Why does bleeding start during pregnancy. There is bleeding during pregnancy - what to do. Causes of discharge with blood during pregnancy. What is an ectopic pregnancy

The waiting time for a baby becomes the most pleasant and natural for every woman. With the onset of pregnancy, tremendous changes occur in the body of the fair sex. So, many expectant mothers are concerned about the issue of vaginal discharge. This article will tell you about what kind of bleeding occurs during and in later periods of fetal development. You will find out what can cause a particular pathology. It is also worth mentioning how to stop bleeding in the early stages.

What happens in the body after conception?

Immediately after the fusion of two gametes (male and female), a set of cells is formed, which begins to continuously divide and move towards the reproductive organ. When the fetal egg enters the uterus, it attaches to the wall covered with the endometrium. It is from this moment that it can be said that the pregnancy has come.

In most cases, the bearing of a baby in women occurs without features. However, there are times when bleeding occurs during early pregnancy. In this case, you should always consult a doctor. Only an experienced specialist will be able to soberly assess the situation and prescribe the necessary treatment. With timely correction, it is possible to maintain the pregnancy and safely bear the child.

Early pregnancy: a general description

To begin with, it is worth saying that this is a period of time. Early pregnancy is considered a period up to 12 weeks. It is during this time period that most interruptions in the development of the embryo occur.

Many doctors say that when you have crossed this line, you can be calm. Pregnancy is more, as a rule, nothing threatens.

Bloody (early term)

While waiting for the baby, the internal hormonal background of a woman is completely rebuilt. As a result of this process, vaginal discharge may increase. In the normal state, they are white or transparent in color, and are also characterized by the absence of any odor.

About a third of all expectant mothers are faced with such phenomena as bleeding during pregnancy. Should I panic in this case? Or can everything be left to chance? The answers to these questions directly depend on the cause of the pathology. Only a doctor can determine what contributed to the occurrence of unusual discharge. Consider what causes of bleeding in early pregnancy are the most common

The first reason: damage to the endometrium by the fetal egg

This situation can be attributed to one of the most harmless. This condition does not threaten the unborn baby. Often, when women are unaware of their new position, they mistake the discharge for menstruation that has begun ahead of time.

Implantation occurs approximately one week after ovulation. It is the same time left before the start of a new cycle. When the fetal egg descends into the reproductive organ, it immediately begins to penetrate the endometrial layer. Thus, the embryo “digs” a hole for itself for further stay and growth. During this process, minor damage to small vessels may occur. Broken capillaries secrete drops of blood, which are subsequently mixed with abundant vaginal discharge and exit the genitals. It is at this point that a woman may notice that she has a brownish or pinkish discharge.

Such bleeding during pregnancy (at an early stage) does not pose any danger. They usually go away on their own within a few days. It is worth noting that in this case, the amount of secreted mucus gradually decreases, and it brightens.

The second reason: cervical erosion

Bleeding during pregnancy (early and late) may occur due to damage to the mucous membrane of the cervical canal. Most often, cervical erosion manifests itself in the normal state (before conception). However, with the onset of fertilization, the mucous membrane becomes even more sensitive. Vessels and capillaries inside the cervix overflow with blood. That is why, with erosion during pregnancy, spotting often appears.

Such a pathology does not pose a threat. However, doctors recommend undergoing a certain examination procedure called a colposcopy. It is this diagnosis that allows you to assess the complexity of the disease. It is recommended to treat erosion only after childbirth. Otherwise, there may be problems with the opening of the cervix.

The third reason: polyps and cysts of the endocervix

Bleeding during early pregnancy or at a later time may occur due to neoplasms in the cervix. Most often, such a pathology is a polyp or a small cyst of the endocervix. Since the cervix is filled with many vessels, their minor damage may occur. In this case, droplets of blood are mixed with vaginal secretions and come out.

Such bleeding during early pregnancy or later does not pose a particular danger to the life of the fetus. However, if an infection enters the wound, infection can occur. The polyp requires mandatory treatment, but it should be carried out only after the birth of the baby.

Fourth reason: lack of progesterone

Bleeding in early pregnancy can be caused by insufficient production of the hormone. In the second phase of the cycle, progesterone is normally released in women. It is produced by the ovaries and adrenal glands. With some hormonal disorders, there may be insufficient secretion of this substance. In this case, premature contraction of the reproductive organ begins. All this leads to the fact that the fetal egg begins to exfoliate from its place and arises

Treatment in this case must be carried out necessarily. Before prescribing medication, the doctor may send you to donate blood to determine the amount of this hormone. After receiving the results, an individual dosage and correction method are selected. Most often, the following drugs are chosen for the treatment of such a pathology: Duphaston tablets, Progesterone injections or Utrozhestan suppositories. It is worth noting that taking medication in some cases takes a very long time. It all depends on the individual characteristics of the body and the further course of pregnancy.

Fifth reason: endometriosis

Bleeding in early pregnancy often has a hormonal cause. So, the disease can be caused by a disease called endometriosis. In this case, the shell of the reproductive organ grows in other places. It can appear on the ovaries, fallopian tubes, or in the vagina. After the onset of pregnancy and the cessation of the menstrual cycle, rejection of the overgrown endometrium sometimes occurs. In this case, the woman observes quite abundant spotting in the early stages of pregnancy.

Treatment in this situation should be carried out in accordance with the individual situation and the general well-being of the expectant mother.

