins from the expanding uterus can cause blood clots to develop in the legs. When a clot breaks free and travels to the lungs, it becomes a medical emergency known as pulmonary embolism (PE).

PE is rare, affecting approximately 1 in 7,000 pregnancies, according to Williams Obstetrics 25th edition. However, PE accounts for approximately 11% of maternal deaths. Nearly two-thirds of pregnancy-related deaths due to PE occurred after delivery.

If PE symptoms are addressed immediately, effective treatment is available. Tennis legend Serena Williams suffered blood clots in the legs after giving birth to her daughter in 2018. Williams, who had a history of PE, recognized her symptoms – which can include shortness of breath and a cough that may include blood – and advocated for herself to receive anti-clotting medication that stopped the clots from reaching her lungs.

However, PE does not always cause recognizable symptoms. Such was the case for Instagram influencer Emily Mitchell who, days before Christmas 2020, collapsed with a fatal PE while pregnant with her fifth child.

There is no way to say for certain who may develop PE, so it’s important for all pregnant patients – and moms who recently delivered – to know the symptoms. Let’s discuss what to look for, who might be at increased risk, and which treatment options are available.

Possible symptoms of pulmonary embolism

The most common symptoms of PE are shortness of breath and a cough that may include bloody sputum. Especially during flu season and the ongoing COVID-19 pandemic, even a little cough warrants being checked out.

What Women Need to Know

Updated January 2020

For many women, pregnancy is a time of joy. But, for women with a history of blood clots, it can be a time of uncertainty.

Much like birth control, pregnancy increases a woman’s chance of experiencing a blood clot because her estrogen levels are higher than normal. Blood also becomes more prone to clotting during pregnancy, because the body is preparing to give birth.

“When you give birth, there’s bleeding. Your body is going to be a bit more inclined towards clotting, so that you can heal up and stop bleeding,” said Dr. Gregory Piazza, a cardiovascular medicine specialist at Brigham and Women’s Hospital. “We don’t want moms bleeding. It’s your body accounting for that.”

Dr. Piazza often works with women to help them manage their risk of clotting during pregnancy.

Women who have experienced a blood clot in the past, especially if it was related to an estrogen-based birth control, need to take certain precautions when pregnant or planning to become pregnant.

“If you’ve already had a blood clot due to high estrogen from the birth control pill, you’re going to need protection,” explained Dr. Piazza.

The Dangers of Blood Clots and Pregnancy

In addition to the known complications of blood clots, pregnant women can experience additional complications.

“Pregnant women are prone to developing pulmonary embolism (PE) and deep vein thrombosis (DVT), but they also can get pelvic vein thrombosis,” explained Dr. Piazza. “Pelvic veins are the veins that go to the legs but are higher up. Those can thrombose and cause massive leg swelling. Pregnant women can also get blood clots in the ovarian veins. These can cause abdominal, pelvic, or side pain. We try to protect patients from that.”

Blood clots can also affect the developing baby.

“Part of giving anticoagulation during the pregnancy is to achieve a live birth and prevent miscarriage,” Dr. Piazza remarked. “You can get blood clots in the umbilical cord or behind the placenta. Those can cause miscarriage.”

“It’s not something that’s talked about a lot for pregnant patients, so they tend to not really be aware of it,” said Dr. Piazza about the risk of miscarriage. “Even if they’re aware of the risk of blood clots, they’re more focused on developing DVT or PE than on the risk of miscarriage.”

Injectable Anticoagulants

How can at-risk pregnant women get the protection they need? From injectable anticoagulants.

“Usually what we do for pregnant patients is give them a low dose of an injectable anticoagulant, such as low-molecular-weight heparin or fondaparinux,” explained Dr. Piazza. “The good thing about those is that they tend not to affect the baby.”

“They’re large chains of molecules that tend not to cross over to the placenta. They’re safe to use,” Dr. Piazza continued. “We use them at preventive doses, not the full treatment dose. Patients do quite well on them and it’s very rare to see bleeding complications.”

Pregnant women with a risk of blood clots are taken off warfarin and direct oral anticoagulants, which have not been studied in pregnant women.

Postpartum Risk

After giving birth, the postpartum period can be a risky time for mothers. This “postppartum risk period” can be anywhere from 6-12 weeks after birth. Women are often told to continue their injectable anticoagulant medications.

“Those are safe for breastfeeding moms. Those long molecular chains get digested by the baby’s stomach acid,” Dr. Piazza remarked, also noting that warfarin is appropriate for breastfeeding moms.

“Warfarin is great for breastfeeding moms because it doesn’t go into the milk. It’s one of the preferred treatments for breastfeeding moms.”

What Can Moms Do?

The most important thing for a concerned expectant mother can do is talk with her doctor and discuss her risk factors. If she has a personal or family history of blood clots, a genetic predisposition, or another risk factor, her doctor can help identify the best individualized medical treatment.

Beyond medical treatment, remaining active is key. Many women slow down late into their pregnancy, but being sedentary increases the risk of developing a blood clot. Even light exercise, such as walking, can be very beneficial.

Finally, compression stockings, often used to help treat complications of DVT such as post-thrombotic syndrome, can help with the leg swelling that pregnant women often develop.

If you’re a woman with a history of blood clots who is pregnant or planning to become pregnant, it’s important to speak with your doctor to decide what treatments and precautions are right for you.

Thrombophilias & Recurrent Miscarriage: University Reproductive Associates: Reproductive Endocrinologists

Thrombophilias are a group of clotting disorders that predispose individuals to inappropriate blood clot formation. These disorders can lead to health problems and recurrent miscarriage.

Thrombophilias increase the risk of developing thromboembolism, or blood clots. These clots block the blood vessels throughout the body. If the clots travel to the brain, they can lead to stroke. Those that move to the lung results in a pulmonary embolism.

