Nutrition and diet 

Bleeding during pregnancy. Causes of small discharge. Threatened miscarriage or miscarriage

In the article, we will consider the factors that provoke bleeding in the early stages of pregnancy, which are accompanied by various symptoms and those that are asymptomatic.

Causes of bleeding

In the early stages of pregnancy, bleeding can be triggered due to the following circumstances:

Ectopic pregnancy is a condition when a fertilized egg is attached not in the uterus, but in another place (in the abdominal cavity, fallopian tubes, cervix, ovaries). At the earliest stage, the symptoms are similar to uterine pregnancy: nausea, drowsiness, breast enlargement, positive pregnancy test, etc.

Primary symptoms begin to appear in the period from 3 to 8 weeks after the last menstruation: abdominal pain, "spotting" spotting. If the tube ruptures, severe bleeding (internal and external) occurs, which is sometimes accompanied by loss of consciousness and a weak pulse. Operative medical intervention is required, since the condition is extremely dangerous for the health and life of a woman.

For the timely detection of an ectopic pregnancy, you should regularly visit a doctor: undergo a gynecological examination and an ultrasound scan.

  • Spontaneous abortion (miscarriage)

This is a condition in which the cervix opens and the ovum partially or completely exits. A spontaneous abortion occurs before 28 weeks. The factors that can provoke a miscarriage are as follows: Rh-conflict between mother and child; development of infection; any kind of injury or fall; severe stress, etc.

Bleeding symptoms

Aching or dull pain in the lower abdomen; bloody discharge, which is replaced by bleeding.

Spontaneous abortion takes place in stages:

  • the threat of miscarriage - the appearance of barely noticeable bloody discharge, accompanied by aching pain in the lower abdomen;
  • started - minor bleeding, spastic pain in the lower abdomen;
  • in the course - profuse bleeding, abdominal cramps;
  • incomplete - clots of a dark shade appear in the discharge, abundance can be observed; accompanied by painful sensations.
  • complete abortion - at this stage, the uterus is completely freed from the ovum, which is accompanied by moderate bleeding. After that, the bleeding stops by itself. Scraping is still done so that there are probably no particles left.

The less blood a woman loses, the more likely she is to maintain a pregnancy. As a rule, this is possible in the first two stages.

  • Bubble skid

After conception, the development of the embryo is disturbed, and bubbles appear on the outer villi of its shell (chorion), which are filled with liquid. In the future, there is an increase in the size of the villi. Symptoms of cystic drift: absence of menstruation up to 4 months; bloody issues; toxicosis.

This pathology can be identified during a gynecological examination - the size of the uterus does not correspond to the expected gestational age, and when an ultrasound is performed, the fetus will not be visualized in the uterus (at 20 weeks).

Bladder drift is extremely rare, but regular examinations will not be superfluous. If a woman has a cystic drift, the next pregnancy is not recommended earlier than 2 years later (this time must be supervised by a doctor).

  • Frozen pregnancy

Fading of pregnancy occurs before the 12th week. The reason for the fading of the development of the fetus can be diagnosed. Some of them can be: a genetic disorder, infectious pathologies or hormonal deficiency.

Symptoms: slight bleeding, pain in the lower abdomen (maybe without pain), signs of pregnancy disappear, swelling in the chest subsides, there are no signs of vital activity of the embryo on ultrasound.

  • Placenta previa

Sometimes it happens that the placenta is placed too low on the wall of the uterus, which causes bleeding (after the 20th week). For a woman, it passes without pain and other symptoms. It is necessary to undergo several ultrasound examinations in order to accurately identify this pathology.

  • Implant bleeding

The cause may be an injured vessel during implantation of the ovum into the uterus. This can provoke a slight release of blood and does not pose a danger to the embryo at all.

It will be characteristic: the appearance of insignificant discharge around the time of the onset of menstruation and the woman will not suspect about pregnancy; can last from several hours to 2 days; bleeding does not increase; not accompanied by pain.

Bleeding with clots

If, during bleeding, a woman discovers clots (from scarlet to dark brown), it is highly likely that these are particles of embryonic tissue. At the same time, the woman feels cramps and pain in the abdomen. Such bleeding occurs in the early stages (up to 12 weeks). As a rule, such a pregnancy is not maintained.

What to do?

With the most insignificant bloody discharge, and even more so if they are accompanied by abdominal pain and there is a deterioration in health, you must immediately consult a doctor or call an ambulance.

  • If the leading doctor is near your location, you can get there on your own.
  • If the blood is scarlet, and the discharge of blood is abundant, call an ambulance.
  • It is not recommended to use tampons, use pads.
  • While waiting for a doctor or an ambulance, lie down with your feet on a hill.
  • Do not take any medication to keep the symptoms so that your doctor can diagnose the condition correctly.
  • If, during bleeding, a woman loses consciousness, she shivers and complains of severe pain in the abdomen - this may be due to a ruptured tube (with an ectopic pregnancy). Every minute counts. Call an ambulance urgently.

