What are the causes of heavy bleeding at 3 weeks pregnant? What are the treatments for first trimester bleeding? Get the answers to these questions and more in this comprehensive article.

Common Causes of First Trimester Bleeding

First trimester bleeding is a relatively common occurrence, affecting up to 30% of pregnant women according to a large 2009 study. While it can be alarming, many women who experience some bleeding go on to have healthy pregnancies. Some of the most common causes of first trimester bleeding include:

Implantation Bleeding

Implantation bleeding occurs when the fertilized egg burrows into the uterine lining, typically around 6-12 days after conception. This light spotting or bleeding is often mistaken for a period, but it’s usually lighter in color and shorter in duration.

Cervical Polyps

Cervical polyps are small, finger-like growths that affect 2-5% of women. While typically benign, these polyps can become inflamed or irritated, leading to bright red bleeding.

Intercourse or Pelvic Exams

Anything that irritates the cervix, such as sexual intercourse or a pelvic exam, can cause temporary bleeding. This is due to the increased sensitivity of the cervix during pregnancy.

Miscarriage

Unfortunately, heavy bleeding in the first trimester, especially when accompanied by pain, can be a sign of miscarriage. Up to 20% of all pregnancies end in miscarriage, most often in the first trimester.

Multiple Pregnancies

Women carrying twins or other multiples have a higher risk of first trimester bleeding, as well as a greater chance of miscarriage during this time.

Ectopic Pregnancy

An ectopic pregnancy, where the fertilized egg implants outside the uterus, most often in the fallopian tube, can also cause first trimester bleeding and requires immediate medical attention.

Distinguishing Between Normal and Concerning Bleeding

Spotting or light bleeding is usually not a cause for concern, especially if it lasts for a day or two. However, heavy bleeding and other symptoms like severe cramps or pain may be indicative of a more serious condition. It’s important to call your doctor if you experience any concerning bleeding or other symptoms during the first trimester of pregnancy.

When to Seek Medical Attention

If you experience any of the following, it’s important to contact your healthcare provider right away:

• Heavy bleeding (soaking through a pad in an hour or less)
• Severe cramping or pain in the lower abdomen
• Dizziness, fainting, or other signs of blood loss
• Fever, chills, or other signs of infection

Your doctor will be able to evaluate your symptoms, determine the cause of the bleeding, and provide appropriate treatment or referral to a specialist if necessary.

Treatment Options for First Trimester Bleeding

The treatment for first trimester bleeding will depend on the underlying cause. In many cases, no treatment is necessary, and the bleeding resolves on its own. However, in more serious situations, the following treatments may be recommended:

Medications

For certain conditions, such as a threatened miscarriage, your doctor may prescribe medications to help stop the bleeding and support the pregnancy.

Monitoring

Your doctor may order regular ultrasounds or blood tests to monitor the pregnancy and ensure the bleeding is not a sign of a more serious issue.

Surgical Intervention

In the case of an ectopic pregnancy or a missed miscarriage, your doctor may recommend surgical treatment to remove the pregnancy and prevent further complications.

Preventing First Trimester Bleeding

While you can’t always prevent first trimester bleeding, there are some steps you can take to reduce your risk:

• Avoid strenuous activity or exercise that could lead to trauma or strain
• Abstain from sexual intercourse if your doctor recommends it
• Manage any underlying medical conditions, such as infections, that could contribute to bleeding
• Attend all scheduled prenatal appointments and follow your doctor’s recommendations

Coping with First Trimester Bleeding

Experiencing bleeding during pregnancy can be understandably stressful and upsetting. It’s important to remember that while bleeding can be a concerning symptom, it doesn’t necessarily mean something is wrong. Try to stay calm, rest as much as possible, and seek support from your healthcare team and loved ones as you navigate this challenging time.

First Trimester Bleeding: Causes and Treatment

In the first trimester — the first three months of pregnancy — your body undergoes some pretty dramatic changes.

While you may still be able to fit into your regular pants, there’s a lot going on inside your body. This includes surging hormone levels and building a new blood flow system. With so much happening, first trimester bleeding is common.

According to one large 2009 study, 30 percent women have spotting or light bleeding in the first trimester. This can be a very normal part of early pregnancy. Many women experience some bleeding and go on to have healthy pregnancies.

There are several reasons why you might find vaginal spotting or bleeding in the first trimester. Let’s take a look at some of the common causes.

Spotting or light bleeding is usually not anything to worry about, especially if it lasts for a day or two. One dated research study showed that women who have spotting and light bleeding in the first trimester have similar pregnancies to women who don’t bleed.

