Signs of internal bleeding during pregnancy. What to do if bleeding during pregnancy

18.09.2019

Bleeding during pregnancy is a fairly common pathology. Some pregnant women may experience small spotting at the very beginning of pregnancy, when the ovum is attached to the wall of the uterus (approximately 7 days after conception). Only in this case is bleeding a normal variant.

There is a fairly widespread belief that during pregnancy, menstruation can go "through the fetus." This is a misconception, any bloody discharge from the genital tract when carrying a child is a serious complication. In this case, a woman should immediately consult a doctor.

Spotting can occur early (before) and late in pregnancy.

Causes of bleeding in early pregnancy

Causes of bleeding up to 12 weeks:

Bubble drift.

Spontaneous miscarriage

Spontaneous miscarriage (abortion) is the termination of pregnancy before 22 weeks (according to the WHO classification).

Main reasons:

History of medical abortions (vacuum aspiration, abortion);
Acute and chronic infections;
Endocrine disorders;
Genetic diseases;
Excessive physical activity;
Immune disorders
Anomalies and diseases of the uterus.

Stages of spontaneous abortion development:

Threatened miscarriage... At this stage, only aching pains in the lower abdomen or in the lower back are characteristic, there is no bloody discharge from the genital tract;
Started abortion... The pains in the lower abdomen intensify, become cramping. Spotting of varying intensity appears (from smearing to profuse bleeding);
Abortion in progress... Characterized by severe pain, profuse bleeding. The opening and shortening of the cervix begins;
Incomplete abortion... The fertilized egg is partially expelled from the uterine cavity. The cervix is slightly open, misses a finger, severe pains in the lower abdomen and bleeding continue;
Complete abortion... The fertilized egg is completely removed from the uterine cavity, it can be in the vagina. The bleeding and pain stop.

Important When the first signs of a threat of termination of pregnancy appear, a woman urgently hospitalized and begin treatment to maintain the pregnancy.

Ectopic pregnancy

An ectopic pregnancy is the development of a fertilized egg not in the uterine cavity, but outside it (more often, in the fallopian tubes). Until a certain time, it develops as usual, without specific signs. Such a pregnancy can only be diagnosed with a gynecological examination or during an ultrasound diagnosis. By 6-7 weeks, the ovum increases, the fallopian tube can no longer stretch and an ectopic pregnancy is interrupted in the form of a tubal abortion or rupture of the tube.

For tubal abortion characteristic:

Paroxysmal pain, often on one side;
Spotting spotting;
Great weakness.

With a complete rupture of the fallopian tube the following symptoms are observed:

A sharp onset of severe pain, which may be preceded by less intense pain;
Profuse spotting;
Nausea, vomiting, loose stools;
, drop in blood pressure;
Pallor of the skin;
General weakness up to loss of consciousness.

dangerous Ectopic pregnancy is an extremely dangerous condition that threatens a woman's life and requires immediate hospitalization and surgical intervention.

If a woman is identified in advance before the onset of bleeding and pain, then it is possible to carry out an operation to remove the embryo without removing the fallopian tube. If the operation is carried out on an emergency basis, then the tube or part of it is removed, and the ovary on this side will not participate in the function of childbirth in the future.

Non-developing pregnancy

Non-developing pregnancy is the spontaneous termination of the development of the fetus and its death. In most cases, pregnancy fading occurs in the early stages of up to 12 weeks.

The main causes of spontaneous fetal death are:

Genetic abnormalities of the fetus are incompatible with life;
Hormonal disorders (lack of progesterone,);
Acute and chronic infections.

Signs of a missed pregnancy:

A sharp disappearance of signs of pregnancy (swelling of the mammary glands);
The discrepancy between the size of the uterus and the gestational age;
Periodic spotting spotting from the genital tract;
Lack of heartbeat and fetal motor activity on ultrasound;
Periodic pulling in the lower back.

A woman with a non-developing pregnancy should be hospitalized in a hospital to the gynecological department, where it is carried out with the removal of the ovum. After the operation, a course of antibiotic therapy is prescribed to prevent infectious complications.

Bubble drift

Bubble drift is a disease of the ovum, characterized by the proliferation of chorionic villi. In appearance, it resembles bunches of grapes with transparent contents. The exact causes of cystic drift have not been identified.

The main signs of cystic drift:

Recurrent moderate bleeding;
The content of small vesicles in secretions from the genital tract;
The size of the uterus does not correspond to the term (much more);
There are no signs of a normal fetus on ultrasound;
Increase in the content of chorionic gonadotropin over 100,000 mIU / ml.