Be healthy!

See you in the next article.

Every fifth woman experiences bleeding during pregnancy. However, it does not always signal a serious threat to the life and health of the mother and the baby. There are reasons that are explained by physiological changes in a woman's body, and in which discharge with blood is absolutely safe. Nevertheless, only a doctor, on the basis of an examination or an ultrasound scan, can say what exactly caused this manifestation.

What is considered bleeding?

Bleeding is a discharge with blood from the genital tract of various volumes. The color of the discharge depends on how much blood - small, medium or large - comes out. It can be red, brown, or pink. The presence of bleeding indicates the ongoing changes in the body and can proceed both without deterioration of well-being, and be accompanied by pain in the lower abdomen and in the lower back.

All pregnancy bleeding can be divided into two categories:

  1. Physiological. Their cause is the restructuring of the female body. They do not pose a threat to the life and health of the mother and child.
  2. Pathological. They are observed during abnormal pregnancy, threaten the life and health of the woman and the fetus and require immediate medical attention.

There are so many reasons for bleeding that only a doctor can correctly diagnose the problem. Even with abnormal development of pregnancy, there is an opportunity to save her and the baby, but only if you do not miss precious time.

Why does it bleed in the early stages?

Most often, bleeding occurs in the 1st and 3rd trimesters. In the early stages, they can be caused by the following reasons:

  1. Gynecological examination or ultrasound. Often, minor bleeding appears after examination by a gynecologist or ultrasound using a transvaginal probe. However, this is not a cause for panic. They are caused by mucosal trauma, which completely disappears in a couple of days.
  2. The onset of the time of menstruation. In some women, on the days when the critical days were supposed to begin, mild, smearing discharge lasting 3-4 days is noted. This usually happens in the first three months after conception. It can be caused by both individual characteristics of the body and hormonal disorders.
  3. Implantation. Blood may be slightly released at the time of implantation of the ovum in the uterine cavity. However, a woman may take her for, albeit meager, but menstruation, and not guess about pregnancy. In the future, this can cause difficulties in determining the duration of pregnancy.
  4. Infection. When pregnancy occurs, the immune system weakens significantly. This can provoke the rapid development of sexually transmitted infections, and, as a result, severe inflammation up to bleeding.
  5. Insufficient amount of progesterone. If the hormone is produced in insufficient quantities, then this can threaten pregnancy. Based on the test results, the doctor prescribes treatment in the form of tablets, suppositories or progesterone injections.
  6. Ectopic pregnancy. The cause of bleeding can be an abnormal attachment of the ovum in the abdominal cavity, ovary, or, most often, the fallopian tube. At an early stage, such a pregnancy has all the signs of a usual one - toxicosis, absence of menstruation, breast augmentation, even two strips on the test. However, with the growth of the fetus, soreness appears at the site of the embryo, as well as spotting spotting, which then intensifies. In this case, it is impossible to preserve the pregnancy; at best, it is possible to leave the fallopian tube. However, if a woman is in pain, does not go to the doctor, then the tube may rupture and severe bleeding, which poses a threat to life.
  7. Frozen pregnancy. Light bleeding can signal fetal freezing. For unclear reasons, it stops developing, which can manifest itself as pain in the lower abdomen. Also, most often all signs of pregnancy disappear - the breast becomes smaller, toxicosis stops, the basal temperature drops. Sometimes the result is a miscarriage, but more often curettage is required. Delaying with the procedure is dangerous for women's health.
  8. Bubble drift. During fertilization, an error occurs and as a result, instead of an embryo, a benign tumor develops in the form of a cluster of small cysts. In this case, there is dark, thick blood with egg bubbles. Bleeding may persist until the tumor is removed.
  9. Spontaneous abortion or its threat. It is accompanied by pain in the lower abdomen and lower back. As a rule, it starts with smearing secretions, which, if not asked for help, develop into massive bleeding, during which the embryo can exit. However, the outcome is not always deplorable. If you call an ambulance in a timely manner and go to the hospital, then if you follow all the doctor's recommendations and drug therapy, there is a high chance to save the baby. However, if the fetus has genetic abnormalities, or the bleeding is already profuse, with clots, accompanied by sharp pain, then the process cannot be stopped, a miscarriage has occurred. It can be complete or incomplete when scraping is required to remove the remnants of the membranes.

Why is spotting bothering in the later stages?