Sixth reason: pregnancy developing outside the cavity of the reproductive organ

With an ectopic pregnancy, bleeding from the genitals of the expectant mother in the early stages can be observed. In this case, the woman begins to feel pain in the lower abdomen, weakness and nausea. Diagnosis of pathology is always carried out with the help of a blood test and an ultrasound examination. It is worth noting that an ectopic pregnancy can affect the ovary, fallopian tube, or even end up in the abdominal cavity. With the development of "tubal" pregnancy, a woman feels stronger signs of this pathology. More blurred symptoms occur when the embryo is in the ovary or peritoneum.

Treatment in this case must be carried out necessarily. It is almost always surgical.

The seventh reason: the low location of the placenta

The causes of bleeding during early pregnancy may lie in low placenta previa. If the fetal egg is attached too low or completely blocked the entrance to the uterus, then these symptoms may appear. In this case, a woman most often does not feel any additional discomfort. Allocations begin to appear after sexual intercourse, when lifting weights or strong physical exertion.

Treatment in this situation is most often carried out in a hospital. The expectant mother is assigned to bed rest. Some drugs that stop the blood may also be recommended: Tranexam tablets, Dicinon injections and others.

Eighth reason: inaccuracy

Bloody discharge in the early stages of pregnancy can be caused by banal inaccuracy. If you are prescribed a treatment in which you need to insert vaginal suppositories or tablets, then you need to do this as carefully as possible. Otherwise, the sensitive vaginal mucosa may be damaged. Also, during sexual intercourse, you need to be careful. Otherwise, the cervix may be slightly injured.

Treatment in this case is not required. However, the doctor will recommend that you continue to be careful and maintain personal hygiene in order to avoid infection of the wound.

Ninth reason: menstruation on time

Only a few pregnant women face such a situation. This category of expectant mothers has monthly menstruation, which comes strictly on time. In this case, spotting lasts several days and can be quite plentiful. Doctors are very wary of such bleeding. However, after conducting examinations and analyzes, experts come to the conclusion that nothing threatens the woman and her unborn baby. These discharges most often stop after the first three months of pregnancy.

Treatment is prescribed only if a woman has complaints.

Bleeding during pregnancy: causes, consequences

So, you know the most common causes of spotting in early pregnancy. The consequences of this disease can be very diverse.

In some cases, when erosion or banal carelessness is the cause, nothing threatens the health of the unborn baby. In this case, most likely, there will be no consequences.

If the cause of bleeding is a lack of progesterone, placenta previa, or an ectopic pregnancy, then everything can be much more serious. The consequences of such ailments can be very deplorable. That is why when they occur, you should contact your doctor as soon as possible.

Summing up and conclusion

You have learned about the causes that cause bleeding during early pregnancy. Always with such symptoms, it is worth consulting with a specialist, and not self-medicating. Don't listen to your friends' advice. Every pregnancy is different and unpredictable.

Treat bleeding during pregnancy promptly. Only in this case you will be able to endure and give birth to a healthy baby. Have a good pregnancy and childbirth on time!

- a sign that can occur regardless of the period of embryogenesis and indicates ongoing changes in the body of a woman. It can be observed with spontaneous miscarriage, ectopic pregnancy, Rh conflict, placenta previa and other conditions. This manifestation can develop against the background of general well-being or be accompanied by painful sensations in the lower abdomen, lower back, and sacrum. Diagnosis of bleeding during pregnancy is carried out on the basis of data from a gynecological examination, an ultrasound assessment of the condition of the patient and the fetus. The treatment of this pathological symptom is determined by its cause and is prescribed exclusively by a specialist.

General information

Bleeding during pregnancy is an obstetric symptom, indicating the possible development of a number of disorders, the cause of which can be both physiological changes in the body of a woman after conception, and pathological conditions. Only an obstetrician-gynecologist can finally find out the etiology of such a manifestation after a complete examination. Bleeding during pregnancy occurs in about one in five patients. In 50%, they indicate pathological changes and end in spontaneous miscarriage. In half of the patients, the symptom is physiological in nature. Bleeding occurs more often in the first and third trimester of embryogenesis.

The danger of bleeding during pregnancy lies in the fact that a variety of factors can provoke them, including those that pose a threat to the mother and fetus. In some situations, there are no other pathological signs. Any bleeding during pregnancy should be a reason for immediate medical attention. Only a specialist is able to assess the danger to the health of a woman and the fetus, as well as decide on further tactics. Timely assistance provided even with an abnormal course of pregnancy allows you to continue its management and save the life of the child.

Causes of bleeding during pregnancy

Bleeding during pregnancy can occur at any time of embryogenesis, develops both against the background of physiological changes in the woman's body, and as a result of the formation of a certain obstetric pathology. In the early stages, half of the women have a slight separation of blood due to the implantation of the fetal egg in the uterine cavity. Such bleeding during pregnancy is often regarded by the patient as menstrual, so she does not seek medical help, which in the future may make it difficult to determine the timing of embryogenesis. A similar symptom is possible with insufficient production of progesterone in the early stages of gestation.

The most common cause of abnormal bleeding during pregnancy in the first trimester is spontaneous miscarriage. This symptom appears both with a just-started and with a complete abortion. Approximately 6 weeks after conception, the symptom occurs with an ectopic attachment of the fetal egg. Also, bleeding during pregnancy at this time may indicate Rh conflict, fetal fading. Similar manifestations are characteristic of women suffering from varicose veins that feed the uterus. In this case, bleeding during pregnancy is due to increased blood supply to the tissues.