When a woman is diagnosed urgently hospitalized to the hospital, where carry out the following treatment:

Vacuum aspiration to remove the cystic drift, after the operation, oxytocin is administered to contract the uterus;
Hysterectomy(removal of the uterus) in the absence of a woman's desire to have more children;
Preventive chemotherapy in the absence of signs of remission;
Chorionic gonadotropin level control.

Causes of bleeding in late pregnancy

Causes of bleeding after 12 weeks:

Detachment of a normally located placenta

Detachment of a normally located placenta is its premature separation from the walls of the uterus before the baby is born.

There are three degrees of placental abruption:

First degree(up to 1/3 of the placenta). There are chances of maintaining pregnancy, the child practically does not suffer;
Second degree(from 1/3 to 2/3). The child suffers from hypoxia and may die;
Third degree(more than 2/3 of the placenta). The child dies in all cases.

The main symptoms of placental abruption are:

Profuse bleeding of their genital tract;
Cramping pains;
Soreness on palpation of the abdomen;
Violent motor activity of the fetus.

When signs of placental abruption appear, a woman. Treatment for premature placental abruption depends on the following parameters:

Detachment time (second or third trimester);
The severity of bleeding;
The general condition of the mother and child.

Prolongation of pregnancy is possible only in a hospital if the following conditions are met:

Placental abruption of the first degree, no progression;
Pregnancy is less than 36 weeks;
The satisfactory condition of the woman and the fetus.

In this case, the woman is prescribed the following treatment:

Strict bed rest;
Careful monitoring of the condition of the fetus: ultrasound,;
Monitoring the state of the woman's blood coagulation system;
Preparations for removing the tone of the uterus (,);
Hemostatic drugs (Vikasol, Decinon);
Iron preparations for the treatment of anemia ().

When the condition of the child or woman worsens, with the resumption or increased bleeding, emergency delivery by cesarean section is indicated, regardless of the gestational age.

Placenta previa

In the normal course of pregnancy, the placenta is located in the area of the bottom or body of the uterus, along the back or front wall. Placenta previa is a pathology in which the placenta is located in the lower part of the uterus, partially or completely overlapping the internal pharynx.

Placenta previa classification:

Complete: the placenta completely overlaps the internal pharynx;
Partial: the internal pharynx is partially covered by the placenta;
Low: the placenta is located at a distance of 7 cm or less from the internal pharynx.

The main symptom of placenta previa is bleeding from the genital tract, which occurs suddenly in the midst of complete health. The flowing blood is bright scarlet and is not accompanied by pain.

When diagnosed as pregnant urgently hospitalized in a hospital where she should be before the onset of childbirth. In the absence of bleeding, prolongation of pregnancy is possible, for this purpose it is prescribed next treatment:

Strict bed rest;
Antispasmodics ();
Iron preparations (Sorbifer);
Preparations for improving blood microcirculation;
Beta-adrenergic agonists ();
Disaggregants ().

Pregnancy in the absence of contraindications is maintained for up to 36-37 weeks, then carried out. A neonatologist must be present in the operating room. If profuse bleeding occurs at any time, an emergency operative delivery is performed.

Prophylaxis

Prevention of bleeding during pregnancy:

Screening for sexually transmitted infections during pregnancy planning;
Timely treatment of chronic gynecological diseases;
Rejection of bad habits;
Avoiding heavy physical exertion and stressful situations during pregnancy;
Natural family planning: avoiding artificial termination of pregnancy.

It is generally accepted that during pregnancy, a woman not only does not have menstruation, but there can be no bloody discharge at all. And any of them are a sign of serious danger and, most likely, a miscarriage. In fact, the situation is not quite the same, and not always, if blood started to flow during pregnancy, it means the threat of its termination.

Knowing such information is necessary, first of all, in order not to panic and act clearly and quickly. If a woman panics, cries, she starts hysterical, this can just provoke an increased tone of the uterus. Therefore, let's agree - in case of bloody discharge, you will be attentive to your condition and sensations, save the pad to show it to the doctor, and be sure to make an extra visit to the gynecologist. But in some cases it is really necessary to immediately go to the hospital.

If bleeding during early pregnancy

We remember that the first trimester is quite dangerous and indeed, blood during pregnancy during this period can be a sign of an incipient miscarriage. But there are other, relatively harmless reasons for the appearance of unexpected discharge.

