Uterine bleeding during early pregnancy. Bleeding during early pregnancy

Pregnancy is the most exciting and responsible period for every girl, but when suspicious signs appear, mommy starts to worry and worry, which is completely in vain. When blood clots appear during early pregnancy, the initial thought is usually that a miscarriage has begun. But there are many reasons for this condition and not all of them have a dangerous pathological character. Therefore, it will be useful for every girl to know the common causes of such discharge and how to act when they appear.

The issue of motherhood should be approached with full responsibility

There is a common belief among patients that the appearance of blood during pregnancy is an extremely dangerous sign, indicating a serious problem. Experts say that such a theory is erroneous.

• Allocations, meager at the beginning of gestation, are noted in a quarter of pregnant women.
• They do not always pose a threat to the fetus or mother and have a different origin.
• But in about half of the patients who turned to a specialist with a slight release of blood, the threat of interruption is detected in the early stages of pregnancy.

In each patient, spotting has individual differences: some have profuse blood loss, others have a slight daub, and still others find blood clots on the linen. Anyway, you need to consult with a specialist who will conduct the necessary diagnostics, prescribe tests and determine how dangerous such discharges are.

Causes of blood clots

Situations in which a blood clot came out during pregnancy require special attention. In the first months of gestation, such phenomena are extremely dangerous and can result in fetal death or severe blood loss of the mother. Usually, such symptoms indicate the development of spontaneous miscarriage, and the clot is a fragment of embryonic tissues. Usually, such bleeding with clots begins suddenly during defecation or urination, when lifting heavy objects, or with any other muscle tension in the perineum or abdominal wall.

If there is tissue loss. It is no longer possible to maintain a pregnancy, because very often fetal malformations provoke the discharge. Then spontaneous interruption is a much better option than the birth of a knowingly sick or unviable baby. In this way, the body itself revealed an anomaly in the fetus and got rid of such a child. You need to come to terms with what happened and move on, because the situation could have ended differently.

If you feel unwell, you should see a doctor as soon as possible

There are many reasons for the appearance of blood secretions and clots. But with any of them, the intervention of specialists is necessary. The fetal egg may not be completely rejected, then particles will remain in the uterine cavity that will begin to decompose, which will cause a severe infectious process.

Sometimes there are no symptoms at all, which should alert. If signs of pregnancy such as chest pain and swelling, dizziness and toxicosis suddenly disappear, then you also need to contact a antenatal clinic.

Threat of interruption

If the threat of miscarriage or spontaneous interruption of gestation hangs over the patient, then periodic pulsating painful sensations appear that accompany the outgoing blood. The process usually begins with a slight bloody daub, but if this sign is neglected, the bleeding will develop to an intense level, and the embryo will exfoliate and slip out of the uterus. But such a sad outcome is not always possible.

• If the embryo has not exfoliated and is tightly attached to the uterine endometrium, then there are chances to save the gestation, and there are not so few of them.
• If already at the very beginning of the abortive process the fetus had any serious defects, or the interruption processes developed to a state of irreversibility, then a complete miscarriage occurs.
• Sometimes such an interruption occurs against the background of inflammatory lesions of the reproductive system, traumatic injuries or infections that affect the genitourinary system.
• At first, profuse discharge of blood clots is accompanied by severe soreness, which indicates a complete miscarriage. Soon, cramping pain stops, as do clots.
• But a miscarriage can also become incomplete if bleeding, clotting continues, and the cervical canal is open. This condition is dangerous for a patient who needs urgent curettage.
• Usually bleeding in the first weeks of gestation and with blood clots indicates an incomplete interruption, which leads to a pronounced feverish state, unbearable pain resembling contractions, and a thick red discharge. Here urgent scraping is needed.

Cramping pains are associated with contractions of the uterine muscles, the purpose of which is to push the fetus out. If tissue elements are clearly visible among the clots, then this directly indicates the exfoliation of the fetal egg. Usually, such an abortion occurs before the 28-week period against the background of severe stressful situations, Rhesus conflict or infections, etc.

Hematoma

The most important factor is proper and healthy nutrition

Sometimes a pregnant woman is faced with bleeding with clots against the background of the formation of a hematoma, in which the discharge becomes dark brown. The fertilized egg itself exfoliates and blood clots form in this area. Characteristic signs of this condition are too dark discharge containing clots.

Bleeding with a hematoma can be quite mild, but the presence of clots in the discharge is an extremely bad sign. A similar situation needs urgent medical intervention, because it is in the early stages that the probability of a miscarriage is incredibly high.