Bleeding during pregnancy in the second trimester is diagnosed much less frequently, in about 5-10% of all cases of gestation. As a rule, the symptom is due to pathological changes and in most cases indicates spontaneous late abortion or isthmic-cervical insufficiency. Sometimes the separation of blood from the genital tract is observed with intrauterine fetal death. Bleeding during pregnancy in the third trimester also always speaks of the development of gestation pathology. The most common cause is placenta previa. In this case, the embryonic organ completely or partially covers the uterine os, while due to the high load on the lower segment, placental micro-ruptures occur, which causes a similar symptom.

Less commonly, bleeding during pregnancy in the third trimester is due to premature detachment of a normally located placenta. In this situation, there is a high threat to the life of the fetus. The danger also lies in the fact that initially internal bleeding develops during pregnancy or the formation of a hematoma, and only then the blood flows out. The rarest, but most dangerous for the life of the mother and child, the cause of the development of this symptom is uterine rupture. Such a complication is diagnosed in the presence of a scar on the myometrium and tissue overstretching, provoked by polyhydramnios, a large fetus or multiple pregnancies. It is extremely rare that bleeding during pregnancy occurs due to a violation of the integrity of the membranes or umbilical cord vessels.

Also, bleeding during pregnancy can be triggered by causes that appear at any stage of embryogenesis. Such reasons include benign neoplasms - fibroids, polyposis growths in the cervical canal and uterine cavity. Often bleeding during pregnancy occurs in women with cervical erosion. Sometimes a sign occurs due to increased blood circulation in the pelvic organs. The risk of developing a symptom is also present with violent sexual intercourse, significant physical exertion, concomitant cardiovascular diseases associated with a weakening of the endothelium.

Classification and symptoms of bleeding during pregnancy

Depending on the origin of bleeding, two groups can be distinguished:

Physiological bleeding during pregnancy- arise as a result of the restructuring of the body, do not pose a threat to the health and life of the fetus or mother.
Pathological bleeding during pregnancy- indicate its abnormal course, may be accompanied by a risk to the life and health of a woman and a baby, require immediate medical attention.

The clinic of bleeding during pregnancy directly depends on the cause of this symptom. Isolation of blood from the genital tract in the early stages of embryogenesis, provoked by physiological changes, proceeds against the background of general well-being. Bleeding during pregnancy, which has developed due to the presence of polyps, erosion, fibroids in most cases also does not cause disturbances in well-being. In this case, there is a slight release of biological fluid - just a few drops, the symptom is of a short-term nature. More abundant, similar to menstrual, will be bleeding during pregnancy associated with a deficiency of progesterone.

In the case of bleeding during pregnancy associated with its spontaneous interruption, the patient is worried about constant or cramping pain in the lumbosacral region, abdomen. Additionally, nausea, dizziness, malaise, and a slight increase in body temperature may occur. Bleeding during pregnancy in this case can be of varying intensity, often in the discharge there are pieces of tissue. With an ectopic attachment of the fetal egg, as well as with a rupture of the uterus, a serious threat to the life of a woman arises. In such a situation, internal bleeding initially develops during pregnancy, and only then do pathological discharges from the external genital tract appear. There is acute pain in the abdomen with irradiation to the anal region, the lateral parts of the body. With significant blood loss, a state of shock occurs with a threat of death.

Bleeding during pregnancy in the later stages is also not always accompanied by a detailed clinical picture. In the case of placenta previa, this is the only symptom that should cause alertness in a woman and become a reason for contacting an obstetrician-gynecologist. As for the premature detachment of a correctly attached placenta, in this case, bleeding during pregnancy develops against the background of uterine hypertonicity, there is pain in the abdomen, deterioration in general well-being. During cardiac monitoring of the fetus, there is a violation of the heart rate, motor activity.

Diagnosis and treatment of bleeding during pregnancy

To identify the cause of bleeding during pregnancy, a gynecological examination of a woman is performed. With changes in physiological origin, no deviations from the norm can be detected. With pathological bleeding during pregnancy against the background of spontaneous abortion, an opening of the cervix is observed. An increase in the tone of the myometrium may indicate the onset of placental abruption. Of the laboratory diagnostic methods, an analysis is used to determine the concentration of hCG (human chorionic gonadotropin). With ectopic pregnancy and bleeding, this figure will be reduced. Instrumental diagnosis of bleeding during pregnancy is to conduct an ultrasound scan. Using this method, it is possible to assess the state of the myometrium and the embryo, the level of blood flow in the vessels, the exact localization of the placenta and (possibly) its incipient detachment. Using CTG, the diagnostician can make a conclusion about the vital activity of the fetus.

Treatment of bleeding during pregnancy also depends on the cause of the symptom. If there are no pathological changes or the manifestation is provoked by damage to the polyp, medical attention is not required. In rare cases, the doctor recommends its removal. Expectant tactics are also used in case of cervical erosion. Her cauterization is carried out after childbirth. Bleeding during pregnancy against the background of the threat of miscarriage and placenta previa requires immediate hospitalization in an obstetric hospital, followed by the appointment of drug treatment. To reduce uterine tone, sedatives, tocolytics are used. Pregnancy management in this case requires careful monitoring by a specialist.

Bleeding during pregnancy caused by ectopic attachment of the ovum, scar rupture, or completed spontaneous abortion requires hospitalization and surgical treatment. After removal of the remnants of fetal tissues or emergency delivery, antibiotic therapy is prescribed. In this case, stopping bleeding during pregnancy is carried out in different ways, depending on its intensity, ligation of the uterine arteries is often performed. With premature detachment of the placenta, an emergency caesarean section is indicated.