For example, they can arise as a result of mechanical damage to the uterine pharynx - this happens during sexual intercourse or as a result of physical training. At this time, the uterine pharynx is actively supplied with blood, therefore, vascular damage may occur. The bleeding is painless, mild, and goes away after a few hours. It is completely safe.

If blood flows during pregnancy at the same time as when you had menstruation earlier, this is also a completely physiological phenomenon. Moreover, it occurs more often than women think. Allocation with such "menstruation" is not strong, smearing, continues for several days.

A woman can bleed during pregnancy even with a lack of progesterone. In this case, the doctor will prescribe treatment, focusing on the test results - a pregnant woman will need to take special drugs, an analogue of progesterone, in the form of tablets, suppositories or injections.

We repeat once again: in all of the above situations, the bleeding will be insignificant - rather smearing, and practically painless. If you notice the following symptoms in yourself, call an ambulance immediately:

Profuse bleeding or discharge, bright blood;
You are in severe pain - cramping or piercing;
Your blood pressure has dropped, your heartbeat has begun;
There was weakness, perspiration, tinnitus, "flies" before the eyes.

Such symptoms can accompany not only spontaneous abortion, but also an ectopic - tubal pregnancy. You will need urgent surgery.

Be sure to tell your loved ones (husband, mother, sister) that you got blood during pregnancy: if you suddenly feel bad or you faint, relatives will be able to explain to the doctors what exactly happened. Before the ambulance arrives, you need to take a horizontal position and not move.

If you bleed during pregnancy in the second or third trimester

Mid-pregnancy is usually the safest time for the mother and fetus. Here, the cause of bleeding is mainly trauma - for example, if a woman hits her stomach or falls.

But if during pregnancy blood flows after the 28th week, this signals a certain threat to the development, and sometimes the life of the fetus: previa or placental abruption. An abnormal position of the placenta is detected by ultrasound, and training contractions or increased physical activity can cause rupture of blood vessels. In this case, the woman will be put on preservation in order to reduce the tone of the uterus and try to restore the functioning of the placenta.

The same situation can occur with partial placental abruption. The woman should be under the supervision of doctors around the clock, and if the situation cannot be stabilized, doctors will perform an emergency caesarean section.

Thus, blood during pregnancy can mean both the presence of a serious situation, and it can be a symptom of some natural physiological phenomena. In order not to provoke bleeding on your own, watch your stress, do not engage in intense physical training and, of course, do not lift weights. If the doctor insists on sexual rest, try to comply with this condition as well.

Bleeding during pregnancy can be very frightening for the expectant mother, but it is important to know that blood loss does not always mean that a miscarriage is taking place at the moment.

Discharge of blood from the genital tract while waiting for a baby is more common than you might think. Approximately 20-25% of women have this problem. The doctor diagnoses a miscarriage in about half of women, but the other half of women will be able to maintain the pregnancy. The most likely time for bleeding to occur is in the first trimester.

For some women, blood loss may be one-time; others may experience it for the entire 40 weeks. These can be small blemishes, smudging discharge, and stronger discharge.

Do I need to report this fact to the gynecologist?

Necessarily! Any, even minor, bleeding should be reported to your gynecologist at the antenatal clinic. Any loss of blood of this nature will be considered "threatened" or "threatened with termination of pregnancy".

It is especially important to see your doctor within 72 hours of the onset of bleeding if you have a negative Rh factor. Usually, during the first pregnancy, the Rh-conflict is not very acute, but it is worth playing it safe.

Why can bleeding occur during pregnancy?

There are a number of reasons that are not always dangerous for the woman and for the fetus. Some arise in the early stages, others at later stages, but you should definitely pay attention to any sensations you do not understand. Remember that if your discharge is accompanied by cramps and pain, you should seek professional help as soon as possible.

Reason # 1: Implant bleeding

Reason # 2: Menses during pregnancy

Some women have what is popularly known as "washing of the fetus" - the discharge occurs at a time when menstruation usually should go.

In addition to discharge, the usual sensations that you experienced during menstruation also appear - back pain, stretching of the abdomen, heaviness in the pelvic region, a feeling of bloating in the lower abdomen.

During pregnancy, hormones prevent your period from occurring. But sometimes it happens that their level is not yet high enough to stop the cycle. In most cases, by the age of 3 months, the placenta takes over the production of hormones and this problem ceases to bother a woman. But it very rarely happens that a woman may have a "washing of the fetus" during the entire pregnancy and they give birth to healthy children on time, but it is important to always be under the close supervision of their gynecologist.