In women who are pregnant, thrombophilias can cause pregnancy complications or loss including:

• First-trimester miscarriage
• Stillbirth
• Placental abruption (a condition where the placenta pulls away from the uterine wall)
• Preeclampsia
• Fetal growth problems

These conditions occur when blood clots develop obstructing blood vessels in the placenta and interfering with blood flow to the fetus.

During normal pregnancy, even women without thrombophilia are more likely to develop a venous thrombosis (blood clot in the leg) because of the changes that take place in the blood clotting system that help to prevent severe blood loss during childbirth.

TYPES OF THROMBOPHILIAS

Thrombophilias can be acquired or inherited. Acquired thrombophilias may be associated with certain medical conditions that cause hypercoagulability of the blood, such as sickle cell anemia, cancer, inflammation or diabetes.

Antiphospholipid syndrome (APS) is an autoimmune system disorder linked to excessive clotting of the blood. In those who suffer from autoimmune disorders, the body cannot distinguish between normal tissues and harmful bacteria, viruses, toxics and other foreign substances. It responds by attacking its own healthy tissue. Women who test positive for antiphospholipid antibodies (APLA) have been shown to be at risk for developing blood clots in both the veins and arteries.

INHERITED THROMBOPHILIAS

Those with genetic or hereditary thrombophilias have a predisposition to blood clotting and are at a greater risk of developing blood clots in veins throughout the body. These conditions also increase the risk of miscarriage or other pregnancy complications such as miscarriage, poor fetal growth, and fetal loss.

INHERITED THROMBOPHILIAS INCLUDE THE FOLLOWING:

• Factor V Leiden Mutation – the most common of the inherited thrombophilias those with this condition have a resistance to the action of activated protein C
• Prothrombin G20210A Mutation – this mutation of this particular gene leads to increased levels of plasma prothrombin, increasing the risk of venous thromboembolism
• Antithrombin deficiency – this rare condition blocks clotting factors impacting coagulation and increasing the chance of developing blood clots
• Protein S/Protein C deficiency – rare inherited thrombophilias caused by too little-activated protein C or protein S

LINK BETWEEN THROMBOPHILIA & RECURRENT MISCARRIAGE

There is evidence to support a link between APLAs and recurrent fetal loss less than ten weeks.

Women with congenital or acquired antithrombin deficiency are at extremely high risk for developing clots during pregnancy or after delivery. Without treatment, the risk of pregnancy loss is also slightly increased and is usually due to blood clots that develop in the placenta, depriving the fetus of blood and oxygen.

MANAGING THROMBOPHILIA IN PREGNANCY

Heparin (a medication that helps to prevent the formation of blood clots) injections may be recommended for pregnant women diagnosed with antithrombin deficiency due to the increased risk of miscarriage.

A low-dose aspirin regimen may also be prescribed during pregnancy and for a few weeks after delivery.

A carefully prescribed treatment regimen can reduce the risk of miscarriage and other pregnancy complications.

Contact your local URA clinic in Hasbrouck Heights, Hoboken, and Wayne, NJ for more information. Your friendly URA team will be happy to provide more details on thrombophilias and discuss treatment options.

Thrombosis and pregnancy – Phlebological Center “Antireflux”

Question:

Hello. At 30 weeks of pregnancy occlusive deep vein thrombosis of the ilio-femoral segment of the lower left leg appeared. switching to warfarin), Detralex 2 months, stocking class 2.
is now 35 weeks old and I am constantly crying. I can’t come to terms with this disease at 24 years old. will do a cesarean at 38 weeks. Cancellation of clexane 8-12 hours before and after the operation.will this aggravate my situation?
1 Is it possible to do some kind of operation and get rid of this disease in you or in general?
2 Will I be able to live normally and fully with it?
3 Is it really impossible to stand and sit for a long time, how to constantly think about it?
4 Will I be able to take care of the child like everyone else-walk play raise him?
5 even if the thrombus dissolves, is it possible to avoid post-thrombotic syndrome? if possible, how?
6 Will your leg always hurt? is this a sentence?
7 Is there a chance that the stocking will have to be worn for a maximum of 2 years?
8 baths are now completely banned?
9 It is absolutely impossible to stand without a stocking? I often go to the toilet at night.and when to wash if you constantly have to be in this stocking?
10 Am I disabled now?
11 there is a chance that if this is all due to pregnancy, then over time it will all come to naught with adequate treatment and I will only remember this with horror? Everyone just reassures me that I’m pregnant after pregnancy everything goes away. I would like it all the same know the truth?
12 long trips and plane? How to go to the sea?
13 all doctors say differently: someone says lie down right now, only someone says you can walk.how to be
14 what is generally prohibited?

Answer:

Ksenia, good afternoon! Your treatment is prescribed correctly, please do not be discouraged.
1. We can help you, PTB is treated by our X-ray endovascular surgeon, Mamedov Ruslan Eldarovich.
2. Of course, after recanalization, and it will certainly come, you will be able to lead a full-fledged lifestyle.
3. Static loads are not useful. When sitting for a long time, try to stand up or move your legs.Don’t think about it all the time.
4. Yes, you can. Be sure to wear compression hosiery.
5. Unfortunately, it cannot be avoided, most likely it will develop. Ruslan Eldarovich will help you.
6. The leg may be bursting, pain syndrome may remain.
7. Yes, if you perform stenting of the iliac veins, and this is done by Ruslan Eldarovich Mamedov.
8. Baths for the moment and for the next 2 years are best avoided.
9. You don’t have to be in stockings all the time.
10. No You are not disabled.
11.PTB – you will have it. But with adequate treatment (stenting), everything will be fine.
12. Wearing compression underwear of the 2nd class of compression
13. Walk around.
14. stay in a static position without compression underwear for a long time.
Yours faithfully, Victoria Alexandrovna Angelova

Thrombogenic risk factors in pregnant women.