Forecast and prevention of bleeding during pregnancy

Bleeding during pregnancy is usually accompanied by a favorable prognosis. Timely medical care can save the life of the fetus and the woman. Lethal outcome is extremely rare. Prevention of bleeding during pregnancy consists in the early detection of benign neoplasms and their treatment even before conception. To prevent the development of a pathological symptom, you should register as soon as possible, take all the necessary tests, and if any violations occur, immediately seek advice from an obstetrician-gynecologist. Prevention of bleeding during pregnancy also consists in avoiding stress, physical exertion, violent sexual contacts.

The very first, outwardly noticeable, sign of pregnancy is the cessation of menstruation. Normally, regular bleeding does not resume during the entire period of gestation. Any spotting that occurs after the pregnancy is established requires attention.

Physiology of amenorrhea during pregnancy

After fertilization, a significant restructuring of the hormonal background occurs. The activity of the synthesis of sex hormones is shifted towards the production of progesterone. First, in the first trimester, it is produced by the corpus luteum of pregnancy in the ovary. This function is then taken over by the placenta.

An increase in progesterone levels prevents the ovarian follicles from producing new eggs, inhibits the proliferation of the endometrium. Due to this, menstruation stops, and the fetal egg gets the opportunity to securely gain a foothold in the uterine cavity and continue its development.

Obstetric blood loss

If a woman "in position" begins to release blood from the external genitalia, we are talking about obstetric bleeding. Whatever causes them.

A normal pregnancy almost always does without blood until the very birth.

The classification of conditions when blood is detected during pregnancy is based on the main criterion - the time of occurrence. Allocate:

Bleeding early.
Bleeding in late pregnancy.
During childbirth.
In the early postpartum period.
In the late postpartum period.

Let us consider in more detail bleeding in the early and late periods of gestation. They will differ from each other in causes, volume and danger to the fetus. In some cases, they can pose an immediate threat to the life of the mother.

First half

At the initial stages, especially in the first trimester, the interaction between the mother's body and the fetus is only getting better. Plus, the embryo has to go through several critical periods, which often lead to a miscarriage.

Therefore, among the causes of spotting in the first trimester, miscarriage is leading. The following is a list of factors provoking blood loss:

Ectopic pregnancy.
Trophoblastic disease (cystic mole).
Neck pregnancy.
Bleeding from varicose veins of the external genitalia.
Benign (polyps) and malignant neoplasms of the cervix.

As you can see, some causes are directly related to the pathology of gestation, while others are of a slightly different nature.

Spontaneous abortion

In about 25% of all conceptions, the embryo does not go through the stage of differentiation. This is the laying phase of all organs and systems of the fetus. During this critical period, errors often occur, resulting in loss of viability of the embryo.

Sometimes all this happens during the time that passes between periods. Then a miscarriage can be confused with regula, which come with a slight delay and look more plentiful than usual. Clots may come out.

A miscarriage may be incomplete and then dead tissues, blood clots will remain in the uterine cavity. If at least a small fragment has not come out, then the uterus is not able to return to its previous volume. Bleeding can be profuse (profuse) in nature, poses a direct threat to the life of a woman.

Ectopic pregnancy

Occurs if the attachment of the fetal egg occurred outside the uterine cavity (most often in one of the fallopian tubes). In most cases, such a pregnancy is terminated on its own.

In this case, a reflex detachment of the inner layer of the uterus (decidua) occurs. Slight spotting is noted, which may not correspond to real blood loss.

A significant mass of blood in an interrupted tubal pregnancy is poured into the abdominal cavity, and not through the genital tract.

If in the first 12 weeks there were small smears similar to menstruation, this may indicate a tubal miscarriage. To find out the cause, you should immediately consult a doctor and undergo an ultrasound scan.

bubble skid

Simplistically, this disease is manifested by the pathology of the placenta, which increases significantly, but becomes more loose. In this case, bleeding during pregnancy is accompanied by an abortion clinic. Clots are released from the external genital tract. Dark blood. Chorionic villi may come across, outwardly resembling bubbles.

Trophoblastic disease requires qualified medical intervention. The embryo, if it was, dies at the very start of the disease.

cervical pregnancy

One of the options for ectopic attachment of the fetal egg. The cervix does not have the necessary elasticity and cannot be stretched. Its mucous membrane is very thin, the submucosal layer is rich in vessels with arterial blood.

If it is not diagnosed in time, it can cause a very serious condition. Blood flows profusely, scarlet.

In the earliest stages, bleeding can proceed painlessly: the cervical vessels are destroyed under the influence of the growth of chorionic villi, and not overstretching.

Varicose veins of the vulva

One of the few cases where bleeding during pregnancy does not pose a direct threat to the fetus. Altered veins, nodes can bleed. The abundance is average, the blood is dark, venous. Clots may be found.

Sexual intercourse is capable of causing such a complication. The risk increases towards the end of the first trimester, reaching a maximum by the third. Spontaneous onset is uncharacteristic.

Neoplasms

Cervical polyps may bleed due to their looseness. The slightest impact on their surface causes capillary bleeding. Visually, this is defined as smearing.

The presence of a malignant tumor may have a similar clinic, so scanty, brown discharge should be the reason for the diagnosis.

Second half

If in the first 12 weeks, bleeding during pregnancy is primarily dangerous for the fetus, then at a later date, the risks for the mother increase significantly. In the second and third trimesters, two pathologies most often cause blood loss:

Placenta previa (complete or incomplete).
Premature detachment of a normally located placenta (PONRP).