Frozen pregnancy

A slight release of blood with clots is also observed when the fetus fades. Just for a number of reasons, the embryo stops developing. In this case, there may be symptoms such as a hyperthermic reaction, pain in the uterus, the sudden disappearance of fullness and soreness of the mammary glands, the cessation of toxicosis and flatulence (typical for pregnancy). Also, intrauterine fetal fading can be indicated by a hyperthermic reaction and a decrease in basal rates.

If the body begins to get rid of the dead fetus itself, then cramping pains may begin, bleeding with clots will open. But in practice, it often happens that the patient finds out about the problem a few weeks after fading, when emergency curettage is required. There can be many reasons for fading (hormonal disorders, genetic abnormalities, etc.), but most often it is not possible to find out the etiology of missed gestation.

ectopic

Abnormal implantation of the embryo can also provoke the release of blood clots in the first weeks after conception. Normally, about a week after the meeting of the sperm and the cell, the fetal egg is fixed to the endometrium in the uterine cavity. But under the influence of pathological factors, fixation can occur outside the uterine body, but, for example, in the fallopian tube. Such a pregnancy is doomed to fetal death, so the question of saving the patient's life comes first.

• First, ectopic conception develops as a completely normal pregnancy, that is, it is detected by a test, accompanied by toxic symptoms, absence of menstruation and breast swelling.
• But with the growth of the fetal egg, the walls of the tube are stretched, which is why it breaks.
• This usually happens at a short time, so blood with clots comes out in the first weeks of gestation, while bleeding is profuse and deadly for the patient.
• The rupture during this period is also indicated by such symptoms as severe pain at the site of attachment of the embryo, dizziness and weakness, cold sweat, etc.

There are many ways to extract the fetus from the pipe, without removing the organ or bringing it to a dangerous state of rupture. For this, modern laparoscopic techniques are used that do not require open access to the tube. If an ectopic pregnancy is not detected in a timely manner, then the tube along with the embryo will have to be removed, which significantly reduces the chances of subsequent conceptions.

bubble skid

In difficult times, the support of a spouse is very important.

Another reason for the appearance of clots in the first months of gestation is due to cystic drift. This is an abnormal development of the tissues that form the placenta. The cause of such a pathological deviation is natural errors during fertilization. In the uterine body, instead of the embryo, a trophoblastic tumor body is formed in the form of a bunch of many small cysts. The uterine body is somewhat enlarged, when in a normal pregnancy it should be much smaller.

The patient is concerned about bleeding, which can be observed for a long time until the entire tumor comes out and frees the uterine cavity. The color of bleeding is usually dark with a thick consistency and clots. The composition of the secretions contains egg vesicles, although they themselves are not abundant. Such secretions can provoke the development of iron deficiency anemia. The symptomatic picture may be supplemented by palpitations and vomiting. If assistance is not provided in a timely manner, then the risk of developing trophoblastic cell structures in other intraorganic systems increases.

Placental abruption

At any gestational period, the occurrence of such a pathology as detachment of placental tissues is possible. But unlike other trimesters, in the very first it is characterized by the most favorable forecasts. Pathology is accompanied by aching pain and slight sipping in the lower abdomen or in the lower back. Basal indicators with such a pathology decrease, spotting appears with small clots.

It is quite possible to stop the detachment process, but timely treatment is necessary. There are usually no negative consequences of pregnancy prolongation, because the growing placental tissues compensate for the damaged area with the development of gestation. For a short period of time, the process of detachment can be determined using ultrasound diagnostics.

sexual diseases

Pregnancy is not protected from pathological problems in the genital area. Moreover, many pathologies are hormone-dependent in nature, therefore, during gestation, they are prone to exacerbation, and those that occur latently begin to manifest themselves. Therefore, the appearance of blood clots may indicate the development of gynecological pathology. Some of them are safe, and some can seriously threaten the little man growing inside. These are the most common factors for bloody clot-like discharge.

1. Venereal diseases. Sometimes increased activity of trichomonas, chlamydia and other pathogenic microorganisms can provoke blood with clots. In addition to blood clots, which increase the risk of spontaneous interruption, these conditions are accompanied by the presence of a fetid odor and itching in the perineum, weakness and hyperthermic reactions.
2. Erosion of the uterine neck. If erosive lesions form on the neck of the cervical canal, then such conditions can also be accompanied by bloody discharge at the beginning of gestation. The discharge is red-brown or pink, but the patient and the fetus are not threatened. Treatment of erosion, as a rule, is carried out after delivery.
3. Polyps. The presence of benign growths on the inner surface of the uterus or cervical canal can also lead to the appearance of blood with small clots. Usually in the early stages, such discharges are painless and have a meager character. Depending on the situation, the polyp can be removed during gestation or after childbirth, although more often doctors postpone treatment until the postpartum period. Moreover, polyps often exfoliate on their own, when the patient's hormonal background changes after the birth of the crumbs.
4. Phlebeurysm. This pathology affects not only the veins of the extremities, varicose veins are often found on the vagina, which is also riddled with many vessels and veins. With such a disease, women experience discomfort during sexual intercourse, because the secret that facilitates the penetration of the penis is practically not released due to impaired secretory function against the background of varicose veins. Such a condition for gestation and the fetus is not dangerous, but it gives mommy a lot of uncomfortable sensations.