If a woman has a history of cases of recurrent miscarriage or loss of a fetus in late pregnancy, toxicosis of the second

half of pregnancy, intrauterine fetal growth retardation, placental abruption or placental infarction, she is shown to be tested for thrombophilia.

Hyperhomocysteinemia, which sometimes develops under the influence of hereditary genetic polymorphism, is associated with late toxicosis and is involved in the development of heart attacks and placental abruption.Inflammation of the vascular endothelial lining with elevated homocysteine ​​levels causes an increased risk of both venous and arterial thrombosis. Hyperhomocysteinemia can be caused by the presence in the body of altered forms of the enzyme methylenetetrahydrofolate reductase (MTHFR), which is normally involved in the conversion of homocysteine ​​to methionine.

Hereditary Leiden (V) polymorphism, which has a strong predisposition to thrombosis, occurs with an increased frequency in women with recurrent miscarriage.

Among patients with recurrent miscarriage, abnormal forms of factor V Leiden are most common in women who have miscarriages in the second trimester of pregnancy.

Hyperhomocysteinemia by itself does not have a significant association with early fetal loss, suggesting that folate deficiency and MTHFR polymorphism may act through additional, as yet unknown factors. An increased level of homocysteine ​​is also detected in pregnancies complicated by preeclampsia, and this increase persists after childbirth.

Other causes of placental thrombosis.

Pregnancy can contribute to the manifestation of a genetic defect, as it develops the following features:

• Physiological increase in blood coagulation.
• Suppression of dissolution of fibrin clot (fibrinolysis).
• Decrease in the content and activity of natural blood anticoagulants.
• Increase in the functional activity of platelets.
• These changes during pregnancy have a protective value, they prevent profuse blood loss during childbirth, but at the same time they also provoke the development of thrombosis in the vessels of the placenta, especially in the presence of congenital pathology in the hemostatic system.
• Low vascular resistance of the placenta and slow blood flow in its vessels are key to ensuring a good blood supply to the fetus, but it creates conditions for the deposition of fibrin and the formation of blood clots.
• Normal increases in fibrinogen and clotting proteins during pregnancy can also cause blood clots. A decrease in the availability of dietary folate occurs with smoking, and this can cause an even greater increase in homocysteine ​​levels.

The risk of thrombosis in inherited forms of thrombophilia can be reduced by using small doses of aspirin, heparin, folic acid, intravenous immunoglobulin G, or hematogenous factor concentrates. For carriers of inherited thrombophilia with recurring adverse pregnancy outcomes, two preventive treatment options deserve attention: the appointment of low molecular weight heparin (enoxaparin) to women with habitual late fetal loss and folic acid treatment for severe toxicosis in the second half of pregnancy.

In all individuals, pregnant and not, consumption of folic acid significantly reduces homocysteine ​​levels. The efficacy is high in cases where the homocysteine ​​level was highest before treatment and the lowest when the homocysteine ​​level was relatively low. A decrease in homocysteine ​​levels is observed when folic acid is used at a dose of 0.5 mg to 5 mg per day in combination with vitamin B6.

There is a high probability of thromboembolic complications in the presence of cardiovascular diseases, overweight, anemia, late toxicosis.The risk of thrombosis also increases in women in the age group after 40 years, in the presence of malignant tumors, a sedentary lifestyle. Prolonged, prolonged labor, cesarean section also predispose to complications. The group of very high risk for the development of thrombosis, including in the postpartum period, includes women with varicose veins of the lower extremities.

Causes of thrombosis

First of all, the development of postpartum thrombosis is associated with changes in the blood coagulation system.Blood is lost during vaginal delivery or caesarean section. The amount of blood loss can be different – from minimal (physiological) to significant (pathological), depending on the specific situation. In any case, the body seeks to stop further blood flow, producing a large number of factors that contribute to an increase in blood coagulation through the formation of clots-plugs in the lumen of blood vessels. And the more blood loss, the more active these processes. In addition, when the placenta leaves or due to mechanical damage to tissues during the operation, the wall of the vessels is also damaged, special proteins and enzymes of the endothelium (the inner lining of the vessel) are released into the blood, which is also important for the shift of processes towards increasing blood coagulation.

To reduce the risk of venous thromboembolic complications during pregnancy, it is recommended to use low molecular weight heparins (LMWH) in prophylactic and intermediate doses in the form of subcutaneous injections. However, at present, the decision to prescribe LMWH to pregnant women is made only on the basis of a thrombotic history or upon detection of a particular thrombophilia (factor V Leiden mutations, prothrombin mutations, antithrombin deficiency, antiphospholipid antibodies, etc.).). These indications for the appointment of LMWH are subjective, since they are not based on accurate laboratory data measuring excessive (thrombotic) activation of blood coagulation at different stages of pregnancy. Accordingly, the use of these indications leads to an unreasonably widespread use of heparins during pregnancy.

The likelihood of blood clots during pregnancy is increased by congenital thrombophilia (a condition of increased blood clotting), caesarean section, mature maternity and overweight.If a woman has previously given birth three or more times or has multiple pregnancies (twins or more), the risk of thrombosis also increases. Additional risk factors for blood clots are: hypertension, cardiovascular disease and diabetes mellitus; the use of oral contraceptives before pregnancy; dehydration.

It is important to note that the risk of blood clots persists for two months after delivery.

Treatment of thrombosis is a complex process that must necessarily take place under the supervision of a physician.Therefore, in the presence of risk factors, thrombosis prophylaxis is recommended. Prevention can be non-drug and medication. The doctor determines the degree of risk for each patient – low, moderate, high. After that, a method of prevention is selected. As a rule, one non-drug prophylaxis for people with an increased risk of thrombosis is not enough, therefore, drug prophylaxis is carried out along with it. In this case, special drugs are used to prevent the formation of blood clots.