These conditions are the most common cause of maternal death.

placenta previa

Usually occurs after 28 weeks or with the onset of labor. This pathology has a sudden onset. There is a significant amount of scarlet blood against the background of the complete absence of pain. Leading reasons:

Detachment of the placenta from the lower segment of the uterine wall.
Increased intrauterine pressure.
Disclosure of the internal os, if it was blocked by a fragment of the placenta.

In some cases, there is a recurrent character with small portions of blood, in the form of drops. This option causes anemia in a woman, chronic fetoplacental insufficiency.

One of the complicating moments is the dense ingrowth of the villi into the muscular layer of the uterus. Then the amniotic fluid can enter the mother's bloodstream and cause embolization (a kind of blood vessel thrombosis). This is an extremely dangerous, critical condition.

Incomplete presentation is easy to detect on ultrasound, so it is impossible to neglect the timing of examinations in the antenatal clinic.

Premature detachment

Sometimes you can find another term: uteroplacental apoplexy. This is a serious complication that can develop due to a number of factors:

Decompensation of hypertension.
Exacerbation of pyelonephritis.
Preeclampsia (severe form of preeclampsia in the second half of pregnancy).
Chronic inflammation of the endometrium.
Rhesus conflict.

These are the main reasons why severe blood loss begins, which can cause antenatal fetal death and dangerous anemia in the mother.

Depending on the severity of the condition, two degrees of PONRP are distinguished:

Light. Hemorrhages may be absent.
Heavy. As a rule, it is accompanied by blood loss.

It is important to know that external bleeding may or may not accompany PONRP, in both cases.

If the blood still went, then hemorrhages have different intensities (from drops to jets), there are dark, loose clots. All this goes against the background of pain syndrome, exacerbation of the clinic of the provocative factor.

If you have any hemorrhages during pregnancy, you should immediately consult a doctor. Timely assistance can save both the mother and the fetus. Delayed treatment often results in removal of the uterus.

Possible Complications

When brown smears appeared or the pregnant woman began to bleed, you can’t joke with it. It even makes sense to call an ambulance if it happened outside of business hours.

Therapy is primarily aimed at the prevention and correction of dangerous complications. These include:

Acute and chronic anemia (anemia).
Fetoplacental insufficiency.
Syndrome of disseminated intravascular coagulation (DIC).
Impregnation of the walls of the uterus with blood (imbibition).
infectious processes.

Any of these conditions can cause fetal death, loss of childbearing ability by the mother. Massive blood loss poses a real threat to a woman's life.

Therapeutic measures

The consequences of miscarriage and incomplete abortion can only be eliminated by curettage. After that, the uterus acquires the ability to contract, and thus the blood stops. In cervical pregnancy, ligation of the uterine arteries is required, and only then curettage. The neck is preserved.

To stop blood loss during tubal pregnancy, laparoscopic techniques allow. Varicose nodes are simply plugged, but serve as an indication for operative delivery (caesarean section).

Polyps are removed remotely, with a laser. Cancer processes in the first and second trimesters are an indication for hysterectomy. In the third, a caesarean section is performed first.

Placenta previa can be controlled with medication. Even if an operation is needed, organ-preserving interventions are carried out.

Against the background of PONRP, depending on the degree and the causes that caused it, urgent surgical intervention may be required, on the timeliness of which at least two lives depend.

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

The nature of bleeding can be different. In some, it is a weak spotting discharge without pain, in others it is strong, at times profuse, accompanied by cramping pains in the lower abdomen, chills, dizziness. According to statistics, a similar pathology occurs in 20-25% of pregnant women.

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

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

Sometimes small brown or dark spotting 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 fetal egg to the wall of the uterus. Implantation bleeding may occur somewhat later, even as early as 5 weeks. It is not dangerous and does not cause discomfort.

At the beginning of pregnancy, bleeding after intercourse is possible. If it is insignificant, you should not be afraid. But if they become regular and are accompanied by other negative feelings, 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. The risk of abortion is very high when bleeding occurs at 8 weeks of gestation.
. It occurs as a result of obstruction of the tubes, when the fetal egg cannot penetrate 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 early. With a frozen pregnancy, the bleeding is not strong, accompanied by minor pains in the lower abdomen. A woman is shown mandatory hospitalization for curettage of the uterine cavity and removal of the fetal egg.
. With this pathology, bloody discharge is accompanied by the discharge of small bubbles. Vacuum aspiration is shown, 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 level of progesterone.

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.

In a miscarriage, contractions of the uterus occur, which tries to get rid of the fetus. One of the signs is discharge with clots, and sometimes together with fragments of the tissues of the fetal egg. If the pregnancy could not be maintained, and a spontaneous abortion took place, curettage of the uterine cavity will be a mandatory procedure, since even minor remnants of the fetal egg can cause an infectious process and other complications. The presence of clots can also signal a miscarriage.

At week 10, a pathological condition may occur with violations of the blood coagulation system.
At week 11, the risk of miscarriage is reduced, but this does not mean that the appearance of spotting should not alert a woman. They can appear after violent intercourse, physical trauma or severe overheating, for example, after visiting the 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.

Impact of ultrasound examination

Today, the procedure is an integral part of mandatory screening. Some expectant mothers fear that the procedure could 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 accumulation of blood.

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 placental pathology.

placenta previa

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

This pathology is dangerous for the expectant mother, as it can cause hemorrhagic shock. It also negatively affects the condition of the unborn child, increasing the risk of preterm labor.