Among the main causes of bleeding in the late stages are:

  1. Placenta previa. Occurs when the placenta is not positioned correctly, partially or completely overlapping the uterine pharynx. It is on the bottom that the main load falls, which provokes rupture of the placenta. With such a diagnosis, the woman is put on preservation and they try to prolong the pregnancy as long as possible with the help of tocolytics and antispasmodics, iron preparations for the treatment of anemia, as well as means to improve blood supply. If therapy does not work and the bleeding does not stop, then an emergency caesarean section is performed to save the woman's life.
  2. Detachment of the placenta. At the same time, there is always a discharge with scarlet, often streaked with blood. There are many reasons for detachment, among the main ones are late toxicosis, a large child, heart defects, a fall, etc. As a result, the tone rises, and the woman experiences severe pain in the lower abdomen. The kid suffers from hypoxia. Detachment is dangerous because bleeding is often internal, when a hematoma develops, and only then pours out. The actions are the same as in presentation.
  3. Bleeding from the vessels of the fetus. It occurs when the umbilical cord or the vessels of the fetal membrane is damaged. However, this is a very rare case, occurring once in 5 thousand. It is accompanied by bleeding of a bright scarlet color, hypoxia, increased and then decreased heart rate. Only the doctor determines how to proceed in each specific case - to preserve or deliver.
  4. Rupture of the uterus. Most often, a uterine rupture occurs as a result of a fresh, unhealed scar from a previous pregnancy. Multiple pregnancies, polyhydramnios, large sizes of the fetus can provoke tissue overstretching and rupture. The scar takes time to heal, so it is optimal 2-3 years after a cesarean section. Bleeding of a bright scarlet color is accompanied by acute pain in the abdomen. In this case, an emergency caesarean section is performed.
  5. Pathology of the cervix. They are rare, but possible with ectopia, cervicitis, polyps, erosion. Blood begins to secrete when the cervix is ​​damaged during sex, taking a smear, etc. Very rarely, bleeding is associated with cervical cancer.

Causes of bleeding at any time

There are reasons that provoke bleeding at any stage of embryogenesis, these are:

  1. Erosion. If a woman has cervical erosion, then this can cause blood droplets to appear. As a rule, expectant tactics are used, and erosion is cauterized after childbirth.
  2. Myoma. It is a benign neoplasm in the uterus. Often the fibroids were already there before pregnancy. However, changes in hormonal levels can provoke its growth. In the presence of fibroids in the 1st trimester, there is a high risk of bleeding and miscarriage due to increased tone.
  3. Sexual intercourse. During sex, due to the strong supply of blood to the uterine pharynx, blood vessels can be damaged. In this case, the bleeding will be mild, without pain and will end in a couple of hours. This is not dangerous for the child, however, it is better to choose safer positions and reduce the intensity of intercourse.

Bleeding is also possible if a woman has increased blood circulation in the pelvic organs, had physical activity, has cardiovascular diseases associated with a weakening of the inner layer of the vessel walls, and polyposis growths are also present.

How to stop bleeding during pregnancy?

If a woman has spotting, the very first thing to do is not to panic. Bleeding is possible and does not always threaten the health and life of a woman and a child, but panic can increase the tone, as well as entail wrong actions on the part of the pregnant woman.

To prevent this from happening, you should:

  • take a horizontal position, placing a roller under your feet;
  • call an ambulance;
  • drink two tablets - no-shpa and valerian, and put a hot water bottle with ice on your stomach;
  • do not wash away, since the nature of the discharge is important to the doctor for making a diagnosis;
  • pad, do not use a tampon;
  • be ready to go with an ambulance for a checkup.

If hospitalization is offered, then you should not refuse. It is important to remember that a woman is responsible not only for her life, but also for her unborn child.

In the hospital, the doctor uses the following diagnostic tools:

  • gynecological examination;
  • early analysis of hCG;
  • CTG at a later date;

Treatment will be prescribed based on the specific cause of the bleeding. If it is caused by damage to the polyp, erosion, or there are no pathologies, then therapy is not required. If the reason is the threat of miscarriage, then the pregnant woman is hospitalized and the following means are prescribed to stop bleeding:

  • hemostatic, for example, Dicinon;
  • antispasmodics - No-shpa;
  • hormonal - Utrozhestan;
  • sedatives - valerian;
  • vitamins - E, B9, magnesium.

If the reason is a frozen pregnancy, then curettage is necessarily carried out, after which antibiotics, anti-inflammatory, hemostatic agents are prescribed. An ectopic pregnancy cannot be saved, only the fallopian tube can be saved, but not always. When placenta previa or its detachment, if the bleeding cannot be stopped, a cesarean section is prescribed.

Is bleeding always a threat?

As noted above, there are physiological bleeding that is associated with the transformation of a woman's organs during pregnancy. Such discharge can appear as a result of implantation, examination on a gynecological chair or as a result of an ultrasound procedure, after sex, etc. In this case, they are not dangerous.

However, you shouldn't make the diagnosis yourself. Often, even with an abnormal course of pregnancy, there are no painful sensations, in which case delay is dangerous and can lead to miscarriage. Therefore, if there is bleeding - strong or weak, with or without pain, an urgent need to see a doctor. Only he will be able to correctly diagnose the cause, as well as immediately provide assistance if necessary.

Finally

Even if bleeding is caused by various pathologies of pregnancy, with timely medical care, the prognosis is usually favorable. Many women face the threat of pregnancy, but nevertheless carry and give birth to healthy babies. To do this, you need to follow all the recommendations of your doctor. However, it is preferable to prepare in advance for conception - to eliminate benign neoplasms, treat infections, and subsequently avoid stress, exertion, violent intercourse.