Antiphospholipid syndrome (APS) is the cause of many obstetric complications such as fetal loss syndrome, HELLP syndrome, and premature birth. The high risk of unfavorable obstetric outcomes in APS makes it necessary to plan pregnancy and select adequate therapy for a pregnant woman with this pathology.

Today, APS is one of the urgent problems in obstetric practice. Clinical manifestations of APS in obstetrics are fetal loss syndrome, intrauterine growth retardation, HELLP syndrome, oligohydramnios, feto-placental insufficiency, premature birth, preeclampsia (preeclampsia and eclampsia).Fetal loss syndrome is currently regarded as a specific marker of APS. Termination of pregnancy with APS can occur at any stage of pregnancy, and very often spontaneous miscarriage is the only symptom that allows the patient to suspect APS.

The high risk of unfavorable obstetric outcomes in APS dictates the need for pregnancy planning in these patients, careful selection of drug therapy and constant monitoring of the condition of the mother and fetus.

At the stage of planning pregnancy in a patient with APS, it is necessary to exclude concomitant risk factors for the development of thrombosis. The range of preventive measures includes the correction of excess weight, treatment of concomitant arterial hypertension, correction of lipid spectrum disorders, smoking cessation, as well as the use of compression hosiery for post-thrombophlebitic syndrome.

From the moment of conception, pregnant women with APS are prescribed low doses of ASA (50-100 mg per day, but not more than 150 mg per day) and low molecular weight heparins until the moment of delivery.Low molecular weight heparins are canceled 12-24 hours before delivery. Heparin treatment is resumed 12 hours after delivery for a period of at least 4-6 weeks.

Timely diagnosis and adequate therapy of APS in pregnant women, careful monitoring of hemostasis system indicators, regular monitoring of the fetus, joint management of pregnancy by an obstetrician-gynecologist and related specialists can improve perinatal outcomes.

90,000 Varicose veins during pregnancy. Phlebologist’s recommendations for pregnant women

Chronic venous insufficiency and pregnancy

Pregnancy is a wonderful, joyful and natural state.However, pregnancy does not always go smoothly. Hormonal changes in this period of life have a positive effect on the woman’s body, protect it in this difficult period, but the same hormones can significantly complicate the work of other organs and systems. Connective tissue undergoes the greatest changes. This can cause various problems: pain in the lower back and joints, the appearance of “stretch marks” on the skin of the chest and abdomen, flat feet. In addition, 50% of women develop either dilated skin capillaries or varicose veins during their first pregnancy.With repeated pregnancies, this percentage increases, and the risk of thrombotic complications also sharply increases.

Nature made sure that during childbirth the mother did not lose a lot of blood. To do this, during pregnancy, under the influence of hormones, the blood becomes thicker. Thickening of blood, as well as venous congestion, significantly increase the risk of blood clots in the veins. In the expectant mother, this risk is 3-5 times higher than in the non-pregnant one. The formation of blood clots in the veins can cause a severe and sometimes fatal complication – pulmonary embolism, which threatens not only the health, but also the life of the mother and the unborn child.The risk of thrombosis remains high and is even especially dangerous for 6 weeks after childbirth, especially after a cesarean section or large blood loss during childbirth. Thus, pregnancy is actually a thrombogenic condition. This means that normal changes in the body during a physiological pregnancy increase the likelihood of deep vein thrombosis.

These changes are as follows:

• Significant slowing of blood flow in the deep veins of the legs due to increased outflow of blood from the placental uterus with overload of the iliac veins;
• Decrease in the tone of the walls of the veins and their physiological expansion, which leads to natural valvular insufficiency and reverse blood flow;
• Increased pressure in the veins of the lower extremities by 2-3 times;
• Increased production of sex hormones, progesterone and relaxin, which directly affect elastic fibers and reduce vascular smooth muscle tone;
• Significant increase in the concentration of blood coagulation factors;
• Decreased fibrinolytic (dissolution of clots or blood clots) blood capacity at the end of pregnancy and in the first stage of labor;
• Entering the blood of active substances after placenta separation

Difficulty in venous outflow from the lower extremities during pregnancy is due to a cascade of five mechanisms:

– Mechanical factor. The enlarged uterus is an obstacle to circulation, as it compresses the inferior vena cava, pressing it against the spine and iliac muscle.

– Circulatory factor. An increase in blood volume and outflow of blood from the heart leads to an increase in the load on the veins and their expansion. This is especially important for the veins of the lower extremities and the vaginal area.

– Hormonal factors. Progesterone, due to its relaxing effect on smooth muscle fibers, leads not only to a decrease in the tone of the venous wall, but also to a decrease in the tone of the urethra, bladder and small intestine.

– Hemostatic factors. Changes in the hemostatic system always occur in the direction of increased coagulability (increased fibrinogen levels, increased platelet activity and decreased fibrinolytic activity).

– Hemorheological factors. Blood viscosity increases despite a decrease in hematocrit

– Other contributing factors. These factors include a family history, a sedentary lifestyle, prolonged immobility while working, driving a car, heels that are too high or too thin, obesity, hot baths, multiple pregnancies or short intervals between pregnancies.

The danger increases from the 5th month of the first pregnancy, significantly increases with each subsequent one. The triggering factor is hormonal changes occurring in the body of a pregnant woman: the release of large quantities of female sex hormones, in particular, hormones of the corpus luteum. In addition, the pregnant uterus grows and, gradually, more and more squeezes the large veins located in the small pelvis and abdominal cavity, creating obstacles for the outflow of venous blood from the lower extremities.As a result, there is stagnation of venous blood and an increase in pressure in the veins of the legs and small pelvis.

During pregnancy, a woman’s body undergoes many changes. The hormone progesterone, which is responsible for the preservation and development of the fetus, affects not only the uterus, but also the veins, their smooth muscle cells, due to which their tone decreases. The effect of progesterone begins from the first days of conception and fetal development. A high level of the hormone leads to the development of degenerative changes in elastic and collagen fibers, as a result of which the veins become less elastic and dilate.The process proceeds more quickly if the hormonal background was disturbed even before pregnancy, as well as if the woman was taking hormonal drugs, oral contraceptives.