These are the most common causes that can provoke the appearance of blood clots in a girl in position, but not all of them pose a threat to the baby and mother.

What to do with such bleeding

Whatever factors caused bleeding during gestation in the first months, a gynecologist's consultation and therapeutic measures are necessary. Waiting or trying to cope with the problem on your own is inappropriate here. Even with a serious threat of interruption, with timely gynecological care, in 80% of cases it is possible to prolong pregnancy.

Usually, with such bleeding, taking into account their origin, drugs like No-shpa or Papaverine are indicated, which reduce excessive stress on the uterine walls, eliminate pain symptoms and prevent the fetal egg from being pushed out of the uterine cavity. Utrozhestan or Dufaston can also be prescribed. These are hormonal drugs that normalize progesterone levels. With a deficiency of this hormone, bleeding often develops. If the threat is more serious, then the hormone is injected in its pure form.

Often in such situations, the reception of Valerian or Motherwort is shown, which eliminates excessive anxiety of the mother and helps to relax the uterine muscles. But the most basic drugs in the event of blood clots in pregnant women are considered to be hemostatic agents, which include Dicinon, Tranexam, Vikasol, Troxaminate or Exacil.

Even the smallest bloody discharge requires the attention of a doctor, therefore, when they appear, it is necessary to consult a gynecologist, especially if there are symptoms such as severe abdominal pain and deterioration in general condition. Only a doctor will be able to correctly assess the seriousness of the situation, identify the threat and prevent miscarriage in a timely manner.

Sometimes it happens that shortly before the end of a successful pregnancy, when future parents are already busy decorating the nursery and buying the necessary dowry for the baby, a woman suddenly discovers or bleeding.

This moment is always a shock for the expectant mother, and sometimes a big surprise for her doctor. What threatens this alarming symptom in late pregnancy?

If the pregnancy proceeds without complications, the woman feels well and, according to the data, and other basic studies, the child develops according to the terms, visits to the doctor are usually kept to the necessary minimum.

When only a few weeks remain before the birth, the bleeding that has begun becomes a big surprise. What is it - a normal harbinger of childbirth or a dangerous condition with which you need to rush to the hospital?

The opening of the uterus and the separation of the mucous plug may indeed be accompanied by secretions with an abundant admixture of blood. If this happens 1-2 weeks before the due date, it means that labor has begun and will end with the birth of a long-awaited healthy baby.

But other causes of bleeding are possible, associated with the pathology of pregnancy or diseases of the expectant mother.

This diagnosis is said when. Its presence near the internal pharynx or on it is a serious complication of pregnancy and is diagnosed in the early stages.

But in milder situations, if the placenta has formed below the bottom of the uterus, but the distance to the internal os is 3 cm or more, alarming symptoms may not be observed at an earlier date.

However, by the end of pregnancy, when the uterus is maximally stretched and the pressure of the fetus on the vessels increases, bleeding may occur. Its source will be determined by the doctor.

Slight bleeding from external vessels is usually not dangerous for the fetus and will allow you to carry the pregnancy.

• Premature placental abruption

Even if the placenta is located correctly and regularly performed its function throughout the pregnancy, the weakness of the mother's vessels, or can lead to (separation of the placenta or part of it from the uterine wall).

This is a dangerous condition, accompanied by profuse bleeding. The blood supply to the fetus is disrupted, and this is a direct threat to the life of the baby. But there are medical techniques that allow, with partial detachment, to stop bleeding and report pregnancy. It all depends on the location of the placenta and the degree of detachment.

• Rupture of the body of the uterus

This is a fairly rare complication. Unable to withstand the growing pressure of the fetus or under the influence of external factors, the integrity of the uterine tissue can be broken, which is accompanied by severe pain, bleeding, and threatens the life of the mother and fetus.

Depending on the size of the lesion, a “crack” is distinguished (on the body of the uterus or in the lower segment), “incomplete rupture” or complete separation of the uterus from the vaginal vaults.