This situation is not normal for a healthy woman; the causes of the disorders must be looked for in the hormonal background.

Reason # 3: Threat or miscarriage

Studies show that about 30% of all pregnancies end in miscarriage (the medical term is spontaneous abortion). This usually happens in the first 12 weeks, and the woman may not even know about her situation. The main cause of miscarriage is fetal anomalies.

Once you have reached the threshold of 14-16 weeks, you can relax and be confident that your pregnancy is safe. That is why it is considered the norm not to tell acquaintances about your situation earlier than this period, until it is precisely known about a favorable outcome.

Common signs of miscarriage include bleeding, cramping, and back and abdominal pain. Women who have experienced this argue that if the signs of pregnancy continued, then usually fetal loss could have been avoided. But when, before the miscarriage, the woman sharply felt the disappearance of all the symptoms (nausea, bloating, chest pain), then in most cases grief could not be avoided.

Reason # 4: Sexual intercourse

Spotting spotting very often occurs after a stormy night with a partner. It is completely harmless and is caused by increased blood supply and softening of the cervix. Although this form of bleeding is not serious, tell your doctor about it. You do not need to completely end the love relationship with your husband, but you should reduce your partner's overly active movements.

Reason # 5: Ectopic pregnancy

It occurs when your fertilized egg becomes attached outside the uterus, usually in the fallopian tube. You may experience severe pain in only one side of the abdomen, or general pain, which causes feelings of weakness and nausea. If the pipe ruptures, the pain may disappear for a few hours or days, but then it will return and the situation will become even more complicated.

An ectopic pregnancy must be treated urgently as it can rupture the fallopian tube, causing internal bleeding and tube damage. In such cases, the fallopian tubes are removed along with the ovum, but this does not mean that now the woman will never be able to have a child. The chance remains fairly high if the second ovary and fallopian tube are healthy.

Reason # 6: Problems with the placenta

Painless vaginal bleeding can be caused by abnormal placement of the placenta. Sometimes this organ is implanted very low on the wall of the uterus, right above the cervical canal. This is called and occurs in about 2% of expectant mothers. Presentation will inevitably lead to bleeding at some point in pregnancy, usually after 20 weeks. There are several degrees of severity of this condition, it will require a second ultrasound to accurately diagnose it.

Another problem that occurs in 1 in 200 expectant mothers is partial or complete detachment of the placenta from the walls of the uterus. Symptoms: Severe pain and blood loss. To learn more about the degree, causes, treatment of detachment, read our article.

What to do?

Don't use tampons, only pads.
Regardless of the gestational age and the diagnosis that you suspect, see your doctor as soon as possible.

Bleeding during pregnancy is a serious threat to the health and life of both the fetus and the mother. Therefore, such a condition cannot be ignored and, if bleeding of any nature appears, seek medical help. It is a discharge of various colors (red, pink, brown) and consistency emerging from the vagina.

According to statistics, bleeding in pregnant women is quite common. This problem affects up to 20% of expectant mothers. In Russia, up to 100 women die every year from bleeding during pregnancy, which indicates the seriousness of the problem.

Causes of bleeding during pregnancy

Bleeding during pregnancy can have a number of reasons, these include the following:

Ectopic pregnancy. It is characterized by the fact that pregnancy occurs and begins to develop outside the uterus.

A frozen pregnancy in which the fetus dies in the womb.

Inflammation of the cervix.

Placental abruption.

Multiple pregnancy.

Abdominal trauma.

Egg implantation to the walls of the uterus.

Cervical erosion.

Polyps of the cervical canal.

Myoma of the uterus.

Sexual intercourse while carrying a child. It occurs due to irritation of the cervix and vaginal lining.

Miscarriage. A concomitant symptom of the smearing discharge that appears is severe paroxysmal pain in the lower abdomen.

Bubble drift. This is a condition in which tissue overgrowth of the placenta occurs. With it, bleeding is profuse, but there is no pain.

Fetal malformations.

Low progesterone levels.

Bladder infections.

Placental abruption.

Premature birth.

Varicose veins of the vagina.

A ruptured uterus that occurs late in pregnancy. At risk are women who have undergone a cesarean section, with multiple pregnancies, with scars left after operations.

Cervical cancer.

Sometimes the causes of bleeding in a pregnant woman can be invasive gynecological examinations, such as taking blood from the umbilical cord, examining the amniotic fluid (amniocytosis), fetal chorionic biopsy.

