What causes vaginal bleeding during pregnancy. How to distinguish between normal and abnormal bleeding. When should you contact your healthcare provider. What are the potential risks associated with bleeding during pregnancy.

Understanding Vaginal Bleeding in Early Pregnancy

Vaginal bleeding during pregnancy can be a source of concern for many expectant mothers. While it’s not uncommon, especially in the first trimester, it’s essential to understand the potential causes and know when to seek medical attention. Approximately 20% of women experience some form of bleeding during the first 12 weeks of pregnancy.

Is early pregnancy bleeding always a cause for alarm?

Not necessarily. In many cases, light bleeding or spotting in early pregnancy is not indicative of a serious problem. However, it’s always best to consult with your healthcare provider to rule out any potential complications.

Common Causes of First Trimester Bleeding

Several factors can contribute to vaginal bleeding during the first three months of pregnancy. Understanding these potential causes can help alleviate some anxiety and guide you in seeking appropriate care.

Implantation Bleeding: A Normal Occurrence

One of the earliest signs of pregnancy can actually be light bleeding or spotting. This phenomenon, known as implantation bleeding, occurs when the fertilized egg attaches itself to the lining of the uterus. It typically happens within 6 to 12 days after conception and is often mistaken for a light period.

• Usually very light bleeding
• Lasts from a few hours to a few days
• Often pinkish or brown in color

Miscarriage: A Common Concern

Miscarriage is often the first worry that comes to mind when experiencing bleeding during pregnancy. While it is most common during the first 12 weeks, it’s important to note that not all bleeding indicates a miscarriage.

If a heartbeat is detected on ultrasound, over 90% of women who experience first trimester vaginal bleeding will not miscarry. However, be aware of these additional symptoms that may indicate a miscarriage:

• Strong cramps in the lower abdomen
• Tissue passing through the vagina
• Severe back pain

Ectopic Pregnancy: A Rare but Serious Condition

An ectopic pregnancy occurs when the fertilized egg implants outside the uterus, usually in the fallopian tube. This condition affects about 2% of pregnancies and can be life-threatening if left untreated.

Symptoms of an ectopic pregnancy may include:

• Strong cramps or pain in the lower abdomen
• Lightheadedness or dizziness
• Shoulder pain

Less Common Causes of Early Pregnancy Bleeding

While less frequent, there are other potential causes of vaginal bleeding during the first trimester that should be considered.

Molar Pregnancy: A Rare Complication

A molar pregnancy, also known as gestational trophoblastic disease, is a rare condition where abnormal tissue grows inside the uterus instead of a baby. In some cases, this tissue can be cancerous and potentially spread to other parts of the body.

Symptoms of a molar pregnancy may include:

• Severe nausea and vomiting
• Rapid enlargement of the uterus
• Grape-like cysts passing from the vagina

Cervical Changes and Infections

During pregnancy, increased blood flow to the cervix can make it more sensitive. This can lead to light bleeding after intercourse or a Pap smear. Additionally, infections of the cervix, vagina, or sexually transmitted infections can cause bleeding in early pregnancy.

Second and Third Trimester Bleeding: When to Be Concerned

Bleeding during the later stages of pregnancy can be more serious and may signal a problem with the mother or baby. It’s crucial to contact your healthcare provider immediately if you experience any bleeding in your second or third trimester.

Placenta Previa: A Rare but Serious Condition

Placenta previa occurs when the placenta sits low in the uterus and partially or completely covers the opening of the birth canal. This condition is rare in the late third trimester, affecting only about 1 in 200 pregnancies.

• Can cause painless bleeding
• Requires immediate medical attention
• May necessitate bed rest or early delivery

Placental Abruption: A Medical Emergency

In approximately 1% of pregnancies, the placenta detaches from the wall of the uterus before or during labor. This condition, known as placental abruption, can be very dangerous for both the mother and baby.

Symptoms of placental abruption may include:

• Abdominal pain
• Blood clots passing from the vagina
• Tender uterus
• Back pain

Rare but Serious Causes of Late Pregnancy Bleeding

While uncommon, there are several other potential causes of bleeding in late pregnancy that require immediate medical attention.