On the other hand, heavy bleeding and other symptoms may be indicators of more serious conditions.

Implantation bleeding

Implanting means the fertilized egg is busy making use of the space and burrowing into the side of your womb (uterus). This happens about 6 to 12 days after you’ve conceived. The fertilized egg floats into its new home and must attach itself to the uterine lining to get oxygen and nutrition.

This settling in can cause light spotting or bleeding. Implantation bleeding usually happens just before you expect your period to begin. In fact, this kind of bleeding is often mistaken for a light period.

Distinguishing between implantation bleeding and your period can be challenging. It doesn’t help that other symptoms are similar to PMS:

• mild cramping
• lower backache
• headaches
• nausea
• tender breasts

But there are some clues that what you’re seeing isn’t a typical period. Implantation bleeding is usually lighter in color than a period — a light pink to a dull brown. It typically lasts from a few hours to a couple days and doesn’t involve heavy bleeding.

Cervical polyp

About 2 to 5 percent of women have polyps — small, finger-like growths — on the cervix, the gateway from the vagina to the uterus.

Cervical polyps are usually benign — they don’t cause cancer. However, they can get inflamed or irritated and lead to bright red bleeding. Or you may not have any other symptoms at all, but they’re easy to diagnose during a routine pelvic exam.

Intercourse or a physical exam

Speaking of pelvic exams, keep in mind that anything that might poke at or near the cervix can also irritate it and cause bleeding. Yes, this includes sex! This happens because pregnancy hormones may make your cervix — along with many other things — more sensitive than normal.

You might see bright red blood on your underwear shortly after sex or a physical checkup. Don’t fret! The bleeding usually happens once and then goes away on its own.

Miscarriage

Sometimes what begins as spotting or lighter bleeding becomes heavy bleeding. It’s true that any heavy bleeding in the first trimester, especially if you also have pain, might be linked to a miscarriage. Most miscarriages happen in the first trimester of pregnancy.

Up to 20 percent of all pregnancies are miscarried. You can’t prevent most miscarriages, and they’re definitely not your fault or a sign that something’s wrong with you. Most women can and do go on to have a healthy pregnancy and baby.

If you’re going through a miscarriage, you might have symptoms like:

• heavy vaginal bleeding
• bleeding that is bright red to brown in color
• pain in the lower stomach
• dull or sharp pain in the lower back
• severe cramping
• passing clots of blood or tissue

If you have any of these symptoms, call your doctor. You can have bleeding and other symptoms of a miscarriage without having miscarried. This is called a threatened abortion (abortion is a medical term here).

Causes of threatened abortion include:

• a fall or trauma to the stomach area
• an infection
• exposure to certain medications

Carrying multiple babies

If you’re pregnant with twins (or another multiple of babies), you might have a greater chance of first trimester bleeding due to causes like implantation bleeding.

Miscarriages in the first trimester are also more common when you’re pregnant with more than one baby.

On the other hand, a 2016 study that followed more than 300 women who were pregnant with twins from in-vitro fertilization (IVF) found that they had a high chance of healthy pregnancies. Bleeding in the first trimester didn’t affect this.

Ectopic pregnancy

An ectopic pregnancy happens when the fertilized egg mistakenly attaches somewhere outside the womb. Most ectopic pregnancies are in the fallopian tubes — the connections between the ovaries and the womb.

An ectopic pregnancy is less common than a miscarriage. It happens in up to 2.5 percent of all pregnancies. A baby can only grow and develop in the womb, so ectopic pregnancies have to be medically treated.

Symptoms include:

• heavy or light bleeding
• sharp waves of pain
• severe cramping
• rectal pressure

If you have an ectopic pregnancy, know that there’s nothing you did to cause it.

Molar pregnancy

Another cause of bleeding in your first trimester is a molar pregnancy. This rare but serious complication happens in almost 1 in every 1,000 pregnancies.

A molar pregnancy or “mole” happens when the placental tissue grows abnormally due to a genetic error during fertilization. The fetus may not grow at all. A molar pregnancy can cause a miscarriage in the first trimester.

You might have:

• bright red to dark brown bleeding
• lower stomach pain or pressure
• nausea
• vomiting

Subchorionic hemorrhage

Subchorionic hemorrhage, or hematoma, is bleeding that happens when the placenta slightly detaches from the wall of the womb. A sac forms in the gap between the two.