Premature detachment of the placenta

Always accompanied by bleeding. It can be caused by late toxicosis, multiple pregnancy or a large fetus, heart defects, physical injuries (fall), abnormalities in the development of the uterus. In women, the appearance of severe pain in the lower abdomen, an increase in the tone of the uterus are noted. The fetus develops hypoxia due to insufficient supply of oxygen and other elements useful for development.

Rupture of the uterus

The blood is bright scarlet in color, severe pain in the abdomen indicates excessive stretching and thinning of the walls of the uterus, destruction of the muscle layer. Occurs with cystic skidding or in the presence of scars on the uterus left after the previous one. Doctors recommend not getting pregnant after a caesarean section for at least two years.

Bleeding from fetal vessels

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, the birth of a child with developmental pathologies.

Elimination of bleeding

What to do if pregnancy is accompanied by significant or scanty spotting? 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 at the antenatal clinic and immediate medical attention. Even if the discharge is insignificant and the general state of health is good, you need to see a doctor as soon as possible.

To find out how to stop bleeding, you need to determine the cause of its occurrence. To do this, a woman is sent to take 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 levels;
vaginal examination.

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

The main task of treatment in the early stages of gestation 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 - Dufaston, Utrozhestan;
sedatives (tinctures of motherwort, valerian);
vitamin therapy - Magne B6, vitamin E, folic acid.

With a frozen pregnancy, a mandatory is shown. After the procedure, hormone therapy and drugs aimed at restoring the functions of the circulatory system are prescribed. If a woman is diagnosed with a negative Rh factor, after scraping, she is injected with anti-Rh immunoglobulin to prevent the Rh conflict.

Treatment of ectopic pregnancy is only surgical. During surgery, the fetal egg 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 a threat of miscarriage should be completely stopped. All prescribed drugs must be taken for a long time, even in the absence of bleeding and satisfactory health. The exact dosage and duration of administration is determined by the attending physician.

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

With scant discharge, 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 ones. 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 it can be contradictory. Indeed, taking Clexane increases the risk of miscarriage, so its use is only permissible under close medical supervision.

The drug "Clexane"

In addition to increased discharge, 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 in:

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

The use of Duphaston

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

The drug "Dufaston"

The calculation of the dosage is carried out 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 as a single dose followed by 10 mg three times a day.

Duphaston is taken until the complete cessation of the symptoms of a threatened abortion. In the future, it is possible to change the dosage to maintain the normal course of bearing a child.

Like most medicines, Duphaston can cause side effects. It can be inflammatory processes in the kidneys, constipation, hemorrhoids. In some cases, there may be negative reactions from the liver (signs of jaundice). 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 with the help of unverified traditional medicine is unacceptable! Only the attending physician can prescribe hemostatic drugs and other medicines!

Prevention

Every pregnant woman should carefully monitor her well-being. Expectant mothers, who are included in the so-called risk groups, should be especially careful.

Among the preventive measures aimed at avoiding pathological discharge during childbearing, the following can be distinguished:

Maximum limitation of physical activity and emotional stress.
Avoid cycling, heavy lifting, fast running, strength sports, walking on stairs.
In the presence of certain indicators, minimize, and in some cases completely eliminate sexual activity.
Do not use tampons or douche, which can cause increased discharge.
Drink plenty of fluids (at least 8-10 glasses a day).

Important conditions for prevention are the prevention of abortion, competent protection, treatment of gynecological diseases before conception, the birth of children under the age of 35 years.

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

The absence of menstruation after the onset of pregnancy is a normal physiological phenomenon. Any appearance of bloody discharge from the vagina during this period is considered a complication that threatens miscarriage. Every fourth woman may develop this problem while expecting a child. Obstetrician-gynecologists carefully examine and examine the pregnant woman in order to understand the cause of bleeding in the early stages, and only after that they finally talk about the diagnosis and further prognosis.

Causes of bleeding in early pregnancy

The embryo in the early stages of pregnancy is very sensitive to the action of external factors and changes in the mother's body. Despite the fact that pregnancy is not a disease, but the normal state of a healthy woman, it may not always end in the birth of a baby. But at the same time, the appearance of a small amount of smearing brown discharge, which resemble drops of blood, in most cases, does not indicate an abortion.

At the very beginning of the development of the embryo, namely during the introduction of a fertilized egg into the endometrium, damage to the uterine mucosa occurs, which causes some discomfort in the lower abdomen of a woman and the so-called implantation bleeding. It does not pose a threat to the development of the fetus and passes on its own.

Bleeding that recurs before 12 weeks should alert the expectant mother and become a reason for an immediate appeal to an obstetrician-gynecologist. The causes of this pathology can be such violations:

Ectopic, or ectopic, pregnancy.
Non-developing or frozen pregnancy.
Bubble drift.
Rupture of the cyst of the corpus luteum.
Spontaneous miscarriage.

How to keep a pregnancy when bleeding occurs - video

The introduction of a fertilized egg into the mucous membrane of the fallopian tube, ovary, cervix or abdominal cavity leads to the development of an ectopic, or ectopic, pregnancy.

Development factors

This phenomenon can be provoked by:

The growth and development of an embryo, which increases significantly in volume, leads to a rupture of the organ into which the egg was implanted. Most often, this pathological condition occurs in the cavity of the fallopian tube.

Symptoms of the disease

Violation of the integrity of the abdominal organ, and often it is the fallopian tube, causes a number of symptoms in a woman:

profuse bleeding into the abdominal cavity and vaginal discharge similar to menstrual;
sharp pain in the groin;
cardiopalmus;
lowering blood pressure;
dizziness;
loss of consciousness.