Uterine Rupture: A Rare Complication

In rare cases, a scar from a previous C-section can tear open during pregnancy. This condition, known as uterine rupture, is life-threatening and requires an emergency C-section.

Symptoms of uterine rupture may include:

• Sudden, severe abdominal pain
• Tenderness in the abdomen
• Rapid heart rate

Vasa Previa: A Rare but Dangerous Condition

Vasa previa is a very rare condition where the baby’s blood vessels in the umbilical cord or placenta cross the opening to the birth canal. This can be extremely dangerous for the baby if these blood vessels tear open.

Signs of vasa previa may include:

• Abnormal fetal heart rate
• Excessive bleeding
• Sudden onset of labor

Premature Labor: When Bleeding May Signal the Start of Delivery

Vaginal bleeding late in pregnancy may be a sign that your body is preparing for delivery. A few days or weeks before labor begins, you may notice the passage of the mucus plug, which can contain small amounts of blood (known as “bloody show”).

Is bloody show always a sign of imminent labor?

Not necessarily. While bloody show can indicate that labor is approaching, it doesn’t mean it will start immediately. Some women may experience bloody show days or even weeks before labor begins.

If bleeding and symptoms of labor begin before the 37th week of pregnancy, contact your healthcare provider immediately, as this could indicate preterm labor.

When to Seek Medical Attention for Pregnancy Bleeding

While some bleeding during pregnancy can be normal, it’s essential to know when to seek medical attention. Always err on the side of caution and contact your healthcare provider if you experience any vaginal bleeding during pregnancy, especially if it’s accompanied by other symptoms.

What should you do if you experience bleeding during pregnancy?

1. Note the amount, color, and duration of the bleeding
2. Use a pad to absorb the blood (avoid using tampons)
3. Avoid sexual intercourse until you’ve spoken with your healthcare provider
4. Contact your healthcare provider or go to the emergency room if bleeding is heavy or accompanied by pain

Remember, while bleeding can be alarming, many women who experience bleeding during pregnancy go on to have healthy babies. The key is to stay informed, monitor your symptoms, and maintain open communication with your healthcare provider throughout your pregnancy.

Coping with Anxiety Related to Pregnancy Bleeding

Experiencing bleeding during pregnancy can be emotionally challenging. It’s normal to feel anxious or worried, but it’s important to find ways to manage these feelings for your own well-being and that of your baby.

How can you manage anxiety related to pregnancy bleeding?

• Educate yourself about the possible causes and outcomes
• Communicate openly with your healthcare provider
• Practice relaxation techniques such as deep breathing or meditation
• Seek support from your partner, family, or a support group
• Consider speaking with a mental health professional if anxiety becomes overwhelming

Remember that each pregnancy is unique, and experiencing bleeding doesn’t necessarily mean something is wrong. By staying informed and in close contact with your healthcare provider, you can navigate this challenging situation with greater confidence and peace of mind.

Preventive Measures and Healthy Pregnancy Practices

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

What can you do to promote a healthy pregnancy?

• Attend all scheduled prenatal appointments
• Take prenatal vitamins as recommended by your healthcare provider
• Maintain a balanced, nutritious diet
• Stay hydrated
• Avoid smoking, alcohol, and illicit drugs
• Exercise regularly, as approved by your healthcare provider
• Manage stress through relaxation techniques and self-care
• Avoid high-risk activities that could lead to falls or injuries

By following these guidelines and staying in close communication with your healthcare provider, you can take proactive steps towards a healthy pregnancy. Remember that while bleeding can be concerning, many women who experience it go on to have successful pregnancies and healthy babies.

Vaginal Bleeding and Blood Clots During Pregnancy

Written by Stephanie Watson

In this Article

• Bleeding in the First Trimester
• Bleeding in the Second and Third Trimesters
• What to Do If You Have Abnormal Bleeding During Pregnancy

Bleeding during pregnancy is common, especially during the first trimester, and usually it’s no cause for alarm. But because bleeding can sometimes be a sign of something serious, it’s important to know the possible causes, and get checked out by your doctor to make sure you and your baby are healthy.

About 20% of women have some bleeding during the first 12 weeks of pregnancy. Possible causes of first trimester bleeding include:

Implantation bleeding. You may experience some normal spotting within the first six to 12 days after you conceive as the fertilized egg implants itself in the lining of the uterus. Some women don’t realize they are pregnant because they mistake this bleeding for a light period. Usually the bleeding is very light and lasts from a few hours to a few days.

