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Bleeding During Pregnancy

What can cause bleeding during pregnancy?
How is bleeding during early pregnancy checked?
When does miscarriage happen?
What are the signs and symptoms of miscarriage?
Is treatment needed after a miscarriage?
What is an ectopic pregnancy?
What risks are associated with ectopic pregnancy?
How common are ectopic pregnancies and who is at risk?
What causes bleeding late in pregnancy?
What is placental abruption?
What is placenta previa?
Can bleeding be a sign of labor?

What can cause bleeding during pregnancy?

  • Manifests as vaginal bleeding or spotting
  • Can have many causes.
  • Some are serious and some are not.
  • Stage of Pregnancy
    • Bleeding may occur early or late in pregnancy.
    • Many women have vaginal spotting or bleeding in the first 12 weeks of pregnancy.
  • Sex
    • Bleeding of the cervix may occur during sex.
  • Infection
    • An infection of the cervix also can cause bleeding.
  • Significance
    • Slight bleeding often stops on its own.
    • However, bleeding during pregnancy may mean something more serious.
    • You may have a higher chance of
      • Going into labor too early (preterm labor)
      • Having an infant who is born too small
      • Having a miscarriage.

How is bleeding during early pregnancy checked?

  • Your health care provider may do a pelvic exam.
  • Questions your health care provider will ask
    • How much blood you have passed and how often bleeding has occurred.
    • Whether you have had any pain, and if so, its location and severity.
  • HCG
    • A blood test may be done to measure human chorionic gonadotropin (hCG).
    • This substance is made by your body during pregnancy.
    • You may have more than one test because hCG levels increase throughout pregnancy.
  • Rh
    • Your blood type also will be checked to see if you need treatment for Rh sensitization.
  • Ultrasound
    • Ultrasound may be used to find the cause of the bleeding.
  • Sometimes the cause is not found.

When does miscarriage happen?

  • Miscarriage can occur any time in the first half of pregnancy.
  • Most often it occurs in the first 13 weeks.
  • It happens in about 15–20% of pregnancies.

What are the signs and symptoms of miscarriage?

  • Vaginal bleeding
    • Sometimes the bleeding stops and pregnancy goes on.
  • Cramping pain
    • Felt low in the abdomen (often stronger than menstrual cramps)
    • Many women who have vaginal bleeding have little or no cramping.
    • Other times the bleeding and cramping may become stronger, leading to miscarriage.
  • Tissue passing from the vagina

Is treatment needed after a miscarriage?

  • If some tissue stays in the uterus, bleeding often continues.
  • Treatment options.
    • Medication may be used to help you pass the tissue.
    • Removal of tissue
    • The tissue may be removed by dilation and curettage (D&C).
    • It also may be removed by a suctioning device.
    • This is called suction curettage.
  • Sometimes more than one option is needed.

What is an ectopic pregnancy?

  • When the fertilized egg does not implant in the uterus.
  • Implants somewhere else, often in one of the fallopian tubes.
  • Causes pain and bleeding early in pregnancy.

What risks are associated with ectopic pregnancy?

  • Fallopian tube rupture
    • A rupture needs prompt treatment.
    • There may be internal bleeding.
    • Blood loss may cause weakness, fainting, pain, shock, or death.

How common are ectopic pregnancies and who is at risk?

  • Much less common than miscarriages.
  • Ccur in about 1 in 60 pregnancies.
  • Women at a higher risk
    • Infection in the fallopian tubes (such as pelvic inflammatory disease)
    • Previous ectopic pregnancy
    • Tubal surgery

What causes bleeding late in pregnancy?

  • Common causes
    • Inflamed cervix
    • Growths on the cervix.
    • Problems with placenta
      • Placental abruption
      • Placenta previa
      • Heavy bleeding usually involves a problem with the placenta.
    • Preterm labor

What is placental abruption?

  • The placenta is attached to the uterine wall.
  • It may detach from the wall before or during labor.
  • This may cause vaginal bleeding.
  • It often causes pain, even if bleeding is light or not seen.
  • When the placenta becomes detached, the fetus may get less oxygen.
  • Prompt care is needed.

What is placenta previa?

  • When the placenta lies low in the uterus, it may cover the cervix.
  • That means it partly or completely blocks the opening.
  • It may cause vaginal bleeding.
  • This type of bleeding often occurs without pain.

Can bleeding be a sign of labor?

  • Late in pregnancy, vaginal bleeding may be a sign of labor.
  • Bloody show
    • A small amount of mucus and blood is passed from the cervix just before or at the start of labor.
    • It is common.
    • It is not a problem if it happens within 3 weeks of your due date.
    • If it happens earlier, you may be going into preterm labor.
  • Other signs
    • Vaginal discharge
    • Change in type of discharge (watery, mucus, or bloody)
    • Increase in amount of discharge
    • Pressure in the pelvis or lower abdomen
    • Low, dull backache
    • Stomach cramps, with or without diarrhea
    • Regular contractions or uterine tightening
  • If you have any of these signs or symptoms, contact your health care provider right away.

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