The cause of this complication may be concomitant diseases of the endometrium, cicatricial changes after surgery or caesarean section, external traumatic factors.

Rupture of the uterus requires urgent medical intervention.

• Rupture of the cervix

Pressure (especially if there is a large fetus) on the tissue of the cervix can lead to bleeding at the end of pregnancy. Blood vessels are pinched, the blood supply to the tissue and its elasticity are disturbed, with the course of pregnancy, these provoking factors increase and the result may be a rupture of the tissue of the cervix or vagina.

This is not as dangerous as uterine rupture, but also requires urgent medical attention.

• uterine fibroids

Fibroids must be diagnosed in advance and the doctor takes this factor into account when managing pregnancy.

Depending on the size and location, fibroids can be an obstacle to pregnancy. but can sometimes be the main cause of persistent bleeding during pregnancy.

When pregnancy has already begun and proceeds safely, many myomatous nodes decrease (and some disappear) due to poor blood supply.

However, for some types of nodes, the degenerative changes that occur mean the formation of cavities with hemorrhagic contents. When such a bubble ruptures, the bloody contents come out. If the integrity of the vessels is preserved, the phenomenon is not dangerous.

• Cervical erosion

Erosion of the cervix means that the mucosa is looser, the vessels are dilated, against this background, wounds or ulcerations may appear. And even if a woman did not have such a diagnosis before pregnancy, in the process of bearing a child, under the influence of hormonal changes and a decrease in immunity, it can manifest itself.

Loose mucosa and dilated vessels, experiencing the pressure of a growing uterus, can be a source of bleeding. As a rule, it is not abundant, but dangerous with secondary complications: infection, pain syndrome or unpleasant sensations in the genitals, which can reflexively affect.

How to behave in case of bleeding?

If a pregnant woman finds bleeding or mucous discharge mixed with blood, this is a reason to see a doctor, regardless of the duration of pregnancy. And the danger to the life of the fetus in the later stages may be no less than at the beginning.

When calling an ambulance, be sure to report the gestational age.

While waiting for help, it is necessary to provide the woman with peace. She should not be busy collecting things for the hospital, as movement can activate bleeding.

Is bleeding dangerous for the unborn baby?

Pregnancy is coming to an end, the fetus is fully formed, organ systems have begun to function. Some mothers are sure that there is no longer a threat to the health of the baby.

However, the risk remains. It is much less than at the beginning of pregnancy, and even after rapid ones, the baby will have a better chance of surviving and maintaining health.

Heavy bleeding can also lead to hemorrhagic shock, which is dangerous for a woman and her child. In addition, a violation of the integrity of tissues threatens sepsis, and this is also a risk to the life of both the woman and the child.

How can you help in the hospital?

A doctor in a hospital can determine the cause and amount of bleeding, and the tactics of therapeutic measures will depend on this.

With some pathologies, urgent surgical intervention is necessary, with others, there is an opportunity to save the pregnancy and prepare the baby's lungs for premature birth.

• Depending on the cause of the bleeding and the localization of the pathology, methods such as suturing, drug treatment (vitamins, antispasmodics, etc.)
• Strict bed rest helps control bleeding and prevent recurrence.
• With partial detachment of the placenta, especially with its low localization, such an unexpected measure as the opening of the fetal bladder helps: the baby's head descends, pressing the exfoliated fragment of the placenta.

This allows you to buy days to provide the necessary strengthening therapy for the mother and prepare the child for birth.

• Medical measures can stop and quite heavy bleeding.

In this case, immediately after the cessation of blood loss, therapy against hemorrhagic shock is carried out (blood transfusion or blood substitutes, anti-inflammatory drugs, the introduction of saline)

In the case when the bleeding cannot be stopped, or the lesions are large and do not make it possible to maintain the pregnancy, premature birth is performed. Usually this is a caesarean section, but other options are possible, depending on the condition of the mother, the position of the baby, the degree of cervical dilatation.

The baby, who was born prematurely, will be examined by neonatologists and placed under observation in the pediatric intensive care unit, if necessary, sent for nursing.

Bleeding in the last weeks of pregnancy can be caused by a number of factors. It is possible to accurately determine its cause and the degree of threat to the health of a woman or her unborn child only after an examination in a hospital setting.

Depending on the situation, doctors will find an opportunity to keep the pregnancy or an urgent delivery will be carried out, and the baby will be placed in the premature ward. Timely access to a doctor will save the life of the mother and the newborn.