Miscarriage. Because miscarriage is most common during the first 12 weeks of pregnancy, it tends to be one of the biggest concerns with first trimester bleeding. However, first trimester bleeding does not necessarily mean that you’ve miscarried or will miscarry. In fact, if a heartbeat is seen on ultrasound, over 90% of women who experience first trimester vaginal bleeding will not miscarry.

Other symptoms of miscarriage are strong cramps in the lower abdomen and tissue passing through the vagina.

Ectopic pregnancy. In an ectopic pregnancy, the fertilized embryo implants outside of the uterus, usually in the fallopian tube. If the embryo keeps growing, it can cause the fallopian tube to burst, which can be life-threatening to the mother. Although ectopic pregnancy is potentially dangerous, it only occurs in about 2% of pregnancies.

Other symptoms of ectopic pregnancy are strong cramps or pain in the lower abdomen, and lightheadedness.

Molar pregnancy (also called gestational trophoblastic disease). This is a very rare condition in which abnormal tissue grows inside the uterus instead of a baby. In rare cases, the tissue is cancerous and can spread to other parts of the body.

Other symptoms of molar pregnancy are severe nausea and vomiting, and rapid enlargement of the uterus.

Additional causes of bleeding in early pregnancy include:

• Cervical changes. During pregnancy, extra blood flows to the cervix. Intercourse or a Pap test, which cause contact with the cervix, can trigger bleeding. This type of bleeding isn’t cause for concern.
• Infection. Any infection of the cervix, vagina, or a sexually transmitted infection (such as chlamydia, gonorrhea, or herpes) can cause bleeding in the first trimester.

Abnormal bleeding in late pregnancy may be more serious because it can signal a problem with the mother or baby. Call your doctor as soon as possible if you experience any bleeding in your second or third trimester.

Possible causes of bleeding in late pregnancy include:

Placenta previa. This condition occurs when the placenta sits low in the uterus and partially or completely covers the opening of the birth canal. Placenta previa is very rare in the late third trimester, occurring in only one in 200 pregnancies. A bleeding placenta previa, which can be painless, is an emergency requiring immediate medical attention.

Placental abruption. In about 1% of pregnancies, the placenta detaches from the wall of the uterus before or during labor and blood pools between the placenta and uterus. Placental abruption can be very dangerous to both the mother and baby.

Other signs and symptoms of placental abruption are abdominal pain, clots from the vagina, tender uterus, and back pain.

Uterine rupture. In rare cases, a scar from a previous C-section can tear open during pregnancy. Uterine rupture can be life-threatening, and requires an emergency C-section.

Other symptoms of uterine rupture are pain and tenderness in the abdomen.

Vasa previa. In this very rare condition, the developing baby’s blood vessels in the umbilical cord or placenta cross the opening to the birth canal. Vasa previa can be very dangerous to the baby because the blood vessels can tear open, causing the baby to bleed severely and lose oxygen.

Other signs of vasa previa include abnormal fetal heart rate and excessive bleeding.

Premature labor. Vaginal bleeding late in pregnancy may just be a sign that your body is getting ready to deliver. A few days or weeks before labor begins, the mucus plug that covers the opening of the uterus will pass out of the vagina, and it will usually have small amounts of blood in it (this is known as “bloody show”). If bleeding and symptoms of labor begin before the 37th week of pregnancy, contact your doctor right away because you might be in preterm labor.

Other symptoms of preterm labor include contractions, vaginal discharge, abdominal pressure, and ache in the lower back.

Additional causes of bleeding in late pregnancy are:

• Injury to the cervix or vagina
• Polyps
• Cancer

Because vaginal bleeding in any trimester can be a sign of a problem, call your doctor. Wear a pad so that you can keep track of how much you’re bleeding, and record the type of blood (for example, pink, brown, or red; smooth or full of clots). Bring any tissue that passes through the vagina to your doctor for testing. Don’t use a tampon or have sex while you are still bleeding.

Your doctor might recommend that you rest as much as you can and avoid exercise and travel.