Subchorionic hemorrhages vary in size. Smaller ones are the most common. Larger ones cause heavier bleeding. Many, many women have hematomas and go on to have healthy pregnancies. But a large subchorionic hemorrhage may also increase the risk of a miscarriage in the first 20 weeks of pregnancy.

Symptoms include:

• light to heavy bleeding
• bleeding may be pink to red or brown
• lower stomach pain
• cramping

Infection

Bleeding in the first trimester might have nothing to do with your pregnancy at all. An infection in your pelvic area or in the bladder or urinary tract can also cause spotting or bleeding. They may be caused by bacteria, viruses, or fungi.

A serious yeast infection or inflammation (vaginitis) can also cause bleeding. Infections typically cause spotting or light bleeding that is pink to red in color. You may have other symptoms like:

• itching
• lower stomach pain
• burning when urinating
• white discharge
• bumps or sores on the outer part of the vagina

Bleeding in the second or third trimester of your pregnancy is normally more serious than first trimester light bleeding.

Causes include:

• Cervix problems. Inflammation or growths on the cervix can cause light bleeding. This is usually not serious.
• Placental abruption.The placenta detaches from the womb wall before or during labor. This happens in just 1 percent of pregnant women.
• Placenta previa. The placenta is too low in the uterus and partly covers the cervix. Bleeding happens without pain.
• Vasa previa. Some of the placenta’s blood vessels go across the cervix.
• Premature labor: Bleeding may mean that you’re in labor too early.
• Missed abortion. A miscarriage may have happened earlier without any signs.

Let your doctor know if you experience any kind of bleeding during pregnancy. Get immediate medical care if you have any of these symptoms:

• heavy bleeding
• discharge with clots or tissue
• severe pain
• intense cramping
• severe nausea
• dizziness or fainting
• chills
• fever of 100. 4°F (38°C) or higher

What your doctor will look for

A quick examination can usually tell your doctor what is causing your bleeding. You may need:

• physical exam
• ultrasound
• Doppler ultrasound exam
• blood test

Your doctor will likely also look at pregnancy markers. A blood test looks at your hormone levels. The main hormone in pregnancy — made by the placenta — is human chorionic gonadotropin (hCG).

Too much hCG can mean:

• twin or multiple pregnancy
• molar pregnancy

Low levels of hCG may mean:

• ectopic pregnancy
• possible miscarriage
• abnormal growth

Scans can show where the developing baby is and how it’s growing. The baby’s size can be measured on an ultrasound. The heartbeat can be checked with the ultrasound or Doppler scan as early as five and a half weeks of pregnancy. All these checks can reassure you and your doctor that everything is just fine.

Some issues that cause first trimester bleeding, like a cervical polyp, may be treated right in your doctor’s office. Other issues may need more treatment, medication, or surgery.

If the bleeding is a sign that your pregnancy can’t safely continue, your doctor may prescribe medications such as:

• Methotrexate is a drug that helps your body absorb harmful tissue like in an ectopic pregnancy.
• Misoprostol is used to end a dangerous pregnancy in the first 7 weeks.

You’ll need follow-up appointments to check on your health. Your doctor will make sure there is no leftover tissue or scarring in your womb. Your doctor can advise when it’s safe to try to conceive again if that’s what you want.

A miscarriage at any point in your pregnancy is a loss. Talking to a therapist or counselor can help you and your partner grieve in a healthy way.

Bleeding in your first trimester can be alarming. But in most cases, spotting and light bleeding are just a normal part of early pregnancy.

Heavy bleeding may be a sign of something more serious. You should always see your doctor if you have any questions or concerns regarding bleeding.

Causes of first trimester light bleeding and spotting that are usually not harmful to you and your baby include:

• implantation
• cervical polyps
• uterine infections
• yeast infection
• carrying multiple babies

More serious causes of bleeding in the first trimester are:

• miscarriage
• threatened abortion
• molar pregnancy
• ectopic pregnancy
• subchorionic hemorrhage (in many cases, women go on to have healthy pregnancies)

Pregnancy can be a roller coaster of emotions and symptoms. Above all, keep people you love and trust in the loop. Having someone to talk to about what you’re going through — even if your symptoms are completely normal — can make the experience much easier.

Bleeding and/or pain in early pregnancy

• Reference Number: HEY-025/2022
• Departments: Gynaecology
• Last Updated: 31 May 2022

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Introduction

This leaflet has been produced to give you general information about your condition.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your nurse/doctor but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is vaginal bleeding in early pregnancy?