Bleeding during pregnancy, and especially in its early stages, is a fairly common phenomenon. In order not to panic in such a situation and not harm herself and the unborn baby even more, a woman should familiarize herself with the information on this topic in advance. It is desirable to do this at the planning stage of pregnancy. There are many causes of vaginal bleeding and not all of them are pathological, but it’s still not worth the risk.

The main causes of vaginal bleeding in the first trimester of pregnancy

Expecting a baby is a wonderful and at the same time very responsible period in the life of every woman, which must be approached with all caution and responsibility. Very rarely, this stage passes without problems and complications that can spoil not only the nerves, but also the health of two or more people. The main one is probably bleeding in early pregnancy. Early terms most often mean the first twelve weeks - the period of formation of the placenta and the main systems and organs of the unborn child. To some extent, 20-30% of expectant mothers face bleeding in the early stages. Gynecologists identify the following causes of blood in the first trimester:

• implantation of an egg in the uterus (implantation bleeding);
• breakthrough bleeding (otherwise, decidual bleeding);
• mechanical damage to the cervix or vagina;
• miscarriage or its threat;
• frozen pregnancy;
• gynecological diseases;
• cystic drift (otherwise, molar pregnancy);

Bleeding during pregnancy can be intense and not very, accompanied by pain or not cause discomfort, the color of the discharge also varies from light pink to maroon. Each cause has its own symptoms, therefore, if you find even a slight bloody mark on your underwear, you should urgently contact your doctor or call for emergency help and in no case try to stop the blood yourself or take painkillers. It should be remembered that only qualified assistance after a diagnostic examination in this case is the key to the life and health of the mother and child!

In the hospital, regardless of the cause of bleeding, the patient undergoes the following studies:

1. general blood analysis;
2. blood test for chorionic gonadotropin (hCG);
3. coagulogram;
4. a blood test for the presence of HIV infection, syphilis, hepatitis B and C;
5. determination of blood rhesus of mother and child;
6. general urine analysis;
7. smear from the vagina;
8. Ultrasound of the fetus and pelvic organs of the patient.

Further research depends on the suspected cause of the discharge.

implantation bleeding

Most often, women confuse this type of bleeding with the onset of menstruation, because. it can be caused by the implantation of an egg in the uterus, which most often occurs on days 24–28 of the cycle. Actually, pregnancy itself occurs along with this phenomenon. The fact is that the egg in the process of penetrating the uterus can damage the thinnest capillaries, which secrete blood.

Unlike monthly discharge during implantation, they are of a slightly different nature and have the following symptoms:

1. scanty, smearing;
2. color from light pink to brownish;
3. absence of clots and mucus.

On linen with implantation bleeding, you can see a slight “daub” or a few light pink drops

In most cases, such bleeding is completely asymptomatic and painless; normally, a woman may not even notice it. It accompanies only 30% of all pregnancies, i. is relatively rare.

Most often, a pregnancy test is too early to carry out, because. the level of the chorionic hormone is still very low. It makes sense to take a blood test for hCG in dynamics in order to accurately determine the onset of pregnancy.

In most cases, implantation bleeding is not threatening and does not require treatment, but in rare cases it can signal the following problems:

• lack of progesterone;
• ectopic or non-developing pregnancy;
• implantation of a viable egg.

In these cases, the discharge is accompanied by painful sensations of aching or spasmodic nature. To exclude possible unpleasant surprises, an ultrasound of the pelvic organs should be done.

To prevent the consequences in this case, the doctor may prescribe hormonal drugs Duphaston and Utrozhestan.

Hormonal drugs will help restore progesterone levels

A woman during this period should enrich her diet with fat-containing foods, add nuts, meat and fish, cold-pressed oils, seeds and cereals to the menu.

Video: implantation bleeding

Breakthrough or decidual bleeding

A very rare occurrence, due to which many women do not know about their situation for quite some time. The fact is that at the beginning of pregnancy, the hormonal background of the expectant mother changes dramatically, and in combination with minor hormonal disorders, this can lead to bleeding that coincides with menstruation in time. Such pseudo-monthly periods last from 1 to 4 months, therefore, when determining pregnancy, you should not focus only on the termination of the cycle. Decidual bleeding practically does not differ in appearance from normal menstruation, but may be somewhat poorer and more fleeting. Sometimes it looks like a "daub".

Most often, this condition is not considered a pathology, does not harm the fetus and does not require treatment. However, any bleeding should be reported to the doctor, who will prescribe an additional blood test for the B-subunit of hCG in the laboratory, a detailed coagulogram and advise to do an ultrasound.