The development of varicose veins during pregnancy occurs as a result of many factors. An increase in the volume of circulating blood leads to an increase in pressure on the vessels. Because of this, the veins suffer, since their wall has a lower density and elasticity compared to the arteries.

An increase in the size of the uterus puts pressure on the veins of the small pelvis, which leads to a delay in the outflow of blood from the legs to the upper region.For this reason, varicose veins of the lower extremities occur. An increase in pressure on the vessels of the lower extremities due to the constant weight gain of a pregnant woman. The saphenous veins, which are not surrounded by muscles, are most affected compared to the deep veins. They most often undergo varicose veins, since their wall is not surrounded by the outer layer of the muscular frame.

There are such forms of varicose veins in pregnant women:

• Varicose veins of the lower extremities
• Varicose veins of the small pelvis
• Varicose veins of the external genital organs
• Pelvic venous congestion syndrome
• Right ovarian vein syndrome
• Varicose enlargement of the ovarian veins (varicoovarium)

Currently, there are 2 variants of the course of varicose veins of the small pelvis: varicose veins of the perineum and vulva, as well as the syndrome of pelvic venous congestion.It should be emphasized that this division is rather arbitrary, since in more than 50% of cases, varicose veins of the perineum and vulva provoke a violation of the outflow from the small pelvis, and vice versa.

Varicose veins of the perineum and vulva

It occurs in 30% of women during pregnancy. The mechanisms of this condition are basically similar to those in varicose veins of the lower extremities. At the same time, the progressive varicose transformation of the perineal veins is aggravated by the compression by the pregnant uterus of the main veins of the retroperitoneal space (iliac and inferior vena cava).Outside of pregnancy persists in 2-10% of cases.

Pelvic Congestion Syndrome

A variety of clinical manifestations and imperfect diagnostics mask it under various forms of gynecological (inflammatory diseases of the uterus and its appendages, endometriosis), urological (cystitis), surgical (colitis, Crohn’s disease and others) and even orthopedic (diseases of the hip joint) pathology.

This disease is associated with varicose veins of the ovaries and the wide ligament of the uterus.The main mechanism is valve insufficiency of the ovarian veins, leading to a discharge of blood and an increase in pressure in the venous plexuses of the small pelvis. Predisposing factors can be retroflection of the uterus, leading to the bending of the wide ligament of the uterus, which impedes the outflow of venous blood, as well as various gynecological diseases (endometriosis, tumors of the uterus and ovaries). In recent years, the adverse effects of hormonal therapy and contraception have been discussed. The influence of the hormonal background is evidenced by the fact that the manifestations of the syndrome of venous congestion of the small pelvis in the postmenopausal period become less pronounced.

The clinical picture of the disease is quite characteristic and is manifested by the progressive varicose veins of the perineum, vulva, vagina, lower extremities (cosmetic defect), progressive as the gestation period increases. Signs of such violations will be:

• Itching in the area of ​​varicose veins.
• Feeling of heaviness and bursting pain in the perineum, small pelvis, edema of the external genitalia, lower extremities.
• Dyspareunia (pain during intercourse)
• Dysmenorrhea
• Severe premenstrual syndrome
• Pain when walking and exercising
• Pain along the veins
• General pain and leg aches
• Dysuric disorders.
• Fatigue.
• Development of acute varicothrombophlebitis and rupture of altered veins, which is accompanied by massive bleeding.

Thrombosis during pregnancy is a major clinical problem. This is due to the high frequency of this condition as a cause of maternal mortality (20% of all causes). As you know, during pregnancy there is a tenfold increase in the risk of thrombosis. The incidence of thrombosis is 0.7 – 4.2 / 1000 in pregnant women versus 1/10 000 in non-pregnant women of childbearing age.

A critical stage of the thrombotic process is pulmonary embolism – the most severe and very often fatal complication of thrombosis. PE is the leading cause of maternal mortality in obstetric practice in the West – 0.7 cases per 1000 births (from 11% to 27%). The likelihood of venous thromboebolic complications (VTO) during cesarean section is 3-6 times higher. The risk of developing VTE returns to levels seen in non-pregnant women 6 weeks after delivery.

The main risk factors for WTO include the following:

• Age (> 35 years old)
• Caesarean section
• Weight> 80 kg
• Individual and family history of thrombosis
• Rebirth
• Ovarian hyperstimulation
• Prolonged immobilization
• Varicose veins
• Thrombophilia

The complexity of the treatment of OBE during pregnancy is as follows:

• Direct dependence on gestational age (safe periods of pregnancy for active treatment tactics 7-8 weeks, 13-17 weeks, 23-27 weeks)
• Difficulty in selecting the type and dosage of anticoagulant
• High probability of termination of pregnancy and (or) development of complications
• The need to resolve a complex issue on the choice of treatment tactics
• The Ethical Issue of Life Preservation Choices
• The problem of achieving compliance with the patient and her relatives

As for varicose veins of the lower extremities during pregnancy, this problem is very extensive and controversial.Patients with varicose veins who are planning a pregnancy should clearly understand the risks, adequately assess the danger that the disease poses not only for the mother, but also for the unborn child, so as not to then impose all responsibility on doctors, who in this case will have very limited possibilities. This responsibility, first of all, should lie with the parents of the unborn child. Experts always insist that varicose veins be cured before pregnancy, then there will be no corresponding risk.