You should expect to receive an ultrasound to identify what the underlying cause of your bleeding may be. Vaginal and abdominal ultrasounds are often performed together as part of a full evaluation.

Go to the emergency room or call 911 right away if you have any of the following symptoms, which could be signs of a miscarriage or other serious problem:

• Severe pain or intense cramps low in the abdomen
• Severe bleeding, with or without pain
• Discharge from the vagina that contains tissue
•  Dizziness or fainting
• A fever of more than 100. 4 or more degrees Fahrenheit and/or chills

Top Picks

Is it common, causes, and seeing a doctor

There are various reasons a person may experience spotting in early pregnancy. For instance, spotting at 6 weeks may be from hormonal changes.

People may experience light bleeding during early pregnancy, known as spotting. This is a common occurrence but can be a sign of a more serious problem.

In this article, we discuss the common causes of spotting, what it may look like, and when to contact a doctor.

About a quarter of pregnant people experience bleeding during the first trimester. Although bleeding is a possible sign of early pregnancy loss, it does not mean this will happen.

Several other conditions and factors, including normal hormonal shifts, may cause spotting in early pregnancy.

The most common causes of spotting in early pregnancy include:

Subchorionic hematoma

A subchorionic hematoma happens when blood builds up near the chorion, the fetal membrane next to the placenta. The bleeding may also appear between the uterus and the placenta.

Some people may also refer to this as a subchorionic hemorrhage.

Subchorionic hematoma is the most common cause of bleeding in the first trimester of pregnancy, accounting for around 11% of cases.

A subchorionic hematoma is not a pregnancy loss. Many pregnant people with this type of bleeding have no further complications during their pregnancy.

People who experience a subchronic hematoma are at a higher risk of early pregnancy loss.

Ectopic pregnancy

In an ectopic pregnancy, a fertilized egg implants outside the uterus, often in the fallopian tubes. A person may still have pregnancy symptoms or get a positive pregnancy test.

The pregnancy, however, cannot survive. It can rupture and cause life threatening bleeding or a dangerous infection if it continues to grow.

An ectopic pregnancy can cause spotting as the pregnancy grows. In the case of a rupture, internal bleeding may get progressively heavier over several hours.

Cervical irritation

The cervix, the doughnut-shaped entry to the uterus, increases its blood supply during pregnancy. This means it is more likely to bleed from irritation, such as after sex or a pelvic exam. Light spotting after any form of vaginal penetration is a possible sign of cervical bleeding.

Cervical bleeding during pregnancy is typically not a cause for concern. However, a serious injury to the cervix, such as an assault or trauma, might cause more severe cervical bleeding.

These injuries can cause infections and other serious complications. It is important to contact a doctor following any traumatic injury to the cervix or vagina.

Learn more about changes to the cervix in early pregnancy here.

Pregnancy loss

Vaginal bleeding is the most common sign of pregnancy loss. The medical term for pregnancy loss in the first 23 weeks is miscarriage.

However, around half of people that experience light bleeding during early pregnancy do not lose their pregnancy.

Any pregnant person who has concerns about their pregnancy should speak with a doctor about risk factors and how to minimize them.

Hormonal shifts

Around week 6–8 of pregnancy, a luteal-placental shift happens. This is when the placenta develops enough to produce hormones that sustain the pregnancy. Before this change, the corpus luteum — a group of cells that forms during ovulation — produces pregnancy hormones.

This hormonal change sometimes triggers a temporary drop in the hormone progesterone. This shift may cause spotting or even bleeding as heavy as a period. As long as the placenta begins producing enough progesterone, the pregnancy can safely continue, and a pregnancy loss will not occur.

Implantation bleeding

Implantation happens when a fertilized egg embeds in the lining of the uterus. This marks the beginning of pregnancy. Some people notice spotting shortly after implantation. However, the body does not begin producing the pregnancy hormone human chorionic gonadotropin (hCG) until after implantation.

A person is not pregnant until after implantation, and a pregnancy test cannot usually detect pregnancy until several days after implantation. So, bleeding that appears after a person already knows they are pregnant is not implantation bleeding.

Implantation bleeding is usually brown. Some people may mistake the bleeding for their monthly period because it usually occurs around the time a person expects their period.