Vaginal bleeding is common in early pregnancy and does not always mean there is a problem. However, bleeding can be a warning sign of a miscarriage.

What are the causes of early bleeding? 

There are a number of causes of bleeding in early pregnancy which include:

Spotting or bleeding may occur shortly after conception, this is known as an implantation bleed. It is caused by the fertilised egg embedding itself in the lining of the womb. This bleeding is often mistaken for a period, and it may occur around the time your period is due.

Hormonal bleeding is when some women experience a light bleed at around four to eight weeks of pregnancy, or around the time their period would have been due. This can be very confusing for women who are pregnant and is the reason many women do not realise they are pregnant for a while.  Again, it is totally normal. This usually settles around the 13^th week of pregnancy as by this time the placenta is sufficiently developed to produce all of the hormones needed to sustain the pregnancy.

After the egg is fertilised, the fertilised egg then goes on to implant itself into the lining of the womb (uterus). Sometimes this results in a little bleeding that shows up on an early scan as a haematoma (collection of blood). This is not anything to worry about. When it happens, the woman may notice a small amount of vaginal bleeding, but this is not necessarily the case.

The haematoma will gradually disappear and in most cases, the pregnancy remains safe.

Cervical Erosion (alternatively known as cervical ectropion) may be a source of spotting or bleeding. The blood supply to the womb and cervix is increased during pregnancy and the cervix may bleed harmlessly and painlessly. An erosion may cause bleeding following sexual intercourse; therefore, this type of bleeding must always be reported to your doctor.

Can bleeding indicate a miscarriage?

Not all bleeding in pregnancy is harmless, and it can be the first sign of a miscarriage. As many as 1 in 5 pregnancies are thought to end in miscarriage. The cause of miscarriage is not always known, but researchers have shown that in some cases there is a problem with the developing pregnancy, which means it is unable to develop normally. For most women, miscarriage is a very sad and upsetting experience.

Experiences of miscarriage vary. In some cases, there may be only very slight spotting, in other cases bleeding may stop and start or heavier bleeding with clots and cramping period type pains can occur. Sometimes there may be no bleeding at all.

For further information relating to miscarriage, please ask your nurse for further details.

What should I do if I experience bleeding during pregnancy?

If you experience bleeding, it is wise to have this checked out. If you have been seen in the Early Pregnancy Assessment Unit (EPAU) during your pregnancy, you may contact us directly, up to 15 weeks + 6 days of pregnancy. Your GP or midwife can also help you.

If you have been seen in the EPAU and you then experience more bleeding contact the EPAU. Depending on how much bleeding and for how long the nursing staff will decide if you need to be seen again. A rescan is not always necessary. Sometimes the nurse will advise that you monitor this bleeding at home.  A rescan will only be performed if bleeding heavy with clots. If there is a significant change in your symptoms, then the nurse will make an appointment to come to EPAU and be either rescanned or to be assessed by the doctor. If bleeding is unmanageable, then the nurse may advise to be assessed on ward 30 or the Emergency department depending on your symptoms.

What if I experience pain in early pregnancy?

If you experience pain that does not go away, or which you feel is becoming more severe, you should seek advice from your doctor, nurse or midwife. It is important that any serious causes of pain are excluded. For example, there is a need to rule out an ectopic pregnancy (this is where the pregnancy develops outside the womb).

What kind of pain may I feel? 

Some women experience abdominal (tummy) pain in early pregnancy. This may be low cramping pain, similar to that felt during a period, or a stitch like or stabbing pain on one or both sides of the tummy. Aches and pains may come and go or be present continuously.

What are the causes of abdominal and back pain?

Some of the aches and pains experienced during pregnancy are thought to be due to hormonal changes. Large amounts of the hormone progesterone are produced, which are needed to sustain pregnancy. In addition to this, progesterone acts on the muscles, ligaments and joints causing them to become slacker and more flexible. This hormonal effect is thought to be responsible for some of the stitch like pains that some women experience in the lower part of the tummy and in some cases this can be quite severe. The same hormones can be responsible for constipation during pregnancy; this can also cause abdominal pain.

The enlarging womb is made up of layers of muscles and is held in place in the pelvis by supporting ligaments. As the womb expands to accommodate the developing baby, it can pull on the ligaments and muscles, to cause these “growing pains”.

The backache that some women get in early pregnancy is also thought to be due to a hormonal effect, and the supporting muscles are softer.