Diagnosis of pathology

Diagnostic measures include:

examination of the cervix in the mirrors and a two-handed vaginal examination - determine the overhang of the posterior fornix over the vagina and its sharp pain, as well as the discrepancy between the size of the uterus and the expected duration of pregnancy;
complete blood count - allows you to diagnose the degree of blood loss and the level of decrease in hemoglobin;
analysis for human chorionic gonadotropin (hCG) - a hormone in the blood and urine of a woman that confirms pregnancy;
ultrasound diagnosis of pelvic organs - determines the presence of an embryo and the place of rupture of the fallopian tube;
puncture of the posterior fornix through the vagina - is carried out in order to obtain and diagnose fluid from the abdominal cavity (in case of ectopic pregnancy and violation of the integrity of the fallopian tube, blood accumulates).

Treatment

Therapeutic tactics for ectopic pregnancy and tubal rupture primarily includes surgery, which can be performed both openly and endoscopically. It is carried out in order to eliminate the embryo, restore and reconstruct the fallopian tube, as well as to cauterize bleeding vessels.

Drug therapy is used to restore blood volume, increase hemoglobin levels and stop bleeding:

hemostatic drugs - Dicinon, Tranexam, Aminocaproic acid, Kontrykal, Vikasol;
drugs that replenish the volume of circulating blood in the vessels - Reopoliglyukin, Albumin;
medicines to restore iron stores and normal hemoglobin levels - Ferrum Lek, Aktiferrin, Maltofer;
means for stimulating uterine contraction - Oxytocin, Dinoprost;
if the diagnosis of an ectopic pregnancy was carried out in the early stages, then conservative methods are used to eliminate the embryo - Vinblastine, Methotrexate.

Drugs that are used to treat ectopic pregnancy - photo gallery

Contrycal is used to stop bleeding
Ferrum Lek restores iron reserves
Reopoliglyukin is used to restore fluid loss Oxytocin stimulates uterine contractions Methotrexate is used to conservatively treat ectopic pregnancy and prevent bleeding.

Complementary Therapies

Nutrition after surgery on the first day should be low-calorie with a predominance of carbohydrate and protein foods in the diet.

The use of physiotherapeutic procedures and alternative methods of treatment is impractical, so as not to provoke increased bleeding.

Forecast and consequences

Rupture of the fallopian tube and bleeding can lead to hemorrhagic or painful shock, which is fatal. Repeated ectopic pregnancies and damage to the tubes force specialists to perform operations to remove the organ, which can lead to infertility as a result.

Frozen pregnancy

The pathology that develops as a result of the death of the embryo is called a missed pregnancy. A woman may not be aware of this for a certain time until symptoms occur:

Provoking factors

A missed pregnancy can be caused by:

genetic anomalies in the development of the fetus, which even in the early stages lead to its death;
infectious diseases:
- toxoplasmosis;
- rubella;
- herpes;
- cytomegalovirus infection;
- Hepatitis B;
- syphilis;
sexual infections of the mother that developed during pregnancy:
- chlamydia;
- gonorrhea;
- ureaplasmosis;
diabetes mellitus and other hormonal disorders in women.

Diagnostics

Interrogation and examination of a woman. The doctor finds out changes in the general condition of a woman whose mammary glands become soft, signs of toxicosis disappear, and unpleasant sensations appear in the lower abdomen and groin. After examination, the gynecologist ascertains the unchanged size of the uterus and the closed external pharynx of her neck.
Ultrasound of the uterus - allows you to visualize the fetus, but its heartbeat is not audible.
Determination of the level of hCG, which decreases in comparison with the previous indicators.

Treatment tactics

After diagnosing a missed pregnancy in a woman, specialists choose one of three tactics for treating pathology:

Expectant - after the death of the fetus, there is a decrease in hormones that ensure the normal course of pregnancy, which provokes a spontaneous miscarriage.
Operative - with the development of bleeding or the occurrence of an intoxication syndrome due to inflammation of the fetal membranes, an urgent curettage of the uterine cavity is necessary.
Medication - a technique that is preferred at gestational ages of less than 12 weeks. Use drugs that provoke miscarriage (Mifepristone, Methotrexate).

Methotrexate after stopping the development of the embryo provokes an artificial miscarriage

To restore the body of a woman, the same groups of drugs are used as in ectopic pregnancy.

Treatment prognosis and possible complications

If a missed pregnancy occurs again in a woman, then this is a sign of habitual miscarriage, which is fraught with infertility. But in general, when choosing the right treatment tactics and determining the cause of the development of this pathology, there is every chance to feel the joy of motherhood. Only in 15% of women, the treatment provided does not bring results. The way out of this situation is the use of in vitro fertilization.

bubble skid

Bubble skid is quite rare, but nevertheless a serious pathology of the development of pregnancy, which occurs in 0.001% of cases.

The membrane surrounding the embryo at the initial stages of development has the form of a sac with many processes-villi that are attached to the inner wall of the uterus and nourish the embryo. Under the influence of certain causes, they are transformed into large bubbles with a liquid that resemble bunches of grapes.

Causal factors

Genetic disorders that occur at the time of the fusion of an egg with two sperm at the same time lead to the formation of a double set of chromosomes from the father and the development of a hydatidiform mole. Its growth provokes not only the destruction of the fetus, but also the walls of the uterus along with the blood vessels.