Specially for- Elena Kichak

The process of carrying a child does not always go smoothly. Quite often, the fairer sex has bleeding during early pregnancy. This is a rather serious pathological process that requires emergency medical attention.

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    Possible reasons

    A pathological condition in women can be observed for a variety of reasons:

    1. 1. In most cases, the appearance of bloody discharge is observed when the egg is attached to the mucous membrane, which has gone through the process of fertility. During the period of this process, damage to the blood vessels can be carried out by the peri-embryonic tissue. As a result, there is a release of blood in small quantities.
    2. 2. Bleeding in early pregnancy can occur as a result of termination. After going through the process of embryo rejection, the woman observes pieces of tissue in the blood clots.
    3. 3. In case of incomplete termination of pregnancy, the appearance of a pathological condition can also be observed. In this case, not only clots are observed in the blood, but also tissue elements.

    Closure of the cervix is ​​not observed after a partial miscarriage. In order to avoid the appearance of an infectious process, as well as uterine bleeding, the patient must carry out uterine curettage.

    In this case, a representative of the beautiful half of humanity may experience cramping pain. The cause of miscarriage can be an infectious process, trauma, taking traditional medicines, etc.

    1. 4. Bleeding during pregnancy may occur when the fetus freezes. During the period of the appearance of this pathological process, spotting and pain are observed. In some women, it proceeds without obvious signs. A blood test is used to make a diagnosis, as well as an ultrasound scan. Doctors can wait for the embryo to reject on its own or perform uterine curettage.
    2. 5. The cause of the pathology is often a cystic drift. This condition occurs when the fertilization process is disturbed. In this case, the villi of the placenta grow blisteringly. The appearance of blood during early pregnancy in this case can be observed at any time.
    3. 6. With an ectopic pregnancy, the development of a pathological condition can also be observed. It is characterized by the fact that the fertilized egg is located outside the uterine cavity.
    4. 7. There are causes of bleeding that are not related to the pregnancy process. These include trauma to the genital tract of a woman during the period of bearing a child. The pathological condition can be diagnosed against the background of diseases of the vagina and uterus. Quite often, it is diagnosed against the background of infectious diseases in the reproductive system of the fairer sex.

    Blood during early pregnancy is a pathology that can have a variety of causes. They can only be established by a doctor after an appropriate diagnosis.

    Pathology in an ectopic pregnancy

    Ectopic pregnancy is characterized by implantation of an egg outside the uterine cavity. In most cases, it is localized in:

    • Abdominal cavity;
    • Pipes;
    • Ovaries;
    • Rudimentary horn;
    • Cervix.

    The formation of a pathological condition is observed against the background of frequent abortions. Also, its causes are hidden in adnexitis or endometriosis. It can appear with genital infantilism or endomyometritis. After surgical interventions on the genitals of a woman, a pathological process can also occur. The disease can be diagnosed in patients who suffer from hormonal imbalances.

    When this pathological condition appears, slight bleeding is observed. Many representatives of the fairer sex note a slight release of blood in the form of smearing bleeding. An ectopic pregnancy is usually accompanied by a delay in menstruation.

    With an ectopic pregnancy, the fairer sex may have an acute abdomen. In this case, urgent surgical intervention is necessary, which is explained by the rupture of the fallopian tube. An ectopic pregnancy lasts a maximum of 8 weeks. After that, a rupture of the tube is observed against the background of continuous growth of the embryo, which is accompanied by bleeding.

    For the correct diagnosis, an ultrasound examination is performed. After assessing the patient's condition, determine the degree of blood loss in her. In the course of treatment, the doctor must collect a gynecological and obstetric history.

    To provide high-quality medical care, a woman must be hospitalized in a medical institution. It is necessary to transport the patient in a horizontal position. During the period of treatment, women constantly monitor blood pressure readings. The development of certain treatment measures in the first month is carried out in accordance with the indications.

    Attention! Ectopic pregnancy is a rather serious pathological process that can cause a variety of complications. That is why a woman is advised to call an ambulance when her first symptoms appear.

    Risk of miscarriage

    In women, miscarriages may occur early in pregnancy. This pathological condition is diagnosed, as a rule, before the 28th week of pregnancy. It is characterized by the opening of the cervix and partial or complete rejection of the ovum from it. Why is this happening?

    1. 1. Early miscarriage is often observed with genetic disorders in the fetus.
    2. 2. Also, the cause of its appearance may be an infectious process that takes place in a woman's body.
    3. 3. Quite often, pathology appears against the background of taking traditional drugs.
    4. 4. The emergence of pathology can be diagnosed against the background of Rh-conflict between mother and child.
    5. 5. As a result of enduring severe stressful situations, girls may also experience miscarriages.
    6. 6. They are often diagnosed against the background of hormonal imbalance - excess testerone and progesterone deficiency.