Bleeding with mechanical damage to the cervix

Here we are not talking about serious injuries to internal organs received in the event of an accident or other accident, which can lead to death. In such situations, immediate hospitalization and surgical intervention of doctors is required. In this case, the issue of the possibility of intimacy in the early stages of pregnancy, as well as existing contraindications, is considered.

Normally, sex during pregnancy is not contraindicated, but rather desirable, since it has a beneficial effect on a woman's health, her psycho-emotional state and the microclimate in the family. Most often, the fears of parents are groundless, because. the baby is reliably protected by the muscles of the uterus and amniotic fluid from possible injuries during intense friction, as well as by a special mucous clot from infection. Then why, after intercourse, bleeding may appear, what is it and what to do in such a situation?

The appearance of traces of blood after intercourse is most often associated with a lack of secretion (natural lubrication), as well as increased sensitivity of the cervical epithelium. The discharge is usually scarlet in color without inclusions of clots and mucus. To avoid such phenomena, you should choose the most comfortable positions for a woman, use special lubricants (intimate moisturizers) and contraceptives. Sometimes spotting speaks of cervical erosion, but in this case they may appear not only after intercourse.

The absence of medical contraindications and a comfortable posture make it possible to enjoy intimacy with a partner

Many people wonder: can an orgasm provoke a miscarriage? It is generally accepted that this is possible a few weeks before the onset of labor, so doctors sometimes recommend having sex in the last stages. At the very early stages, there is a fear that the experienced orgasm will increase blood flow in the pelvic organs and this can lead to spontaneous abortion, because the placental barrier is not yet fully formed and the fetus is not firmly attached to the uterus.

Reasons to see a doctor may include:

• cramping pains after intimacy;
• pungent smell of discharge after orgasm;
• bright burgundy color of discharge;
• profuse incessant bleeding.

Ectopic pregnancy

In an ectopic pregnancy, the embryo does not reach the uterus, but begins to develop outside it, most often settling on the fallopian tube. Tubal pregnancy is the most common type of ectopic pregnancy. The disease is quite serious and insidious, because. is determined most often after a spontaneous miscarriage or rupture of the pipe. This happens most often no later than 4-6 weeks of pregnancy.

Ectopic are on average 0.8-2% of all pregnancies

Blood discharge during an ectopic pregnancy can begin in the early days. Most often they “smear” underwear, the color of the discharge is dark. Patients complain of pulling pain in the lower abdomen, often radiating to the anus.

When the fallopian tube ruptures, severe bleeding begins, the pain becomes unbearably acute, some women lose consciousness. This is a direct indication for immediate hospitalization!

Internal bleeding during ectopic pregnancy is accompanied by:

• sharp pain;
• nausea and vomiting;
• decrease in pressure and body temperature;
• weakness.

Unfortunately, this type of pathology always ends in miscarriage or abortion. because it is not possible to save the fetus. In some cases, especially with internal bleeding, the life of a woman is also at risk. The disease requires emergency surgery, in which the fetal egg is removed and the tubes are sewn up to preserve childbearing function. Previously, the fallopian tube was completely removed, after which the woman could no longer have children; now resort to this method as a last resort. Currently, hormonal treatment of ectopic pregnancy with the help of specialized drugs that prevent cell division of the embryo and cause its death (Methotrexate) is gaining more and more popularity.

Methotrexate is a strong anticancer hormonal drug that helps with ectopic pregnancy.

To avoid complications, it is necessary first of all to plan a pregnancy. It is possible to diagnose the disease using ultrasound diagnostics in conjunction with a blood test for hCG.

The diagnosis of "ectopic pregnancy" is not a sentence today, with proper treatment and a recovery period, two years later, you can re-plan a pregnancy.

Video: bleeding during an ectopic pregnancy

Bleeding during miscarriage and its threat

Miscarriage is popularly called spontaneous termination of pregnancy or spontaneous abortion. The process of rejection of the fetus from the uterus has several stages, each of which is accompanied by bleeding to one degree or another. There are the following stages of spontaneous abortion:

The main way to diagnose this dangerous condition and prevent it is ultrasound diagnostics. To prevent recurrence, genetic tests are carried out, as well as an anamnesis and numerous laboratory tests, including the material obtained after curettage.

1. antispasmodics to relax the uterine muscles (Baralgin, No-Shpa, etc.);
2. sedatives (Sedasen, tinctures of valerian and motherwort);
3. hormonal drugs that regulate the course of pregnancy (Dufaston, Utrozhestan);
4. vitamins (folic acid, Magne B6, vitamin E, Omega 3 and others);
5. glucocorticoids - drugs that reduce the level of male hormones in the body of a pregnant woman (Dexamethasone, Metipred).