Symptoms

The main and most alarming symptom is bleeding, which occurs at the 8th week of pregnancy. It can be external, with the release of dirty, brown blood with skid bubbles, and internal - into the abdominal cavity.
A woman may also complain about:
- increased feeling of nausea;
- vomiting;
- the appearance of edema;
- pain in the right hypochondrium;
- urine color changes.
Repeated bleeding leads to a decrease in hemoglobin levels, which is manifested by dizziness, dots before the eyes, and fainting.

Diagnosis of hydatidiform mole

Inspection - a vaginal examination helps to determine the consistency of the uterus, since with cystic drift it is enlarged and stiff, and during pregnancy it is softer and doughy.
Ultrasound - shows the absence of signs of vital activity of the embryo: movement, heartbeat and formed parts of the body, according to the gestational age. The uterus has an uneven shape with bulges, which indicates the degeneration of the chorion.

Medical tactics

Treatment of the immediate cause of bleeding - cystic skidding, is carried out by vacuum suction of the contents of the uterus. The resulting material is sent for histological examination, after which the woman is observed in the oncology dispensary for two months.

If the cells of the cystic mole have spread to neighboring organs, then radiation therapy is performed to destroy them.

Dicinon, Tranexam and other drugs from this group are also used to stop bleeding.

Consequences

A woman has a high chance of becoming pregnant again and giving birth to a healthy baby after a course of hormone therapy. Timely treatment renders it possible to avoid a lethal outcome.

Rupture of a corpus luteum cyst

For a long time, a corpus luteum cyst may not bother a woman of reproductive age at all, and even more so, do not bring any harm to her body.

Education does not prevent fertilization and the development of pregnancy.

Causes: orgasm, exercise, stress

The influence of some factors can provoke cyst rupture and hemorrhage in the early stages:

active sex and pronounced orgasm;
physical exercise;
torsion of the cyst leg, which occurs, most often, spontaneously;
strong feelings.

Clinical manifestations: severe pain, nausea, bleeding and others

Violation of the integrity of this neoplasm causes a number of symptoms:

Diagnostic Measures

Finding out the cause of such an acute condition in a pregnant woman should not take much time, since it is more important in this situation to quickly relieve pain and eliminate bleeding. Therefore, diagnostic manipulations include:

two-handed examination by a gynecologist. In this case, there is a sharp pain on palpation (feeling) of the uterine appendages and bleeding from the internal pharynx of the cervix;
Ultrasound, in which a certain amount of free fluid (blood) will be visualized in the abdominal cavity.

Treatment

The main goal is to eliminate the main cause of acute bleeding, i.e., removal of cyst remnants and vascular coagulation. It can be performed using both open surgical access and endoscopic method, if the obstetrician-gynecologist has extensive experience in this type of intervention.

Drug therapy with the same drugs as in ectopic pregnancy is used to support the body of a woman and a child in a stable state, restore hemoglobin levels and blood loss.

Prognosis and complications

The surgical treatment ends with the removal of the ovary. But even in such cases, it is possible to keep the pregnancy or become a mother again.

In order to avoid unpleasant consequences after the formation of a cyst, a woman needs not to delay with drug therapy, and with an increased size of the neoplasm, with surgical treatment.

Spontaneous abortion

The most common complication in early pregnancy is spontaneous abortion and the resulting consequences. It can provoke:

female orgasm;
excessive physical activity;
pathology of the development of the fetus or the internal genital organs of a woman;
taking hormonal drugs;
overwork and psycho-emotional overload.

Symptoms: bleeding with clots, dizziness, pain and others

A woman notes the appearance of pain in the lower abdomen and can clearly indicate the provoking factor. Sometimes palpitations may occur with normal blood pressure readings. A common complaint is profuse bleeding with clots from the vagina, which is accompanied by dizziness and loss of consciousness.

Diagnosis of complete abortion

Spontaneous miscarriage is diagnosed after:

Treatment for complete abortion

After a spontaneous abortion, a woman is prescribed:

drugs to increase iron - Ferrum Lek and others;
medicines to increase blood clotting and stop bleeding - Etamzilat;
antibiotics - Cefotaxime, Amoxicillin;
surgical intervention (if the membranes of the fetal egg remain in the uterine cavity).

Consequences and prognosis

As a rule, a pregnant woman with the onset of bleeding turns to specialists, which helps prevent complications in the form of shock, inflammation of the genital organs or sepsis.

The prognosis for life after a complete abortion is favorable, but for a second pregnancy it is doubtful. It is necessary to clearly find out the cause of this phenomenon and only after long-term treatment to think about the possibility of giving birth.

Additional treatments for causes of bleeding in early pregnancy

It is possible to choose treatment options in the form of alternative methods or physiotherapy procedures only after the recommendation of a doctor. But the main task during the period of acute pain and bleeding is to save the life of a woman. In the future, such therapy is also very doubtful, as it can provoke relaxation of the uterus and the occurrence of repeated bleeding.

As additional methods, you can use vitamin therapy, a diet with a high content of vegetables and fruits.

Treatment of missed pregnancy, cystic skidding, rupture of the corpus luteum cyst, complete abortion with folk methods can lead to the death of a woman.

Preventive measures

In order to prevent bleeding and other complications of pregnancy, a woman needs:

plan your pregnancy and prepare for it;
undergo a complete examination of the body before conception. This also applies to the future father;
to refuse from bad habits;
avoid the action of provoking factors;
lead an active and healthy lifestyle;
timely treat chronic diseases;
register at the antenatal clinic at the place of residence and regularly undergo examination by a gynecologist.