    At the same time, the woman's uterine tone increases, and bloody discharge is also observed, which, if untimely treatment, turns into bleeding. The volume of blood loss, the duration of the pathological condition, anemia are factors that affect the condition of the fairer sex.

    If a woman has a spontaneous miscarriage, then it requires a timely stop of bleeding in order to avoid the appearance of hemorrhagic shock. If it is impossible to maintain pregnancy, scraping is performed.

    When bleeding occurs before the 12th week of pregnancy, doctors diagnose an early abortion, the causes of which are difficult to establish. By its nature, spotting is varied. They can be both plentiful and smearing. The possibility of maintaining pregnancy in this case directly depends on the intensity of blood loss.

    The effectiveness of the treatment of bleeding during pregnancy is directly influenced by how timely the woman turned to the doctor for help and how exactly she followed his recommendations. If there is a threat of miscarriage, a woman should be provided with bed rest.

    Others should do everything possible to ensure that the pregnant woman is in full emotional peace. If necessary, a woman is prescribed hormone therapy - Dufaston, Utrozhestan, Progesterone. Also in this case, infusion treatment is required.

    Often the patient is placed in a hospital for conservation, where she is under the supervision of specialists.

    Bubble drift

    This pathological process is trophoblastic. The development of this disease is observed against the background of ectopic or physiological pregnancy. The fairer sex is diagnosed with the disease most often after conditions such as:

    • Hormonal disorders;
    • The period after childbirth;
    • Inflammatory processes;
    • Artificial abortion.

    With the development of this disease, modifications appear in the chorion. At the same time, the villi increase in size and bubble-shaped elements are formed on them. In most cases, the disease occurs in girls aged 20-30 years.

    When pathology appears, menstruation is absent for 2-4 cycles. This is why the woman thinks she is pregnant. During the course of the disease, bubbles are rejected, which leads to bloody discharge. During the period of the gynecological examination, the doctors establish a discrepancy with the period of the uterus.

    To make a diagnosis, an ultrasound scan is done, which shows the absence of the fetus. Representatives of the beautiful half of humanity claim that they develop early toxicosis in view of the development of similar symptoms.

    To stop bleeding in the second month of the course of the disease, the uterine cavity is scraped out. After the treatment, the woman is monitored for two years. At the same time, she needs to be systematically tested for chorionic gonadotropin. If there are no negative test results. Then the woman is allowed to re-become pregnant only after two years.

    Bubble drift is a specific pathological condition that requires timely therapy. For this purpose, the fairer sex needs to seek help from a doctor.

    Features of implantation bleeding

    Bleeding is most common in the first trimester of pregnancy. It, in this case, is not dangerous for the embryo, so many doctors class it as normal.

    When the ovum is implanted into the lining of the uterus, a vessel is touched. As a result, the fairer sex observes the appearance of minor bleeding from the vagina. In most cases, the pathological process is observed on the expected days of the next menstrual cycle. That is why many of the fairer sex perceive the appearance of bloody discharge during menstruation, not knowing about the beginning of pregnancy.

    When this pathology appears, the discharge is scarce. Their maximum duration is two days. The woman does not observe an increase in bloody discharge. When implantation bleeding occurs, in most cases, therapy is not performed.

    Doctors do not classify implantation bleeding as pathological processes. That is why it cannot be treated.

    Frozen pregnancy

    The pathological process can be observed in patients up to the 12th week of pregnancy. The most common cause of a frozen pregnancy is hormonal deficiency. Also, pathology can be observed against the background of genetic disorders of the development of the fetus in the womb. If the fairer sex has infectious diseases, then this can lead to a frozen pregnancy.

    In some cases, the pathology proceeds without symptoms. But most often it is manifested by scanty secretions, which are of a bloody nature. When carrying out an ultrasound examination, the signs of life of the embryo are not established. Women note that their signs of pregnancy are abruptly disappearing.

    The mammary glands become soft. During the period of the gynecological examination, it is noted that the size of the uterus does not correspond to the duration of pregnancy.

    When a frozen pregnancy appears, a woman is hospitalized without fail, and the cavity of her uterus is scraped out.

    First aid

    Regardless of the cause of the appearance of the pathological process, a woman must be provided with first aid. If a girl observes spotting during pregnancy, then she must definitely seek help from a doctor.

    With minor bleeding, a woman can go to see a doctor in a day hospital.

    If you have bright red blood or profuse discharge, you must call an ambulance. If, during bleeding, a woman loses consciousness, she is thrown into sweat, there is severe soreness, then this indicates the course of such processes as an ectopic pregnancy or rupture of the fallopian tube. In this case, it is necessary to inform the ambulance about this, since every minute is important.

    Before the arrival of the doctor, the fairer sex should be in a horizontal position. Her legs must be slightly raised above the level of the body. During this period, it is strictly forbidden to take medications. Otherwise, the woman will eliminate the symptoms, which will greatly complicate the diagnosis process for the doctor.