The flow of implantation bleeding is often lighter and shorter than a period, so people who experience unusual bleeding after having sex should consider the possibility of pregnancy.

A doctor or other healthcare professional may conduct or order numerous tests to diagnose bleeding.

Ultrasound

An ultrasound can diagnose a subchorionic hematoma. It can also tell a healthcare professional the location of the pregnancy, helping in the detection of an ectopic pregnancy.

Doctors can also use ultrasound scans to assess the viability of the pregnancy. If the embryo is growing correctly, and there is a sufficiently strong heartbeat, this suggests that the pregnancy will continue and the risk of pregnancy loss is low.

An ultrasound can also examine other pelvic organs to check for causes of bleeding. For example, an ovarian cyst may cause bleeding.

Blood tests

Blood tests can measure levels of the pregnancy hormone hCG. Low hCG may suggest that a pregnancy is not developing correctly or is in its early stages.

Some healthcare providers also check progesterone levels. Low progesterone may cause temporary bleeding, while very low progesterone may be a sign of an abnormal pregnancy.

While many people who experience bleeding have healthy pregnancies, it is important never to treat bleeding as usual.

Bleeding can be a critical symptom of several pregnancy-related symptoms, and prompt treatment for conditions such as ectopic pregnancy can save lives.

People should speak with a doctor about any bleeding early in pregnancy. While the bleeding may be harmless, it is impossible to diagnose its cause without blood work, an ultrasound, or other diagnostic tests.

Bleeding from a ruptured ectopic pregnancy can endanger the life of the pregnancy carrier. While many pregnancy losses pass on their own, some require treatment to prevent excessive bleeding and infection.

If a person experiences light bleeding at any time, they should contact a midwife, doctor, or another healthcare professional.

A pregnant person should also visit an emergency room if:

• they develop a fever
• bleeding gets heavier over several hours
• bleeding is heavy, similar to a period
• there are large clots in the blood
• they have cramps
• they have severe pain in the abdomen
• they feel dizzy or lightheaded

Prompt medical care can be lifesaving. Even when there is no serious problem, the right care can offer peace of mind.

If a pregnant person experiencing spotting has Rhesus-negative blood, a doctor may prescribe RhoGAM. This treatment can help prevent a condition known as erythroblastosis fetalis.

Many people panic when they bleed during pregnancy, especially if they have a previous history of pregnancy loss. Seeking prompt care is the fastest way to ease anxiety and get clear answers.

It is not advisable for people to try to self-diagnose bleeding or assume that bleeding means a pregnancy loss. Quick tests can usually diagnose the cause, and prompt treatment can prevent possible complications.

List of documents

Bleeding and formation of retrochorial hematomas in the first trimester of pregnancy are clinical forms of miscarriage and in 10-15% of cases complicate the course of pregnancy in women with recurrent miscarriage. In half of these cases, these clinical manifestations are recurrent and extend not only to the first trimester (up to 12 weeks), but also to the second (up to 16-18 weeks). However, at such terms of gestation, the placenta has already been formed, and hematomas are retroplacental in nature and are a manifestation of premature placental abruption. It is the recurrent course of retrochorial hematoma that presents the greatest difficulty in management tactics.

During 2015, a study was conducted in the third gynecological department of the KSBUZ “KMKB No. 4” on the rational use of tranexamic acid in the event of bleeding during pregnancy.

The purpose of the study was to evaluate the effectiveness of tranexam in this pathology.

Due to the high prevalence of miscarriage today deserves special attention. For many years, this complication has remained an urgent problem in obstetrics, despite the progress of science in general. The desired pregnancy in 15-20% of cases ends with early spontaneous termination, and the embryonic period accounts for up to 75% of all reproductive losses associated with miscarriage. It is difficult to overestimate the medical and social relevance of the problem of miscarriage in modern conditions of declining birth rates and increasing mortality. One of the signs of early pregnancy termination is retrochorial hematoma, due to partial rejection of the fetal egg from the chorion, the precursor of the placenta.

Retrochorial hematoma is a formation that occurs when the fetal egg is torn away from the chorion. This forms a cavity filled with clotted blood, which is the most retrochorial hematoma.

