Waiting for the birth of a child is the most beautiful time in the life of every woman. However, even this period can give a woman a lot of anxiety, one of which is bleeding. Bleeding during pregnancy is a pathology that is most common in pregnant women today. A similar phenomenon during this period is fraught with serious complications, which far from everybody knows.
Many women are absolutely convinced that during childbearing periods can be observed. However, I hasten to immediately dissuade you, this is normal can not be. If such cases occur, it is extremely rare (for a hundred people three percent of cases), and, as a rule, at the very beginning of pregnancy. In this case, the bleeding has the form of spotting and occurs on the background of implantation of the ovum to the wall of the uterus. Usually this period coincides with the period of the onset of menstruation. For the duration of such a discharge of blood may take several hours. Only it can be considered normal, however, as a rule, usually a woman does not even realize her position, taking such bleeding for menstruation. Such blood discharge does not represent a risk for pregnancy.
Causes of bleeding during pregnancy and its treatment.Bleeding during gestation can occur in both early and late periods. It is the timing that suggests one or another reason that provoked this pathology. For up to three months of pregnancy, blood may signal the onset of a spontaneous miscarriage, an ectopic pregnancy, a non-developing missed pregnancy, or a vesicle drift. In the later stages of childbearing (after twelve weeks), bleeding can be triggered by placenta or placental abruption.
For future mothers, I note that not always bleeding is a signal that there are some problems with the fetus, because it can be provoked by a simple exacerbation of gynecological diseases, for example, uterine fibroids or cervical erosion. Even the usual trauma of the female genital organs can provoke the occurrence of a similar phenomenon.
Bleeding during childbirth can be of a different nature and vary in intensity – spotting, moderate, abundant with clots. Often this process in a woman is combined with strong pain in the abdomen of a sharp, pulling and cramping character. In addition, the woman has other serious symptoms, in particular weakness, her blood pressure goes down, her heart rate increases. Only the characteristics of bleeding cannot be diagnosed.
It is important to say that even if the bleeding during pregnancy (no matter how long) is of a minor nature, it is still necessary to immediately consult a doctor. Do not act and calmly wait for their termination is impossible, because it can threaten the life of the fetus or mother. At the reception, the doctor should describe in detail the existing symptoms and the nature of the discharge.
It should also be noted that the bleeding in the case of gestation can also be spontaneous. This is due to the fact that during this period the cervical tissue softens due to an increase in the production of hormones and increased blood flow to the genitals, becoming friable. Against this background, bleeding develops, which may occur by itself or after sexual intercourse. Most often, the discharge is bright red in color, is moderate or smearing in nature and ceases on its own. You should not worry about this either.
However, the cause of bleeding can be more serious pathology, in particular, the threat of abortion. The reasons for its development can be mass. In such a state, a woman has pain in the lower abdomen and lower back of a pulling and aching nature, bloody discharge of the smearing property. In this case, the further preservation of pregnancy depends on the speed of treatment to the doctor and the appointment of optimal therapy. With the threat of miscarriage, treatment and remedial measures are prescribed to preserve pregnancy and stop bleeding. In the case of the viability of the fetus in early pregnancy (as indicated by ultrasound data), women are prescribed hemostatic agents, antispasmodics to reduce the tone of the uterus, hormonal drugs (gestagens up to 16 weeks) to maintain progesterone levels, as well as vitamins and trace elements (vitamin E, Yodomarin , folic acid, MagneV6). Proper and timely therapy gives good results. If the therapy does not help, and the miscarriage still happened, the uterus is scraped out to eliminate the remnants of the ovum. In this state, a woman needs rest, bed rest and the absence of stressful situations. Hospital treatment is recommended. If you let the situation take its course, the threat of interruption eventually turns into a spontaneous abortion, in which there are marked pains in the lower abdomen of a cramping nature and abundant bleeding.
Cystic or missed abortion may also cause heavy bleeding. Intrauterine fetal death after a week leads to spontaneous abortion, and, as a consequence, bleeding. This occurs as a result of the beginning proliferation of placental tissue. In this case, the woman does not experience any pain or discomfort. As a result, she is prescribed curettage, and is also recommended to monitor hormonal status for a year.
Spotting can also occur due to chromosomal abnormalities and other abnormalities that lead to spontaneous miscarriage. Against this background, to prevent the onset of post-hemorrhagic shock, a woman is scraped from the uterus to eliminate the remnants of the ovum, placenta, and other parts.