Baralgin has not only antispasmodic. but also analgesic and antipyretic effect
No-shpa - a unique antispasmodic
Valerian tincture is one of the most affordable sedatives.
Vitamin E is recommended to be taken during the entire period of pregnancy.
The hormonal drug duphaston has proven itself as a means of helping to maintain pregnancy.
Folic acid deficiency during pregnancy can be corrected by taking vitamin tablets
Metipred has an immunosuppressive, anti-allergic and anti-inflammatory effect.

In case of termination of pregnancy, you can try again 6-12 months after curettage.

Frozen pregnancy

Frozen pregnancy or fetal death for up to 28 weeks is a terrible diagnosis for any woman, especially because many women may not be aware of this pathology for a long time, since the symptoms do not appear immediately. Previously, they had no idea about such a phenomenon and it was about a sudden miscarriage, and if this did not happen, then the woman could begin severe intoxication against the background of infection of the body, which often led to death.

Modern possibilities of medicine help to diagnose pathology with the help of:

• collection of anamnesis;
• ultrasound diagnostics;
• blood test for hCG;
• palpation of the uterus on examination by a gynecologist;
• listening to the fetal heartbeat.

In order to seek help from a specialist in time, you should listen to your body, because obvious signs of a violation, such as bleeding and pain, appear after a while. Symptoms of a missed pregnancy in the early stages are as follows:

1. Sudden cessation of pregnancy symptoms:
   • disappearance of toxicosis;
   • the breast stops growing and hurting;
   • decrease in basal body temperature.
2. The appearance of pulling pains in the lower abdomen.
3. Deterioration of general well-being: chills, weakness, etc.
4. A sharp increase in body temperature.
5. The appearance of frequent bleeding:
   • if the fetus froze in the first three weeks, then the discharge will appear instead of menstruation and will be more prolonged;
   • with a later fading of the fetus, the discharge is likely to indicate an abortion that has begun and have an appropriate character (see "Bleeding during a miscarriage and its threat").

In any case, no matter how long the development of the fetus stops, the patient is subject to emergency hospitalization. In the hospital, procedures are carried out to clean the uterus from the contents. In the early stages, curettage is resorted to only as a last resort, more often they try to do with sparing methods: medical abortion (for up to 12 weeks) or vacuum aspiration (for up to 5 weeks). It is mandatory to prescribe antibiotic therapy and droppers to relieve intoxication.

After a vacuum abortion, the reproductive function of a woman is most often preserved.

Sad statistics show that up to 40% of pregnant women face this problem at different times. Recurrent missed pregnancy can lead to infertility; primiparous women over 35 are more susceptible to this. In other cases, after hormonal therapy, a six-month rest period, you can try to repeat the pregnancy.

Gynecological diseases as a cause of bleeding

Untreated gynecological diseases or pathologies of the cervix in time can lead to bleeding during pregnancy. Most often, they do not signal possible problems with the fetus, but cause significant harm to the health of the mother. Such diseases include:

1. uterine myoma;
2. erosion of the cervix;
3. cervical cancer;
4. polyps of the cervical canal.

Uterine fibroids are a type of benign tumor that is increasingly being diagnosed in pregnant women. This is due to an increase in the childbearing age, as well as to the improvement of diagnostic methods. During an exacerbation, the disease is accompanied by the following symptoms:

• increased uterine tone and body temperature;
• increase in leukocytes in the blood and erythrocyte sedimentation rate (ESR);
• profuse severe bleeding with an immediate threat of miscarriage;

In most cases, with small myomatous formations, the disease is asymptomatic and does not threaten pregnancy. Complications can arise directly during delivery, in this case, the operation of Cesarean section is most often indicated. Conservative treatment of fibroids is reduced to the following activities:

• to prevent iron deficiency anemia, which contributes to the growth of formations, treatment with iron preparations is indicated (Sorbifer Durules, Maltofer, Ferrum-Lek);
• protein diet;
• vitamins of group B, A and E;
• folic and ascorbic acids.

Cervical erosion often does not require treatment before delivery.

Erosion is a rather unpleasant phenomenon, but most often it does not threaten pregnancy.

The disease is characterized by irregularities and redness of the mucosa, which are diagnosed during examination by a gynecologist. The main symptoms of the disease are purulent and bloody discharge, especially after sex, the sexual intercourse itself causes pain.