    During the period of bleeding, a woman needs to trust the doctors and not take any measures on her own, which will ensure the effectiveness of the treatment.

    Prevention and prognosis

    No specific prophylaxis is performed in early pregnancy. This is due to the fact that the cause of the appearance of the pathological process is a variety of genetic disorders that are not associated with the influence of environmental factors.

    The patient needs to lead a healthy lifestyle. A woman is advised to properly organize the daily routine and provide a balanced diet. After the onset of pregnancy, stressful situations should be completely excluded.

    If a woman has diseases of the genital organs, then they must be treated in a timely manner. After pregnancy, it is strictly forbidden to smoke and take alcoholic beverages. Before taking certain medications, a woman should consult with a gynecologist.

    Various factors influence the prognosis of pregnancy. In the absence of changes in the uterus, it is possible to maintain pregnancy. With a slight shortening of the cervix and a slight opening of the external pharynx, timely treatment will also make it possible to preserve the fetus.

Bleeding during pregnancy belongs to the group of obstetric bleeding, that is, those that occur during gestation and childbirth, as well as after childbirth. They are considered a serious complication, as they are often the cause of maternal death.

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Bleeding during pregnancy: features

Blood discharge in a given period of a woman's life is characterized by certain criteria:

  • sudden onset of bleeding;
  • massive blood loss;
  • first of all, the fetus suffers (therefore, emergency delivery is often practiced);
  • except in some cases, blood loss is accompanied by severe pain;
  • bleeding during pregnancy forms a rapid depletion of the defenses and compensatory reactions of the woman's body;
  • a sharp decrease in the BCC (circulating blood volume) with disturbances in the work of the heart;
  • the risk of disseminated intravascular coagulation (disseminated intravascular coagulation) increases significantly.

Causes of bleeding during pregnancy in the first and second trimesters

There are a lot of factors that can provoke the development of bleeding during this period of pregnancy. The reason directly depends on in which trimester it happened.

Bleeding in early pregnancy occurs due to the following reasons:

  • spontaneous miscarriage;
  • cystic drift;
  • implantation bleeding;
  • frozen pregnancy;
  • gynecological diseases.

Medical tactics, algorithm and treatment regimen depend on the cause that triggered the bleeding before the 20th week of pregnancy.

Symptoms and treatment of bleeding during an ectopic pregnancy

It is also called ectopic pregnancy, in which the egg is implanted after fertilization and begins to develop outside the uterine cavity. Typical places of its localization are tubes, abdominal cavity, ovaries, cervix, rudimentary horn (one-horned uterus).

An ectopic pregnancy is formed as a result of such pathologies in the anamnesis:

  • adnexitis;
  • abortion;
  • genital infantilism;
  • endomyometritis;
  • surgical interventions on the internal genital organs;
  • hormonal imbalance.

It can be progressive and disrupted due to a ruptured tube or ovary. In some cases, this condition ends with a tubal abortion.

The main symptom in this case is bloody discharge during pregnancy, which is "smeared", women have a delay in menstruation, she complains about. An ectopic pregnancy can also cause an acute abdomen, a medical emergency due to a ruptured fallopian tube. This type of pregnancy can develop up to a maximum of 8 weeks, and after that the tube ruptures and bleeding (internal and external) opens.

A gynecological examination and an ultrasound scan must be performed in order to correctly verify the diagnosis.

Further treatment tactics are as follows:

  • assessment of a woman's condition;
  • determination of the degree of blood loss;
  • collection and specification of anamnesis (gynecological and obstetric);
  • urgent hospitalization in the gynecological department;
  • transportation of a woman should be carried out in a horizontal position, the head end must be lowered;
  • it is important to maintain blood pressure figures at an optimal level;
  • in case of massive blood loss, the patient is hospitalized by the resuscitation and surgical team;
  • all further measures are developed and taken already in the hospital.

Causes and symptoms of bleeding during early miscarriage

The correct name for this condition is spontaneous abortion, which is considered to be the termination of pregnancy before 28 weeks. With it, a woman's cervix opens, and the ovum is partially or completely expelled from the uterine cavity.

The reasons that can provoke an early miscarriage are as follows:

This pathology is accompanied by pain with localization in the lower abdomen, increased tone of the uterus, bloody discharge, turning into bleeding. The condition of a woman directly depends on the amount of blood loss, the duration, the presence of anemia and other diseases.

Important: in case of spontaneous miscarriage, it is necessary to stop bleeding in time in order to avoid hemorrhagic shock, which occurs with the loss of a large volume of blood (individually for each patient). If the pregnancy cannot be saved, they resort to scraping.

Bleeding at 12 weeks gestation is considered an early abortion and is often due to an unexplained cause. From 13 to 28 weeks we are talking about late abortion. 2-8 pregnancies out of 100 end in spontaneous miscarriage due to various causative factors.

Bloody discharge has a different characteristic (from smearing to profuse), as well as pain syndrome (from aching to dull pain in the lower abdomen). Pregnancy is usually saved in the event of a threatening and incipient abortion, but the more blood is lost, the worse the prognosis.