Another serious bleeding factor is ectopic pregnancy. This condition is characterized by the development of pregnancy outside the uterus. This usually occurs due to obstruction of the fallopian tubes. The indication is emergency surgery. Usually, the fallopian tube is removed and the abdominal cavity is then washed. In addition to spotting dark red in this situation, the woman has bouts of pain cramping (often to loss of consciousness).
Emerged bleeding at a later stage of pregnancy can be life-threatening, both for the mother and the fetus. Here you can note the placental abruption. This phenomenon most often occurs in women at risk (chronic gynecological diseases, multiple pregnancies, preeclampsia, abdominal injuries, polyhydramnios). It should be noted that the blood may not be, but here is a strong pain in the abdomen, resembling labor, it will be necessary. Plus, there is hypertonus of the uterus. In this situation, it will be bad not only for mummy, but also for the fetus, whose condition will get worse every minute. Therefore, in this situation, doctors on an emergency basis carry out delivery by surgery, regardless of the duration of pregnancy and the viability of the fetus. In addition, prescribed infusion therapy (plasma and red blood cell transfusions). Bleeding can be of different intensity.
Another factor in this pathology in the second half of pregnancy may be placenta previa (partial or complete overlap of the internal uterine throat by the placenta). Against the background of thinning of the uterine wall, the vessels rupture and bleeding occurs, the color of which is usually dark. It is possible to identify the presentation by repeated uterine bleeding, the intensity of which increases with each repetition. The process is painless. Further management of the pregnancy depends on its duration, the volume of blood lost and the type of presentation (full or partial). With insignificant secretions in order to preserve the pregnancy, women are prescribed antispasmodics, magnesia in the form of droppers, beta adrenomimetics, disaggregants and vitamins. In the case of placenta previa, spotting may occur before the birth itself. Therefore, a woman is placed in the maternity hospital, where a cesarean section is performed when the pregnancy reaches its full-term term. In case of abundant discharge, a Caesarean section is performed on an emergency basis, regardless of whether the pregnancy is full or not. To compensate for blood loss, plasma and erythrocyte mass transfusions are prescribed.
A ruptured uterus can also cause bleeding in the last stages of a baby’s birth. Usually this happens in women who have a scar from the surgical intervention, induced abortions, frequent births, or whose uterus is overgrown due to polyhydramnios and multiple pregnancies. The bleeding in this case is mixed (internal and external), combined with constant pain or cramping attacks, and the condition of the woman often causes hemorrhagic and traumatic shock. With the existing threat of uterine rupture, women are under the special supervision of gynecologists and obstetricians, in the later stages of the woman is placed in hospital.
Diagnosis of the cause of bleeding during pregnancy.In order to accurately diagnose the causes of the bleeding that has occurred, a gynecologist examination is required, as well as in-patient diagnostic tests. In addition, smear tests are taken, blood tests are done, including HIV, hepatitis, syphilis, urinalysis. Also conduct an ultrasound examination of the pelvic organs and fetus, determine the blood group and Rh factor. As the pathology is revealed, the doctor may prescribe additional tests: if a non-developing pregnancy is suspected and a miscarriage, additional blood is screened for hCG, hormones, TORCH infections, an STI smear, and if an ectopic pregnancy is suspected, diagnostic laparoscopy is carried out, and if the person has a vesical drift, they determine and examine hCG level in the blood. In the later stages, no additional examinations are performed to identify the causes of the bleeding that has occurred.
Women who have Rh negative blood, after curettage of the uterus, surgery for ectopic pregnancy and cesarean section, it is recommended to administer antiresus D-immunoglobulin as a preventive measure for the occurrence of Rh-conflict between the mother and the fetus when the fetal blood enters the mother’s bloodstream.
All women in a position who, against the background of the arisen bleeding, were able to maintain a pregnancy, are recommended a complete rejection of sexual intimacy with a partner, as well as complete emotional peace. In addition, a number of drugs used in the course of inpatient treatment may be prescribed for and after discharge to prevent the risk of miscarriage.
During the period of rehabilitation after the cessation of bleeding, prescribe drugs with a sedative effect. Non-pharmacological and physiotherapeutic methods of treatment, in particular acupuncture and the like, are also recommended.
Prevention of bleeding:
- abortion prevention;
- exclusion or severe limitation of physical activity during childbirth;
- treatment of all gynecological diseases before pregnancy;
- compulsory birth of a child up to thirty-five years.