Abdominal and/or backache can also be a sign of a urine infection. This may also cause burning or stinging when passing urine and the need to pass urine more frequently. You must inform your doctor of these symptoms, so that a urine test can be obtained, and treatment given if needed.

Pain on its own does not mean that a miscarriage will occur. However, if you experience bleeding as well as pain this could indicate a threatened miscarriage and you should always seek advice from your doctor, nurse or midwife.

Can I take pain relief medication during pregnancy?

If you find that you need to take pain relief medication to relieve any pain, it is safest to use something simple such as paracetamol. Drugs such as aspirin and ibuprofen should be avoided. If you find that you need a stronger pain relief medication, you must always check with your doctor, nurse or midwife first.

Scanning in early pregnancy

An ultrasound scan is used during pregnancy for a number of reasons. In the first three months of pregnancy, it can be used to check the presence of the baby’s heartbeat, which can be reassuring if you have experienced a problem, such as vaginal bleeding or pain. A scan will also be used to check to see if the pregnancy is in the correct place and to accurately predict the estimated date of delivery (the date the baby is due) by measuring the end points (size) of the embryo or fetus.

Will I have an ultrasound scan? 

Yes, if the nurse/doctor thinks it is appropriate for you to have a scan. 

What is an ultrasound scan? 

Ultrasound uses high frequency sound waves that are sent out from a transducer or probe. These sound waves are received back and converted into an image on a screen. 

Is it safe to have a scan in early pregnancy? 

Yes, it is safe, there is so far no evidence to suggest that an ultrasound scan is unsafe. 

What type of scan will I have?

A vaginal scan is the best method in early pregnancy (under 8 weeks) as it gives us a more accurate result at an earlier stage in pregnancy than an abdominal scan.   It may be a little uncomfortable, but it is safe to be done, you do not need a full bladder when having a vaginal scan. If you have concerns about a vaginal scan, please let the nurse, midwife doctor know.

What will the scan tell us?

A scan can only tell us how your pregnancy is at that particular time. Unfortunately, it is no guarantee that your pregnancy will continue successfully. If your symptoms persist or become worse, you must contact EPAU, midwife or your GP.

In later pregnancy ultrasound scanning is used to look more closely at the anatomy and organs of the developing baby. This is usually done between 18 – 21 weeks.

What if the scan confirms a miscarriage?

If the scan confirms that you have miscarried, the choices of how we can manage this will be discussed with you.

Occasionally, the scan may pick up an unexpected finding such as a cyst on the ovary. If this is the case, the staff will explain the findings and any necessary follow up.

Common abbreviations used on scans

LMP – Last menstrual period

FH – Fetal heart-rate

EDD – Estimated date of delivery

FM – Fetal movement

USS – Ultrasound scan

YS – Yolk sac

CRL – Crown to rump length (a measurement of the embryo/fetus used in early pregnancy)

BPD – Bi-Parietal Diameter

HC – Head circumference. Both of these measurements of the fetus are used in later pregnancy, after 12-14 weeks.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the:

Early Pregnancy Assessment Unit/Emergency Gynaecology Unit
Women and Children’s Hospital
01482 608767.

Gynaecology Ward
Women and Children’s Hospital
01482 604387.

Useful information

Information on Gynaecology Services at Hull University Teaching Hospitals NHS Trust can be found at:

www.hey.nhs.uk/content/services/gynaecology.

Information on Maternity Services at Hull University Teaching Hospitals NHS Trust can be found at:

www. hey.nhs.uk/maternity

www.womens-health.co.uk

www.nhs.uk

www.earlypregnancy.org.uk

www.patient.org.uk

www.screening.nhs.uk/annbpublications

This leaflet was produced by the Gynaecology Service, Hull and East Yorkshire Hospitals NHS Trust and will be reviewed in May 2025.

Ref: HEY025/2022

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.

Rational use of tranexamic acid in complex treatment in case of bleeding during pregnancy

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 abortion 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 degree. 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.

KMBUZ “KMKB No. 4” 3rd gynecological department

interruption with pills, herbs and folk remedies

How to terminate an early pregnancy at home: interruption with pills, herbs and folk remedies

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The article was checked by Akhundova Sabina Sergeevna

Obstetrician-gynecologist, ultrasound doctor, experience 15 years

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How to terminate an early pregnancy?

Medical abortion possible up to 6 weeks, vacuum aspiration up to 8 weeks. For up to 3 months, surgical curettage is performed.

What are the interruption tablets?

If pregnancy occurs, the doctor may write a prescription for mifepristone and misoprostol antihormonal drugs.