On the one hand, the presence of varicose veins is the main risk factor for VTO, i.e. there is a strong need for the prevention of such complications – for surgical treatment. On the other hand, during pregnancy, the possibilities of surgical treatment are sharply limited by the safe periods of pregnancy. And if before pregnancy the patient has a fairly large choice in treatment methods, then in the event of complications of varicose veins during pregnancy, for example thrombophlebitis, only a standard operation will be a possible method of removing veins, and this is general anesthesia and the need to prescribe medications, which is a direct threat to the fetus. and in addition, a pronounced surgical trauma, causing certain changes in the body, clearly not going to the benefit of the pregnant woman and the fetus.A clear advantage in this case will have modern low-traumatic methods of surgical treatment – EVLO and RFO, because they do not require the use of general anesthesia and the appointment of a significant amount of medications, and also do not cause severe surgical trauma and are safe. However, in this case, given the constant growth of the pregnant uterus and progressive changes in the venous circulation with a sharp increase in pressure in the veins, the likelihood of a relapse of the disease is very high.Certain conditions and technical possibilities of performing such an intervention will also be an important factor.

Therefore, if a patient with varicose veins seeks help already during pregnancy, in most cases conservative methods of prevention are still prescribed, as a rule – compression therapy, taking phlebotropic drugs in safe periods of pregnancy, dynamic observation with an objective assessment of the condition. In the absence of complications during pregnancy, surgical treatment is prescribed after the period of breastfeeding.However, the high risk of VTO in case of varicose veins in pregnant women, even with compression therapy, remains, especially in the presence of several risk factors, which we mentioned above.

For example, the standard for the prevention of WTO in Europe in the presence of several risk factors for thrombosis, in the presence of varicose veins, is the appointment of daily injections of drugs that “thin” the blood for the entire period of pregnancy! Is it really worth it not to operate on your varicose veins before pregnancy, using modern methods, quickly, painlessly, and then be absolutely calm for yourself and your unborn child ?!

So, the main measure for preventing the development of VTO in the presence of varicose veins is timely and adequate treatment (timely surgical treatment, compliance with the compression therapy regimen, correction of the rheological properties of blood and blood coagulation processes, an active lifestyle).

The main simple preventive measures are as follows:

• Wear comfortable underwear;
• Limit physical activity, while doing simple exercises to keep fit, swimming
• Monitor nutrition by adding more fiber to the diet
• Sufficient liquid
• Walking in loose shoes, heel no more than 4 cm, comfortable, not tight clothing
• Do not take hot baths, do not visit the bathhouse, sauna
• Daily rising contrast shower
• Active motor mode, avoid long stationary positions, walking 2 h / d
• Perform Special Venous Gymnastics
• Track weight
• Sleep on the left side
• Wear compression hosiery
• Observe a phlebologist

Considering all of the above, our advice for pregnant women with varicose veins:

• Wear compression hosiery at all times throughout pregnancy;
• Observe an active motor mode;
• be observed by a phlebologist throughout pregnancy;
• strictly follow all the recommendations of a specialist;
• At the first sign of deterioration, seek help immediately.

If you are planning a pregnancy and you have varicose veins, operate them before pregnancy and protect yourself and your unborn child.

The article was prepared by a vascular surgeon of the highest category, phlebologist Gerasimov Vladimir Vladimirovich .

To receive information about treatment and make an appointment, call the Dobrobut MS Contact Center:

044 495 2 888 or 097 495 2 888

Phlebologist’s consultation
Prevention of varicose veins

Thrombophlebitis / thrombosis during pregnancy – 7 responses to Babyblog

This trouble happened to me at 28 weeks.

The day before was a busy day – all day on my feet. When I felt the aching bolts in my thigh (pain, as after an intense workout), I did not attach any importance to this. I decided to stretch my leg, take a long walk. The next day, the pain intensified. But since I did not know about the existence of thrombosis, but knew about the pinching of the sciatic nerve, then I took the pain that began somewhere in the pelvis for a sore I know of. I did the exercises, it seemed like it became easier, even at the stove I was able to stand for an hour and a half.But after that, the pain in the upper thigh began to intensify every day, the temperature slightly increased. I did not go to the doctor, because it is worth contacting our doctors, they will send them to others who will tick the box, and you ask in the queues for a couple of days.

Further whining. You can skip the next paragraph.

But the day of the planned visit to the residential complex came, and with great difficulty, leaning on the mop, I could reach the toilet. I called my gynecologist, she insisted that I come, I explained for a long time that I was physically unable, after which she recommended that I call a therapist at home, i.e.because gynecologists do not go to the house. I called, the call was recorded, the therapist called me back and insistently asked me to come to the clinic, I again explained for a long time and convinced that I could not. After 10 minutes of persuasion, she gave up.

The nagging review is over.

The therapist diagnosed thrombophlebitis. I called an ambulance and I was hospitalized. An ultrasound scan showed a thrombosis in one vein, but the uzist was young and the equipment was not very good. When, after 10 days of treatment, I was referred for a consultation at the regional hospital, it turned out that the entire thigh was clogged – 4 veins.

I experienced terrible pain for 2-3 weeks. Thrombophlebitis is when a clotted vein becomes inflamed. Every surgeon I encountered in the hospital was asked a question: when will everything go away. How many doctors – so many opinions, but coincidences were very rare. Someone said that it would hurt before childbirth, someone said that my veins were more dysfunctional and there were many other fears, but when, after 10 days of treatment, they were referred to a vascular surgeon, only with him I realized that life goes on and is not so scary thrombosis and thrombophlebitis.

You experience pain only in the acute period, during the period of inflammation. When the inflammation in the vein goes away, the pain subsides. Compression of the legs helps: the pain is not so acute, and the heaviness in the legs disappears. The main thing is that the blood clot is securely fixed, because a floating (loose, floating) thrombus is terrible. Mine are attached to a vein.

Colola Fraxiparine 2 times a day + Detralex.

A month later, the pain was gone.

Angiosurgeon recommended KS, because one of the blood clots was in the groin and could come off due to pushing.Gynecologists insisted on the EP, because surgery – the risk of new thrombosis.

At 35 weeks I was admitted to the hospital.