Bleeding during early pregnancy

Bleeding in early pregnancy does not always indicate the presence of any pathology, however, such a condition should not be ignored. There are both natural bleeding and those that can pose a serious threat.

Sometimes, at an early stage, when a woman does not yet know that she has become pregnant, a small amount of blood may be released from the vagina. This is due to the fact that the ovum is attached to the wall of the uterus. During this process, there is a natural rejection of minor elements of the mucous membrane lining it. In connection with such changes in the body, a woman may observe small brown-brown or red discharge, accompanied by a feeling of discomfort and short-term pain.

Sometimes a little bleeding can occur at 3-4 weeks of pregnancy. It does not always indicate a problem. This may happen due to the fact that the woman at this time should have started another menstruation. The hormones that regulate the course of pregnancy naturally interfere with this process, interrupting it. That is why some blood is sometimes released. Such bleeding can sometimes continue up to the 2nd trimester, and therefore, a woman sometimes does not know about her position.

Sometimes early bleeding can result from increased blood supply to the growing uterus. In this case, varicose veins can be observed, polyps form in the cervical canal. At the same time, the pregnant woman does not feel any discomfort and treatment is not prescribed by doctors.

However, one should not be silent at the next visit to the doctor that bleeding occurred during early pregnancy, since in some cases they are a symptom of serious processes. In this case, both the fetus and the woman herself can suffer.

Sometimes bleeding can occur at 5 weeks of gestation. This may be due to the Rh-conflict between the mother and the fetus. It is at this time that the hematopoietic system of the embryo is laid, and if an immuno-conflict occurs, this can provoke a miscarriage. If, with smearing discharge and accompanying pain, a woman does not go to the doctor, then most often the pregnancy cannot be prolonged. If the bleeding increases, clots and severe pain appear, this indicates that the miscarriage is already in the process.

At about 6 weeks, sometimes a little earlier or later, bleeding may occur, indicating an ectopic pregnancy, when the ovum is located outside the uterus.

It is impossible to recognize the cause of bleeding on your own, so you need to see a doctor. Moreover, in the early stages, they can indicate both pathological and natural processes.

Ectopic pregnancy bleeding

Ectopic pregnancy refers to a pathological condition and is a complication of pregnancy. It is characterized by the fact that the fertilized egg is attached outside the walls of the uterus. This condition requires urgent hospitalization, as it causes internal bleeding and can be fatal for a woman.

The danger of an ectopic pregnancy is that at the beginning of the birth of life, it is no different from the uterine one. A woman may experience nausea, weakness, breast tenderness.

Typical symptoms begin to appear at a period of 5 to 8 weeks, they are expressed as follows:

Bleeding occurs in the abdominal cavity, since this is where the vessels are damaged. But uterine bleeding can often be observed, which is caused by a sharp drop in progesterone levels. Discharge is usually only slight, sometimes it can resemble menstrual discharge. Profuse bleeding occurs, but is extremely rare.

The pain is of a different nature, it can be cutting, paroxysmal and aching, localized in the lower abdomen, followed by irradiation to the side and the anus.

If the blood loss is significant, the woman may develop shock. It is characterized by loss of consciousness, pallor, and a sharp drop in blood pressure.

In case of bleeding, a surgical method is always used to remove the ovum. Either only the egg is removed, or the fallopian tube, in case of rupture.

Implant bleeding is the natural discharge of blood during the early stages of pregnancy. It is due to the fact that the fertilized egg is trying to invade the walls of the uterus. This type of bleeding is not pathological and is not observed in every woman.

The name of this type of bleeding is due to the fact that the introduction of an egg into the walls of the endometrium of the uterus is called implantation. Damaging tissues and blood vessels, the egg hardens inside the body of women, causing bloody discharge. This process takes place on average for 8 days, after the sexual intercourse that has happened, sometimes the process can take up to 12 days. The discharge does not last long, the discharge is observed for 2 hours, no more.

It is important to be able to recognize the signs of implantation bleeding and distinguish it from the onset of menstruation or another type of blood loss.

The fact that the woman began implantation bleeding is indicated by the following:

The presence of unpleasant, but not too painful sensations in the lower abdomen. They are pulling in nature. Caused by muscle spasms of the uterine muscles.

A short-term decrease in basal temperature. But this sign is very difficult to track, since the decrease is insignificant and short-lived.

The bleeding itself is weak, the discharge is more often a light, creamy shade.