Depending on the duration of pregnancy, two types of hematoma are distinguished:

Retrochorial (with detachment of the ovum from the chorion). This type of hematoma can occur up to 16 weeks;
Retroplacental (with detachment of the fetal egg from the placenta). The placenta finally completes its formation by the 16th week of pregnancy. When a hematoma occurs, they speak of premature detachment of a normally located placenta.

Severity classification:

1) Mild. In most cases, a mild hematoma is an incidental finding on ultrasound, the woman does not present any complaints;

2) Average degree. The pregnant woman is disturbed by pulling pains in the lower abdomen, the appearance of bloody discharge from the genital tract is possible;

3) Severe. There are strong cramping pains in the lower abdomen, intense bleeding, a drop in blood pressure. The general condition of the woman is significantly deteriorating, loss of consciousness is possible.

There are many reasons that can cause such a complication:

1) Disorders associated with diseases of the endocrine system.

2) Great physical activity. That is why pregnant women are not recommended to lift weights, as this can lead to complications during pregnancy and fetal malformations.

3) Infectious and inflammatory processes in the urinary organs. Any signs of an infectious disease should be cause for immediate treatment.

4) Harmful work associated with constant noise or vibration.

5) Autoimmune diseases. These are deviations in which the immune system produces antibodies that react not to some foreign elements and microorganisms, but to healthy cells of their own body.

6) Blood coagulation disorders.

7) Chronic endometritis.

8) Frequent stress.

9) Injuries.

10) Tumors of the uterus.

11) Severe form of toxicosis.

12) Bad habits of a woman.

13) Malformations of the child

14) Congenital malformations of the uterus.

15) Genital infantilism. This term refers to a delay in sexual development, in which an adult woman has a number of sexual characteristics that are more characteristic of a child or adolescent.

It is almost impossible to prevent the occurrence of retrochorial hematoma, as well as to determine the exact cause of its formation.

Fig 1. Retrochorial hematoma

In the 3rd gynecological department, the complex of treatment includes gestagenotherapy (utrogestan, prajisan, duphaston, oily solution of pogesterone) in a therapeutic dosage, hemostatic therapy (dicinone, tranexamic acid). Hemostatic drugs should be prescribed according to indications. Tranecamic acid is indicated for:

1) Threat of early pregnancy termination (chorionic detachment, hematoma)

2) Low position of the placenta and bleeding in the first and second trimesters of pregnancy

3) Pregnancy with malformations of the uterus (double and bicornuate uterus, intrauterine septum – bleeding in the first and second trimesters of pregnancy)

4) Transmenopausal hematomas in the second trimester of pregnancy

5) Marginal abruption of a normally located placenta in the second trimester of pregnancy

Tranexam is an antifibrinolytic agent that specifically inhibits the activation of profibrinolysin (plasminogen) and its conversion to fibrinolysin (plasmin). It has a local and systemic hemostatic effect in bleeding associated with an increase in fibrinolysis (platelet pathology, menorrhagia), as well as anti-inflammatory, anti-allergic, anti-infectious and antitumor effects by suppressing the formation of kinins and other active peptides involved in allergic and inflammatory reactions.

Fig. 2. The mechanism of action of tranexamic acid

When analyzing the studied case histories of patients, negative experience has accumulated in the appointment of tranexam with scanty dark bloody discharge from the genital tract. In the presence of acute bleeding (scarlet spotting), the use of the drug has a positive result. In the case of bloody discharge from the genital tract associated with the emptying of the “old” retrochorial hematoma, there was a reverse trend towards an increase in the volume of the hematoma. In this case, tranexam is not shown. With scant brown discharge from the genital tract, it can be regarded in the early stages of pregnancy as nidation or migration of the fetal egg into the uterine cavity. In the case of the appointment of the drug dicynone, there is a positive trend. From this we can conclude: the point of application of tranexamic acid is acute bleeding during pregnancy, which, according to the doctor, will require immediate action to stop the bleeding.

For bleeding during pregnancy, we use the following regimen for prescribing tranexam — 250-500 mg 3 times a day until the bleeding stops completely. With local fibrinolysis, therapy begins with parenteral (in / in) administration of Tranexam®, followed by the transition to oral administration of 250-500 mg 2-3 times a day. The average duration of the course of treatment is 7 days. Side effects of the use of the drug tranexam in the department were not observed.