At 38, labor was induced.

After childbirth (this is 3 months after thrombophlebitis), the blood clots have resolved by half, blood flows appeared in the veins.

The angiosurgeon switched me to aspirin and said that another 3 months and there would be no trace of blood clots.

These are the adventures my second pregnancy brought me.

90,000 Are you pregnant and planning to travel by plane? Take note of these recommendations

Did you find out that you are pregnant and you are planning a flight to a warmer region? No problem! You can fly during pregnancy, but there are some restrictions in this regard.

As a rule, flights do not pose a particular risk to a pregnant woman and the baby she is expecting. However, it is not recommended to fly long distances in the last trimester, i.e. from week 36. Shorter flights are permissible for another two weeks after that, that is, up to 38 weeks, provided that the pregnancy is proceeding without complications. With multiple and difficult pregnancies, the restrictions are more stringent.

You should check the airline’s practice with regard to pregnant women in advance of your flight, as rules may vary from airline to airline.

Finnair will allow you to board the aircraft until the end of your 36th week of pregnancy. At a later date, short flights within Finland and Scandinavia are allowed up to 38 weeks, provided that the pregnancy proceeds without complications. Finnair requires a doctor’s certificate that the pregnancy is normal if the pregnancy is 28 full weeks or more. The completed application form is on the airline’s website, and it must be provided before the trip.

In order to avoid possible delays, some airlines recommend taking with you a doctor’s certificate in English about your well-being already in the early stages and in the middle of pregnancy.The stringent restrictions arise for safety reasons: the airline does not want a pregnant woman on board to become a cause for unnecessary anxiety.

The restrictions are due to the risk of premature birth, as the conditions for childbirth and childbirth on board are very poor.

– If you fly at a later date, it can provoke childbirth, since the uterus is large and sometimes to some extent also in good shape, says obstetrician-gynecologist Mika Nuutila .

Pregnant women are advised to check what the travel insurance policy says regarding pregnancy.

Increased risk of blood clots

The greatest risk of flight is not for the baby in the womb, but for the pregnant woman. Pregnancy itself increases blood clotting, and prolonged sitting increases the risk of a blood clot by 6-10 times.

A large abdomen and mechanical pressure from the uterus on the large ascending veins in the legs increase the risk of blood clots.In addition, the seats on planes tend to be narrow, and this compresses the veins even more.

– You should get up about once an hour. It is recommended to do leg exercises in a seated position – some airlines even have special instructions for this. It is also recommended to drink plenty of water and wear compression socks, shares Nuutila’s advice.

D-dimer

D-dimer is a protein fragment that is formed when a blood clot that occurs during blood clotting dissolves.It is a marker of thrombus formation, since in this process, along with the occurrence of thrombi, their dissolution is triggered with the formation of D-dimers.

Synonyms Russian

Fragment of fibrin cleavage.

Synonyms English

D-dimer, Fragment D-dimer, Fibrin degradation fragment.

Research method

Immunoturbidimetry.

Units

μg FEU / ml (micrograms of fibrinogen equivalent units per milliliter).

Which biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

• Avoid fatty foods from the diet 24 hours before the study.
• Eliminate physical and emotional stress 30 minutes before the study.
• Do not smoke within 30 minutes prior to examination.

General information about the study

D-dimer – a protein fragment that is formed as a result of the breakdown of a blood clot.If a vessel or tissue is damaged in the body, the process of blood coagulation is triggered – the formation of blood clots, which include a special protein called fibrin. It “holds” the components of the thrombus together and holds the thrombus where it was formed.

Thrombi can occur not only at the site of tissue or vascular damage, but also inside the vessels in the presence of factors predisposing to this: damage to the inner lining of blood vessels by various endogenous and exogenous substances and antibodies, disturbance of local hemodynamics – stagnation of blood, the presence of turbulent flows.Blood clots in blood vessels are found in a number of diseases: varicose veins of the lower extremities, atrial fibrillation, complicated course of infectious diseases, complications after surgery. During thrombosis, the body triggers mechanisms that contribute to the destruction of blood clots, during their work, fibrin begins to be destroyed by plasminogen and D-dimers are formed. Thus, the amount of D-dimers in the blood indicates the activity of the processes of destruction of thrombi and indirectly makes it possible to assess the activity of thrombus formation.Most often, this test is used to diagnose disseminated intravascular coagulation syndrome (DIC), as well as to monitor the therapy of thrombosis with anticoagulants (for example, heparin).

The number of D-dimers can be increased during pregnancy, usually it gradually increases by the third trimester. Until recently, high rates were considered a sign of a threat of thrombotic complications during pregnancy, but recent studies have shown that there is no clear relationship between the level of D-dimer and pregnancy pathology.

The D-dimer test is used in the vast majority of cases as an auxiliary test, and the diagnosis is made taking into account the clinical picture and the results of other studies.

What is the research used for?

• For the diagnosis of disseminated intravascular coagulation.
• For the diagnosis of deep vein thrombosis.
• For additional assessment of the severity of thrombus formation and monitoring of the ongoing anticoagulant therapy in pulmonary thromboembolism, stroke.

When is the study scheduled?

• For symptoms of deep vein thrombosis:
  • severe pain in the legs (leg),
  • pronounced edema of the legs (legs),
  • pallor of the skin in the area of ​​thrombosis.
• If ​​pulmonary thromboembolism is suspected:
  • sudden onset of shortness of breath,
  • shortness of breath,
  • cough,
  • hemoptysis (blood in sputum),
  • sharp chest pain,
  • increased heart rate.
• With DIC, when the following symptoms occur against the background of the underlying disease:
  • shortness of breath,
  • cyanosis of the skin,
  • bleeding gums,
  • nausea, vomiting,
  • severe pain in muscles and abdomen,
  • pain in the region of the heart,
  • decreased urination.
• When monitoring anticoagulant therapy.