A woman may feel mildly unwell, accompanied by dizziness, weakness, and lethargy. They arise after the implantation of the egg is completed.

Unlike menstruation, this bleeding is short-lived.

The color of the discharge will not be as intense.

The number of such secretions is equivalent to a few drops.

When an ectopic pregnancy occurs, implantation bleeding is slightly different. The woman experiences pain, sharp and paroxysmal. Most often, ectopic implantation is immediately accompanied by dizziness and nausea. During the passage through the fallopian tube, the blood will become dark, therefore, the discharge will acquire a corresponding character.

If the discharge occurred before the specified time or later. Are intense, this may indicate the presence of any other disease. In this case, you need to go to the doctor for advice.

It is problematic to independently determine implantation bleeding using a pregnancy test. As a rule, at such early stages of pregnancy, it does not give a reliable result and it must be done only after the first day of delayed menstruation.

There is a more reliable method for determining the presence of pregnancy - this is a blood sampling and an analysis for a specific hormone hCG. When fertilization occurs, the level of human chorionic gonadotropin in the woman's blood rises. Its release is actively carried out by the membrane of the ovum. This method of determining pregnancy is very reliable and can be carried out as early as 6 days after intercourse. However, it will be more reliable after implantation bleeding has occurred.

If a woman experiences bleeding while carrying a child, it is necessary to act in accordance with the following instructions:

Profuse blood loss during pregnancy rarely begins abruptly and unexpectedly. Most often, it is preceded by pain and tension in the lower abdomen.

If a woman finds bloody discharge, then it is necessary to call an ambulance, and before she arrives, lie in bed with a roller under her feet.

If the arrival of the doctor is delayed for any reason, you need to drink two tablets of No-shpa and valerian extract.

You should put something cold on your lower abdomen, it can be an ice heater or a bottle of water. But first, you need to wrap it with a cloth.

It is forbidden to use douching solutions and even wash away so that the doctor can determine the cause of the blood loss by the color and nature of the discharge.

You cannot use a tampon to stop bleeding; in order not to stain your clothes, you should use a sanitary napkin or a clean cloth.

You cannot use progesterone-based hormonal agents on your own, without a doctor's prescription, in order to stop bleeding. In some cases, they help, but the doctor must determine the cause of the bleeding.

After the arrival of the ambulance team, the woman will be taken to the hospital and transferred to a specialist for observation.

Depending on what caused the blood loss, the pregnant woman will either be left in the hospital or sent home for treatment. Most often, hemostatic agents (Dicinon, Vikasol, etc.) are used for therapy, which reduce the uterine muscles (oxytocin), and raise the hemoglobin level of funds. Pregnant women are prescribed vitamins and drugs that help strengthen blood vessels - Ascorutin.

Bleeding is one of the most common complications that accompany pregnancy. For most expectant mothers, spotting causes fear, and sometimes real panic. Indeed, even minor discharge may indicate a risk for the development and preservation of the fetus. However, the condition does not always signal the threat of miscarriage.

Bleeding patterns vary. In some, it is a weak spotting discharge without pain, in others it is strong, at times abundant, accompanied by cramping pains in the lower abdomen, chills, and dizziness. According to statistics, this pathology occurs in 20-25% of pregnant women.

The expectant mother must remember: whatever the causes of the pathological condition, she must definitely inform the gynecologist about them. Any discharge, even very scanty and not presenting discomfort, is regarded as a pathology and can be dangerous for the development of the fetus. The most commonly diagnosed bleeding is in the first trimester of gestation.

Causes of pathology in the early stages - up to 15 weeks

Sometimes small spotting brown or dark color occurs at the very beginning of pregnancy, at 2 weeks. Some women may mistake them for the onset of menstruation. In fact, this is the result of the attachment of the ovum to the wall of the uterus. Implantation bleeding may occur somewhat later, even at 5 weeks. They are not dangerous or discomforting.

At the beginning of pregnancy, bleeding may occur after intercourse. If it is insignificant, you should not be afraid. But if these become regular and are accompanied by other negative sensations, there is a threat of termination of pregnancy.