Spontaneous abortion has a gradual course:

  • Threatened miscarriage. This condition can be accompanied by very scant bloody discharge, the pain is mild and has a dull aching character with localization in the lower abdomen.
  • Started abortion. With it, the release of blood will also be scarce, and the pains are cramping. This stage of spontaneous miscarriage usually proceeds with satisfactory health. The woman should be taken to a gynecological hospital to resolve the issue of the feasibility of maintaining the pregnancy. The prognosis in this case may be favorable, but it all depends on the amount of blood loss.
  • Abortion in progress... The patient has massive bleeding and cramping pain in the lower abdomen. This condition requires immediate hospitalization and appropriate measures (curettage of the uterus, blood transfusion to replace lost blood).
  • The abortion is incomplete. The blood is secreted in clots and has a dark tint, it can be a lot. Pain is necessarily present. In this case, it is impossible to maintain pregnancy, therefore, they resort to scraping the uterine cavity.
  • Complete spontaneous miscarriage. It most often occurs very early in pregnancy. The clinical picture is as follows: uterine contraction, opening of the cervical canal, removal of the ovum with some blood from the uterine cavity, closure of the cervical pharynx and cessation of bleeding. A complete spontaneous abortion does not require emergency care, but the woman is still hospitalized. Diagnostic curettage is performed in the hospital. This procedure allows you to make sure that there are no particles of the ovum left in the uterine cavity.

Treatments for early spontaneous abortion

The outcome of the treatment of bleeding during pregnancy largely depends on the timely treatment of a woman in a medical institution and her strict observance of all the doctor's prescriptions.

The complex of therapy for such conditions includes:

  • The first and foremost rule for a woman who is at risk of early miscarriage is strict bed rest.
  • Full emotional peace.
  • If necessary, hormone therapy agents are prescribed (Progesterone, Utrozhestan).
  • Infusion therapy is also carried out (intravenous infusion of solutions according to the prescription of the attending physician).

Treatment should take place in a hospital under the supervision of the attending gynecologist. If the cause can be eliminated and at the same time also maintain the current pregnancy, then the woman should be under medical supervision until delivery.

Early bleeding through clots: causes, symptoms, prognosis

The presence of clots in bloody discharge during pregnancy is, with a high probability, the release of fragments of tissue from the embryo. Often a woman notices clots when visiting the toilet or after lifting weights. The process itself is accompanied by cramping pains (similar to labor pains). This bleeding is an early miscarriage and is very common during the first 12 weeks. Doctors will not maintain such a pregnancy, especially if the blood is red and there are clots.

Note:the appearance of the blood clots themselves (brown, scarlet, red), as well as the proposed symptomatology, can be symptoms not only of a miscarriage, but also of such pathologies:

  • frozen pregnancy;
  • detachment of the ovum;
  • cervical or tubal pregnancy.

These conditions are very dangerous for the life and health of a woman, therefore, they require urgent care and hospitalization.

Bleeding in early pregnancy with cystic drift

This pathology is a type of trophoblastic diseases that are formed from derivatives of female and male germ cells. Bubble drift can develop both during physiological and ectopic pregnancy, after childbirth, artificial abortion, with inflammatory processes of the reproductive system, hormonal disorders. This disease is characterized by the presence of modifications in the chorion: there is an increased size of the villi with the formation of vesicle-like elements on them. It affects mainly women at a young age from 20 to 30 years old.

Symptoms of cystic drift:

  • delay in menstruation up to 2-4 months (a woman considers herself pregnant);
  • bloody discharge (they appear as a result of the rejection of bubbles) with the presence of the very bubbles in them;
  • during a gynecological examination, the uterus does not correspond to the expected gestational age;
  • when performing ultrasound at week 20, the fetus in the uterus is not visualized, but a picture of a "snow storm" is visible;
  • the clinic of early toxicosis is very pronounced;
  • the titer of chorionic gonadotropin in the blood is 1000 times higher than normal;
  • bleeding can only be stopped by scraping the uterine cavity.

note: This pathology is an indication for constant observation in the antenatal clinic for 2 years with a systematic test for chorionic gonadotropin. Re-pregnancy is allowed only after 2 years with negative research results.

First trimester implantation bleeding

It is considered a variant of the norm, since it does not pose a danger to the embryo. The mechanism of its development is as follows: the ovum is implanted into the lining of the uterus, during this process a vessel can be affected, which causes minor bleeding in women in the early stages of pregnancy. This usually happens on the days when the expected next menstrual cycle was supposed to begin. Therefore, women often take implantation bleeding for the next menstruation, since they simply do not know about pregnancy yet.

The clinical picture in this case will be as follows:

  • scanty discharge;
  • the duration of the discharge from several hours to 2 days maximum;
  • bleeding does not increase.

Note:if the discharge is more abundant and accompanied by pain, then these are signs of another pathology, and not implantation bleeding.