A retrospective analysis of 30 case histories of patients of the 3rd gynecological department who received tranexam was carried out. At 19cases, the appointment of tranexam for acute bleeding, not associated with the volume of retrochorial hematoma – a positive trend. In 11 cases, the appointment of the drug for scanty bloody discharge from the genital tract in patients admitted with a clinic of previously occurring retrochorial hematomas, emptied against the background of tranexam, the volume of the hematoma increases by 2-3 times, after a while in the absence of any manifestations of ongoing uterine bleeding. In the future, such patients undergo antibiotic therapy to prevent ascending infection, enzyme therapy at the outpatient stage.

References

1) Torchinov A. M., Umakhanova M. M., Doronin G. L., Ron M. G. Short-term pregnancy and retrochorial hematoma: diagnosis, treatment and prognosis at the present stage of development of obstetrics (literature review ) // Young scientist. – 2013. – No. 4. — S. 659-662.

2) Milovanova A.P., Serova O.F. 2011. Causes and differentiated treatment of early miscarriage.

3) Sidelnikova V.M., Sukhikh G.T. 2010. Miscarriage.

4) Strizhakova A.N., Davydova A.I., Ignatko I.V., Belotserkovtseva L.D. 2011. Miscarriage.

5) Korneeva I.E., Serova O.F. 2013. The threat of termination of pregnancy at various gestational ages. Tactics and strategy of modern therapy.

6) Makatsaria A.D. 2015. High Risk Pregnancy.

7) Podzlkova N.M., Skvortsova M.Yu. 2010. Miscarriage

Mashina I. N., Elizariev E.A., Rustamova E.Kh.

3rd gynecological department of KMBUZ “KMKB No. 4”

Threatened miscarriage in early pregnancy – symptoms and treatment

When a woman is pregnant, the safety of the unborn child becomes the number one priority, so she must be aware of early signs and symptoms miscarriage. Since the risk of miscarriage in early pregnancy is especially high, up to 12/13 weeks, you need to carefully monitor the health of the expectant mother. It is believed that in the first week after conception, up to 50% of fertilized eggs die, when a woman is not yet aware of the changes taking place in her body.

At this time, dangerous symptoms that indicate a threat of pregnancy are so implicitly expressed that they can be ignored. Later, after the conception becomes known, and the test confirms that fertilization has occurred, at least 10-20% of pregnancies end tragically.

According to statistics, from 1 to 4% of women have two miscarriages in the early stages in a row. Even more rarely, threats of miscarriage lead to three or more miscarriages. This condition is referred to as habitual miscarriage. A synonym for the word “miscarriage” is “spontaneous abortion”, when it means that the body itself gets rid of the embryo.

Signs of a threatened miscarriage – warning signs

Signs of a threatened miscarriage in early pregnancy include the following conditions: The blood may have a brown or brownish tint, or it may be bright scarlet;

If you are in danger of having a miscarriage and some of the symptoms listed above have you on your guard, don’t waste your time. Contact your doctor immediately who is monitoring your pregnancy. The specialist will examine you, send you for an ultrasound, and then diagnose whether there is a threat and what treatment will be effective. Or he will say that fears are in vain.

Types of early miscarriage

If we talked about the signs of early pregnancy termination, it is necessary to understand how doctors classify the condition. The typology is based on the following groups:

1. Threatened miscarriage – slight bleeding in the first trimester. About 1/3 of women will bleed during this period, and only half of them are diagnosed with spontaneous abortion;
2. Complete miscarriage – symptoms of a threatened early miscarriage are confirmed by a medical examination, which shows that a miscarriage has occurred. In this case, all embryonic tissues come out of the uterus. Subsequently, no additional treatment or observation by specialists is required;
3. Incomplete miscarriage – the threat of miscarriage in early pregnancy is confirmed. The embryo dies, but its tissues do not completely leave the uterus, which threatens to provoke an infection and can cause sepsis. Some women may need emergency surgery due to heavy bleeding. Medications may be used to provoke the uterus into contractions and ejection of fetal debris. In some cases, waiting tactics are acceptable without taking any action;
4. Anembryony is a condition in which the symptoms of a threatened miscarriage may not be observed in the early stages. Fertilization of the egg occurs, its implantation in the wall of the uterus, but there is no formation of the fetus. In some cases, even a gestational sac is formed;
5. Missed miscarriage – in case of a missed pregnancy, when it stops developing, the embryonic tissue does not leave the uterus for at least 4 weeks. One of the main symptoms of a miscarriage in the early stages is absent – severe bleeding. There may be slight spotting;
6. Septic miscarriage – accompanied by infection in the uterine cavity. A serious illness that requires immediate treatment to prevent the death of the failed mother. Early signs of a threatened septic miscarriage are fever, abdominal pain, and foul-smelling bleeding. It is important to start injecting antibiotics as soon as possible and remove the foreign contents of the uterus.