Consider the main causes of bleeding during pregnancy:

Miscarriage. Spontaneous abortion before 28 weeks. It occurs for various reasons. Among them are pathologies of the structure of the genital organs, endocrine and infectious diseases, genetic pathologies of the fetus, stress, excessive physical exertion or injuries. There is a very high risk of termination of pregnancy when bleeding occurs at 8 weeks of gestation.
... It occurs as a result of obstruction of the tubes, when the ovum cannot penetrate into the uterine cavity for further development. Bleeding in this case often occurs at 6 gestational weeks, when the fallopian tube can no longer stretch. This is an extremely dangerous condition for a woman, which requires immediate surgical intervention.
... Usually occurs in the early stages. With a frozen pregnancy, the bleeding is slight, accompanied by minor pain in the lower abdomen. A woman is shown compulsory hospitalization for curettage of the uterine cavity and removal of the ovum.
... With this pathology, spotting is accompanied by the discharge of small bubbles. Shown is vacuum aspiration, and sometimes removal of the uterus.
, fibroids, polyps. These neoplasms in the organ cavity are not directly related to pregnancy, but can cause bleeding at 3-4 weeks and later.
Infectious diseases. They can not only cause severe bleeding, but also harm the development of the fetus. Therefore, such diseases require immediate treatment.
Insufficient progesterone levels.

Some procedures, such as taking blood from the umbilical cord (cordocentesis) or examining the amniotic fluid (amniocentesis), can provoke a small discharge with an admixture of blood.

With a miscarriage, contractions of the uterus occur, which is trying to get rid of the fetus. One of the signs is discharge with clots, and sometimes together with tissue fragments of the ovum. If it was not possible to save the pregnancy, and a spontaneous abortion took place, scraping of the uterine cavity will be a mandatory procedure, since even minor residues of the ovum can cause an infectious process and other complications. The presence of clots can also signal a frozen pregnancy.

At week 10, a pathological condition can occur with violations of the blood coagulation system.
At 11 weeks, the risk of termination of pregnancy decreases, but this does not mean that the appearance of spotting should not alarm a woman. They can appear after violent intercourse, physical injury or severe overheating, for example, after visiting a sauna.
At 13-15 weeks, a woman is recommended to undergo tests to identify possible fetal malformations. Such tests will avoid complications in the second half of pregnancy.

Influence of ultrasound examination

Today, an integral part of compulsory screening is the procedure. Some mothers-to-be fear that the procedure might harm the baby. You can often hear that after an ultrasound, a woman has bleeding.

The discharge in this case is insignificant, lasts no more than two days and does not harm either the mother or the unborn baby. They can be caused by hypersensitivity of the internal genital organs or blood accumulation.

Bleeding in the second half of pregnancy

If bleeding in the first half of pregnancy is associated with the threat of spontaneous miscarriage, in the later stages it is most often associated with pathology of the placenta.

Placenta previa

It occurs in 2-5% of pregnant women when the placenta is not located correctly. Allocate full and partial presentation. In the first case, scarlet bleeding is observed without pain. With a partial presentation, the opening of the fetal bladder is shown to correct the condition.

This pathology is a danger to the expectant mother, since it can cause hemorrhagic shock. It also negatively affects the condition of the unborn child, increasing the risk of premature birth.

Premature detachment of the placenta

It is always accompanied by bleeding. Can cause late toxicosis, multiple births or a large fetus, heart defects, physical injury (fall), abnormalities in the development of the uterus. In women, severe pain in the lower abdomen is noted, an increase in the tone of the uterus. The fetus develops hypoxia due to insufficient oxygen and other elements useful for development.

Ruptured uterus

The blood is bright scarlet, severe abdominal pains indicate excessive stretching and thinning of the walls of the uterus, destruction of the muscle layer. Occurs with cystic drift or when there are scars on the uterus left over from the previous one. Doctors recommend not getting pregnant after a cesarean section for at least two years.

Bleeding from the vessels of the fetus

A rare pathology that occurs no more than one case per 1000 births. The cause may be damage to the umbilical cord or vessels of the fetal membrane.

Bleeding in the second half of pregnancy is dangerous because it can provoke hemorrhagic shock in the mother, premature birth, and the birth of a child with developmental pathologies.

Elimination of bleeding

What if the pregnancy is accompanied by significant or poor bleeding? First of all, a woman must remain calm and not panic. Not in all cases, such a violation leads to the death of the fetus.

Of course, yes, subject to timely registration with the antenatal clinic and immediate medical attention. Even if the discharge is insignificant and the general well-being is good, you need to see a doctor as soon as possible.

To find out how to stop bleeding, you need to establish the cause of its occurrence. To do this, a woman is sent to pass tests and undergo the following diagnostic procedures:

general urine and blood tests;
blood test for HIV and syphilis;
Ultrasound of the pelvic organs;
blood test for hCG level;
examination from the vagina.

