Uterine bleeding during pregnancy

Bleeding during pregnancy can threaten the life of the future mother and fetus. The reasons for it may be different, but under any circumstances the patient needs careful observation, and in some cases - a caesarean section. Prenatal hemorrhages are bleeding from the birth canal, observed after the 28th week of pregnancy.

They can lead to insufficient blood flow to the fetus and are potentially dangerous for both the mother and the baby. In the article "Uterine bleeding during pregnancy" you will find a lot of interesting and useful information for yourself.

Causes

There are several causes of prenatal bleeding. The primary diagnosis is made in view of their intensity and the presence of other symptoms, most of them are uninvolved and begin suddenly. For any bleeding during pregnancy, you should immediately consult a doctor. The source of bleeding is usually the vessels of the placenta or cervix. It is necessary to exclude the low location of the placenta in the uterine cavity (praevia).

• Bleeding from the cervix

During pregnancy, there may be an ectropion of the cervix (eversion of the mucous membrane of the cervical canal). The mucous membrane of the cervical canal is very tender and can bleed. This bleeding is usually uninfluential and often occurs after sexual intercourse. The development of ectropion can be triggered by an infection that is accompanied by pathological excretions from the vagina.

• Placenta praevia

The presentation of the placenta refers to its attachment in the lower uterine segment at the gestation period of more than 28 weeks. Before the 18th week of pregnancy, every sixth woman has a low placental location. However, as a rule, as the size of the uterus increases, the placenta position changes, and in most cases by the 28th week it is determined at the bottom of the uterus. Prevalence of the placenta is more common in smokers who have undergone cesarean delivery and in older women.

• Premature detachment of the placenta

With premature detachment, the placenta is separated from the uterine wall. This pathology entails severe consequences for the fetus, especially when detaching an extensive site. Bleeding can be complicated by premature birth. Detachment of a significant part of the placenta requires immediate caesarean section, since in this case the flow of blood to the fetus is disrupted. With detachment of a smaller area, emergency delivery is not performed, but the condition of the mother and fetus should be carefully monitored.

• Edge of the placenta

Bleeding may occur when the placenta is in the marginal position. Usually it is low-intensive and does not harm the mother and the fetus. The diagnosis is made after the exclusion of the pathology of the cervix, previa and premature detachment of the placenta. As a rule, such bleeding stops easily. To determine the cause of bleeding in the prenatal period, a thorough examination of the pregnant woman is necessary. To assess the condition of the mother and fetus, several methods are used. For any bleeding during pregnancy, a woman should be examined immediately by a doctor. It is possible to suspect its cause already on examination - for example, with placental abruption, the uterus is dense and painful, with placenta previa, the fetus often occupies the wrong position (breech presentation of the fetus) and its head does not enter the pelvic cavity.

Vaginal examination

Vaginal examination is performed only after exclusion of placenta presentation with the help of ultrasound, because with this pathology it can provoke massive bleeding. When vaginal examination can reveal the pathology of the cervix, for example ectronion. To determine the cellular composition, the blood of the pregnant woman is analyzed. It is also necessary to select donor blood for blood transfusions in an emergency situation. Usually, a venous catheter is placed in the pregnant woman.

Assessment of the fetus

To assess the condition of the fetus, cardiotocography (CTG) is performed, which registers its cardiac activity. Bleeding from the placenta may be accompanied by uncoordinated uterine contractions. With the help of a cardiotocograph, the first contractions and signs of premature birth can be recorded. Ultrasound is used to exclude placenta previa and to observe the development and activity of the fetus. A pregnant woman with bleeding is usually sent to a hospital for observation. More often there are low-intensity bleedings, which stop on their own (only control of the condition during the day is required). However, with placenta previa, it is difficult to make any predictions, and many patients need long-term hospitalization. The greatest risk of developing massive bleeding occurs when the placenta completely overlaps the cervix. This makes it impossible for a natural delivery, so medical personnel should be prepared for an emergency cesarean section.

Premature birth

Moderate bleeding of any etiology increases the risk of premature births - spontaneous or artificial, by caesarean section. The most clinically significant problem for a premature baby is the immaturity of the lungs. At the risk of premature birth low doses of steroids are prescribed to accelerate the maturation of the fetal lungs. It is safe for the unborn child.

Blood types

Approximately one in 15 women has a negative Rh factor of blood. To prevent Rhesus conflict during subsequent pregnancies, such patients are prescribed injections of anti-D immunoglobulin within 72 hours after bleeding.