Many women are interested in the natural question of what to do with the threat of miscarriage in early pregnancy and how to prevent a dangerous condition. We will talk about this a little later, first we will designate the factors provocateurs of spontaneous abortion.

Provocateurs of threatened miscarriage in early pregnancy

Among the factors that future parents can influence are smoking, alcohol, drugs, excessive physical labor of the mother during pregnancy. This can be corrected by minimizing their effect. However, there are reasons that are difficult to influence:

• Genetics – about half of spontaneous abortions are due to genetic abnormalities that are incompatible with the life of the fetus;
• Maternal diseases – even a banal temperature increase to extreme values ​​can harm the developing embryo, but there are more dangerous infections – measles, rubella, cytomegalovirus and others;
• Hormonal imbalance – women with irregular periods have a higher risk of threatened miscarriage in early pregnancy than those who have regular periods;
• Placental problems – disorders of the blood supply to the placenta, which provokes a lack of nutrition of the embryo;
• Early dilatation of the cervix , fibroids, unusual organ shape that prevents the fetus from developing;
• Mechanical injuries – may cause spontaneous abortion in the early stages, threatened miscarriage at 20 weeks and beyond.

One of the common threats of miscarriage in early pregnancy is an ectopic pregnancy, when the embryo develops in one of the fallopian tubes or elsewhere – outside the uterus. The age of the mother is of no small importance:

There are other reasons why there is a single miscarriage and two miscarriages in the early stages in a row. Finding out the reasons is better to entrust to specialists, if necessary, visit a genetics consultation, pass the necessary tests and undergo examinations. This is especially true for women who have had two miscarriages in the early stages. However, this is not a reason to put a sentence on a woman’s ability to bear children. The chance to endure and give birth to a healthy baby is great even after three unsuccessful pregnancies.

What to do if there is a threat of miscarriage – getting ready for a new conception

If you have had two early miscarriages, but you are striving for the birth of a healthy baby, it is important to carefully plan your pregnancy, avoid stress, overload, hypothermia and other negative factors. You do not need to be alone with your misfortune, it is important to find a specialist you will trust, who knows what to do with a threatened miscarriage and how to reduce the risks when planning a new conception.

One of the important points is to find the root cause of what is happening. It is important to remember the symptoms of a threatened miscarriage, when they occurred, whether they were preceded by some events that could play a decisive role. On the recommendation of a doctor, undergo special examinations:

1. Blood tests – deciphering the results in the laboratory will help to find hormonal problems or identify negative features of the immune system;

2. Chromosome tests – to detect signs of a threatened miscarriage in the early stages, it is enough for partners to donate blood, in which chromosomal abnormalities can be detected.

3. Ideally, fetal tissue should be submitted for analysis, which will also be rigorously examined.

To find out how to prevent the threat of miscarriage in the early stages, resulting from the pathology of the uterus, you need to go through:

• Ultrasound – thanks to the action of high-frequency sound waves, an image is formed on a computer monitor, which accurately reflects the features of the studied areas, tissues, organs. The specialist conducts an examination by external scanning and examination through the vagina. Thanks to the ultrasound method, fibroids and other anomalies can be detected;
• Hysteroscopy – the introduction of a hysteroscope through the cervix into the internal cavity of the organ. Thanks to special illumination, the doctor clearly sees structural transformations in tissues, which allows him to diagnose the problem and prescribe effective treatment to prevent miscarriage in the early stages;
• Hysterosalpingography and sonohysterography – a contrast agent is injected into the uterus through a catheter.