If there is a suspicion of an ectopic pregnancy, a diagnostic one is performed.

The main goal of early gestation treatment is to stop bleeding and prevent miscarriage.

Treatment involves the appointment:

hemostatic drugs - Dicinon;
antispasmodics that lower the tone of the uterus - No-shpa;
hormonal drugs that provide the level of progesterone necessary to maintain pregnancy - Dyufaston, Utrozhestan;
sedatives (tinctures of motherwort, valerian);
vitamin therapy - Magne B6, vitamin E, folic acid.

With a frozen pregnancy, mandatory is shown. After the procedure, hormone therapy and drugs are prescribed to restore the functions of the circulatory system. If a woman is diagnosed with a negative Rh factor, after curettage, an anti-Rh immunoglobulin is administered to her to prevent the Rh-conflict.

Treatment of an ectopic pregnancy is only operative. During the surgical intervention, the ovum fixed in the tube or the fallopian tube itself is removed.

After the first successful results of treatment, when the pregnancy can be maintained, the woman is shown complete rest. In some cases, bed rest is recommended. Intimate life with the threat of miscarriage must be completely stopped. All prescribed medications must be taken for a long time, even if there is no bleeding and you feel well. The exact dosage and duration of admission is determined by the attending physician.

Therapeutic measures for placenta previa depend on the intensity of the discharge. If they are abundant, an immediate cesarean section is prescribed, even if the fetus is premature. In the future, the woman is undergoing treatment aimed at restoring blood loss.

With scant secretions, they are limited to opening the fetal bladder. However, if this measure is ineffective and the discharge does not stop, a caesarean section is also indicated.

Bleeding caused by placental abruption is more difficult to diagnose, since with this pathology, internal bleeding is observed, combined with external. In 25% of cases, there is no external discharge at all. To stop the blood, a caesarean section is performed with further treatment to compensate for blood loss.

Can Clexane Cause Bleeding During Pregnancy?

This drug is used to treat thrombosis, angina pectoris, renal failure. Reviews about him can be conflicting. Indeed, taking Clexane increases the risk of miscarriage, so its use is permissible only under the close supervision of a doctor.

The drug "Clexan"

In addition to increasing secretions, the drug can cause side effects such as hemorrhoids and local allergies. It is prescribed in cases where the effectiveness of its use outweighs the possible risks.

Clexane is contraindicated for:

the threat of spontaneous abortion;
diabetes mellitus;
some diseases of the upper respiratory tract;
tuberculosis.

Application of Dufaston

The drug is prescribed to replenish progesterone. It is a hormone that is essential for a successful pregnancy. With bleeding during pregnancy, Duphaston is prescribed in the first trimester.

The drug "Duphaston"

The dosage is calculated individually, taking into account the hormonal disorders of the patient, the nature of the discharge and her general well-being. The most typical dosage is 40 mg of a single dose of the drug and further administration of 10 mg three times a day.

Duphaston is taken until the symptoms of the threat of termination of pregnancy have completely ceased. In the future, it is possible to change the dosage to maintain the normal course of bearing the child.

Like most medicines, Duphaston can cause side effects. It can be inflammatory processes in the kidneys, constipation, hemorrhoids. In some cases, the appearance of negative reactions from the liver (signs of jaundice) is possible. With such side effects, the drug is canceled. It can be replaced with other drugs, for example, Utrozhestan. Duphaston does not have a negative effect on the development of the fetus.

Self-medication at home using untested traditional medicine is unacceptable! Only the attending physician can prescribe hemostatic drugs and other medicines!

Prophylaxis

Every pregnant woman should carefully monitor her health. Expectant mothers who belong to the so-called risk groups should be especially careful.

Among the preventive measures aimed at avoiding pathological discharge during the bearing of a child, the following can be distinguished:

Maximum limitation of physical activity and emotional stress.
Avoid cycling, lifting weights, running fast, doing strength sports, walking up stairs.
In the presence of certain indicators, reduce to a minimum, and in some cases completely exclude sex life.
Do not use tampons or douching, which can provoke increased discharge.
Drink plenty of fluids (at least 8-10 glasses a day).

Prevention of abortion, competent contraception, treatment of gynecological diseases before conception, and the birth of children under the age of 35 are important conditions for prevention.

Bleeding early in pregnancy, as well as in the third trimester, is quite treatable. Fulfillment of all the prescriptions of the attending physician will allow a woman to avoid negative consequences and give birth to a healthy strong child.