What do the results mean?

Reference values: 0 – 0.55 μg FEU / ml.

For pregnant women:

A sharp increase in the concentration of D-dimer may indicate a large number of blood clots in the bloodstream, which is most often caused by venous thromboembolism or disseminated intravascular coagulation.At the same time, the results of the study do not allow establishing the localization of thrombosis. A normal D-dimer level means that the patient most likely does not have an acute form of the disease that causes blood clots.

A moderate increase in D-dimer concentration is often observed at:

• recent surgeries,
• injuries (not extensive),
• cardiovascular diseases,
• oncological diseases,
• liver diseases,
• normal pregnancy, especially in the later stages.

Download an example of the result

Important notes

The concentration of D-dimer may be elevated in the elderly, as well as in patients with high rheumatoid factor levels in rheumatoid arthritis.

Also recommended

Who orders the study?

Surgeon, anesthesiologist-resuscitator, cardiologist, phlebologist, therapist, infectious disease specialist.

90,000 When COVID-19 patients are at risk of thrombosis – Rossiyskaya Gazeta

Why can postcoid patients develop blood clots? Who has the higher risk? And is it possible, after vaccination, to become a source of coronavirus for other people? Experts of “RG” -Week continue to answer the questions of our readers.

Vaccination will protect against both infection and future complications. Photo: iStock

Is it true that after being vaccinated, a person can become a carrier of the coronavirus and infect others with it?

If a person becomes ill with COVID-19 soon after vaccination, this has nothing to do with the introduction of the vaccine. Most likely, he was already infected at the time of vaccination or caught the virus immediately after, even before the development of protective antibodies. According to the Ministry of Health of Russia, up to 2.5% of those vaccinated fall ill with COVID-19, while the disease can proceed either as a mild ARVI, or even without symptoms at all.Such a person can really spread the virus if he actively communicates with people without observing protective measures.

It is no coincidence, for example, that the United States introduced mandatory tests for COVID-19 for vaccinated people if they came into contact with sick people. Moreover, they were obliged to pass the analysis even in those cases if they do not have symptoms of the disease. Such recommendations were published by the CDC (US Centers for Disease Control and Prevention) based on new data that even after vaccination, people can become infected with coronavirus and remain carriers of it for some time, spreading the infection.

“Our updated guidelines recommend that vaccinated people get tested if they have been exposed to an infection, regardless of their symptoms,” explained CDC Director Dr. Rochelle Walensky.

In addition, the CDC has tightened the recommendations for wearing masks:

– fully vaccinated people should wear a mask in public places (closed rooms) after contact with a sick person;

– three to five days after contact, they should be tested for the virus;

– if the test results are negative, they may stop wearing masks indoors;

– If the test is positive, the carrier of the coronavirus must be isolated by staying at home for 10 days.

The new CDC solution is based on the latest research that even fully vaccinated people infected with the delta strain can carry the virus and transmit it to others.

Why can thrombosis occur in a person who has had a coronavirus?

This risk, according to the Ministry of Health of Russia, is quite high – a tendency to thrombosis is noted in every third postcoid patient.

“One of the tropic cells, that is, favorable for the reproduction of the SARS-CoV-2 virus, is the endothelium lining the inner surface of blood vessels, which is in contact with blood,” explains the infectious disease doctor, chief physician of the Clinical Diagnostic Laboratory “Invitro- Siberia “Andrey Pozdnyakov.- Normally, they are very elastic and blood moves through them without hindrance. When endothelial cells are invaded by a virus, the inner lining of the vessels loses its elasticity, making it difficult for blood to flow.

Since the endothelium is restored rather slowly, thrombosis may occur if the inner lining of the vessels is disturbed by the SARS-CoV-2 virus. In this case, a person may not even suspect that he is developing a blood clot. “

Who has such complications as thrombosis more often?

” First of all, these are people with a genetic predisposition.This is quite common in the population, so there are a lot of people who need to closely monitor the state of blood vessels, “says Andrey Pozdnyakov.

At the same time, it is impossible to judge whether there is a genetic predisposition or not, if, for example, the closest relatives suffered from thrombosis. “Absolutely anyone can be a carrier of hemostasis mutation and have a tendency to thrombosis. This can be detected using genetic tests, for example, “hemostasis mutations”, – explained Dr. Pozdnyakov.

He also explained why you need to control your condition by performing the necessary tests as prescribed by your doctor. “This tendency is practically not manifested in ordinary life. Unfortunately, in genetically predisposed people, the first detection is often fatal – it can be a stroke, heart attack or thrombosis of any other vein,” Pozdnyakov says.

Coronavirus affects the blood vessels, hence the high risk of thrombosis

The doctor advised to be especially careful for people with endocrine diseases associated with impaired glucose metabolism, those who are overweight, chronic diseases of the heart and blood vessels – in these categories the risk of thrombosis is higher.”In” cores “traditionally thrombosis is one of the most frequent complications, since almost all of them suffer from atherosclerosis of the vessels. If the integrity of the inner lining of the vessels is damaged, blood clots easily form on them. If already compromised people become ill with COVID-19, the risks of thrombosis are enormous for them. That is why COVID-19 is dangerous for people with cardiovascular and endocrine pathology, their blood clotting changes greatly and they die most often from thrombotic complications, “the doctor said.

Why are women often warned about the threat of thrombosis?

In some cases, it is worth checking the blood clotting parameters in healthy people. For example, young women who take oral contraceptives are more likely to develop blood clots. “Therefore, if there are problems with blood clots, it is better not to use contraceptives. You need to consult a doctor and switch to other methods of contraception,” Andrei Pozdnyakov advised.

Can vaccination increase the risk of thrombosis?

“Any vaccination is a stress reaction for the body, which, among other things, can carry the risk of increased blood clots.This can be susceptible to people who have mutations in the hemostatic system, “Pozdnyakov noted.