Early bleeding due to a frozen pregnancy

With this pathology, the fetus freezes in the early stages up to 12 weeks. The reason usually lies in genetic disorders of the embryo, hormonal deficiency, acute infectious pathologies, which can be diagnosed. Sometimes this condition is asymptomatic for a woman.

In other cases, these symptoms are observed.:

  • scanty discharge of a bloody nature;
  • lack of signs of fetal activity on ultrasound;
  • lower abdominal pain;
  • a sharp disappearance of signs of pregnancy;
  • softening of the mammary glands;
  • discrepancy between the size of the uterus and the gestational age.

Therapeutic tactics for a frozen pregnancy and accompanying bleeding is reduced to hospitalization of a woman and curettage of the uterus.

Early pregnancy bleeding: what to do?

Given that the causes of bleeding can be different, if they appear, you should immediately consult a doctor.

  • If the bleeding is insignificant, there is no pain and it is not far from the antenatal clinic, you can seek help there yourself.
  • When the blood is bright or the bleeding is strong, you need to call an ambulance and wait for it.

With a normal pregnancy, a woman's menstruation stops. In some cases, bearing a fetus may be complicated by bleeding from the genital tract. Blood discharge can be of varying intensity and character - scanty, abundant, smearing, scarlet, brown. In any case, the separation of blood from a woman's vagina while waiting for a baby is a reason for an immediate visit to a gynecologist, otherwise the pregnancy may be terminated.

Can you bleed during pregnancy?

Separation of blood from the vagina during the period of gestation can occur in many reasons, the most common of them are:

  • ectopic pregnancy;
  • implantation bleeding;
  • the threat of spontaneous abortion;
  • detachment of the ovum and its membranes (abortion in progress);
  • placental abruption;
  • placenta previa;
  • damage to the mucous membrane of the vagina and cervix during gynecological diagnostic procedures or rough sexual intercourse;
  • discharge of the mucous protective plug.

If bloody streaks are found, a woman should consult with her gynecologist or contact the nearest maternity ward for examination, then in threatening situations, pregnancy and the child's life can be saved. Depending on the cause of the bleeding, the expectant mother will be prescribed treatment, which includes:

  • hemostatic drugs;
  • bed rest;
  • sexual and psycho-emotional peace.

Initial bleeding in expectant mothers

The appearance of blood in the early stages of pregnancy requires immediate action from a woman and an urgent appeal to a gynecologist. This is usually a sign that pregnancy has occurred and the embryo has successfully attached to the lining of the uterus. During implantation, damage to the small blood vessels of the endometrium occurs, which is accompanied by a small release of scarlet blood. Normally, the bleeding ceases as early as 2-3 days after implantation, while the discharge should not increase.

Blood on the underwear along with cramping pains in the abdomen and lower back may indicate an abortion in progress or a spontaneous miscarriage. With a timely visit to the clinic, the bleeding can be stopped and the child's life saved.

To bleed early in gestation may be due to attachment of the ovum in the fallopian tube... In this case, in addition to bloody discharge and pain in the lower abdomen, the woman will be disturbed by weakness, dizziness, drop in blood pressure, shortness of breath, and increased heart rate. Tubal rupture is a serious complication of an ectopic pregnancy and can be fatal if the patient does not receive emergency medical attention.

Bleeding at 10, 11, 12 weeks

Blood from the vagina at 10, 11, 12 weeks of gestation in most cases is caused by the fading of pregnancy or spontaneous abortion. This can happen for various reasons - from chromosomal abnormalities to previous infections, as a result of taking medications, abdominal injuries, cervical pathology.

Erosion of the uterine cervix can also bleed, however, the doctor can establish the exact cause by means of an ultrasound scan and examination of the patient. As a rule, they refuse to examine on a chair, so as not to provoke even more bleeding.

Bleeding in the second trimester

Second trimester vaginal bleeding is most commonly caused by abnormal placenta previa- full or marginal. In this case, as the uterus grows, the blood vessels extending from the placenta rupture and blood is poured out. Sometimes bleeding can be severe enough, which threatens with acute fetal hypoxia and its death. With partial placental abruption, blood from the genital tract is scarlet.

Bleeding in the third trimester

The appearance of blood from the vagina in the third trimester of pregnancy is caused by:

  • placental abruption;
  • full or partial placenta previa;
  • the beginning of labor.

Detachment of the baby seat is a formidable complication that can lead not only to the death of a child, but also to the death of his mother.

Brown or bloody discharge in expectant mothers after examination by a gynecologist

After examination on a gynecological chair or diagnostic procedures, scarlet or brownish blood may be released from the genitals of a pregnant woman. This is most often caused by damage to cervical erosion or injury to the vaginal mucosa instrumentation. If the bleeding does not increase and the general condition of the expectant mother remains normal, then there is no reason for concern, one in order not to provoke increased bleeding in the next few days, the patient should refrain from sexual intercourse, lifting weights and taking a hot shower (bath).