Erosion of the cervix can threaten the development of the fetus if accompanied by infections of the genital tract (chlamydia, herpes, gonorrhea, human papillomavirus, etc.). For diagnosis, the doctor will prescribe a blood test for hidden infections and viruses, and also take a swab from the vagina. If concomitant diseases are detected, the following treatment is prescribed:

• antibiotics and antiviral drugs for the treatment of concomitant diseases;
• suppositories to relieve itching and inflammation (Suporon, Hexicon, Depantol);

Gallery: vaginal suppositories for the treatment of cervical erosion

Depantol - a drug that improves tissue regeneration, with antimicrobial action for topical use in gynecology
Suporon is a prophylactic anti-inflammatory agent for topical use.
Hexicon is used to treat sexually transmitted infections

Cervical cancer is quite rare in pregnant women. If there is a suspicion of the presence of the disease, it is necessary to take tests and conduct a cytological screening. Treatment and diagnosis should be carried out by a qualified specialist who will decide whether to continue or terminate the pregnancy and select the best treatment option, because. there is no uniform way. Many factors must be taken into account: the degree of the disease, the stage of pregnancy, aggravating circumstances, and so on.

A polyp of the cervical canal is also a benign formation that is attached to the cervical canal and can affect the uterine area. The disease is diagnosed by colposcopy. Usually does not threaten pregnancy and most often comes out during childbirth. But sometimes, during an exacerbation of the disease, as well as after sexual intercourse or examination on a gynecological chair, spotting from white-pink to brown may appear. In this case, the doctor suggests removing the polyp without scraping the uterus.

Bleeding with hydatidiform mole

A cystic drift is not a pregnancy, but a benign formation caused by a violation of the fertilization process. Unlike normal fertilization in hydatidiform mole, the egg contains two sets of paternal chromosomes and none of the maternal. This leads to the active growth of the chorionic villi, along which bubble-shaped extensions are formed. There are several distorted symptoms of pregnancy:

• excessively pronounced early toxicosis;
• spotting on the background of delayed menstruation;
• the size of the uterus often exceeds the prescribed time;
• inability to establish the presence of a fetus in the uterus;
• extremely high levels of the hormone chorion.

In addition to purulent whites, which are a constant companion of the pathology, a woman may open active bleeding caused by detachment of the placenta from the decidua. It can only be stopped by scraping the uterine cavity.

In addition to the patient's complaints about well-being, hydatidiform mole can be diagnosed using:

• collection of anamnesis;
• ultrasound diagnostics;
• blood tests:
  • general;
  • extended coagulogram;
  • determining the level of creatinine;
• examination by a gynecologist.

To treat the disease, quite complex methods are used, including:

1. Surgical curettage of the pathogenic contents of the uterus, if necessary, hysterectomy - complete removal of the uterus.
2. Chemotherapy to remove cancer cells in a so-called total mole.
3. Radiation therapy to shrink tumors.

After the measures taken and discharge from the hospital, a woman should be under the supervision of a gynecologist-oncologist for two years and regularly donate blood for hCG. Unfortunately, about 30% of cystic drifts end in infertility, and 12% of women who have had the disease have amenorrhea (permanent or temporary absence of menstruation).

- 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.

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.

They can be very scary, but blood loss does not always mean a miscarriage. Bleeding during pregnancy, especially in the first trimester, is more common than you might think. Therefore, it is important to know why they occur and what to do.

According to studies, about 25% of women surveyed confirmed that they had bleeding during pregnancy, and 8% of them were quite heavy. Most cases occurred between weeks 5 and 8, and lasted no more than 3 days.

Of those who bled, only 12% of women experienced a miscarriage. One-time bleeding occurs in many women, but there are those who have them periodically throughout pregnancy. may look like there may be drops, streaks, or discharge similar to menstruation.

Bleeding During Pregnancy: Should You Tell Your Doctor?

Yes. Any bleeding during pregnancy should be reported to the gynecologist immediately.

Any vaginal discharge of blood before 24 weeks of gestation is considered a potential threat of miscarriage. After 24 weeks, this is called prenatal bleeding.

Those with a negative Rh factor should definitely see a doctor within 72 hours after bleeding, as there are suspicions that the baby’s blood may mix with yours. If mixing occurs, the mother's body may begin to produce antibodies against the baby's Rh-positive blood.

Rh positive is much more common than Rh negative. For the first pregnancy, the mixing of blood has no consequences, but in subsequent pregnancies the body may decide to attack unfamiliar matter with antibodies if the baby is Rh positive again.

Below are the most common causes of bleeding during pregnancy. Not all of them are scary and dangerous. During pregnancy, small cramps and pulling sensations occur, and this is normal. But if the bleeding is accompanied by severe pain and cramps, seek medical help immediately.

implantation bleeding

breakthrough bleeding

Some women have what is called a breakthrough or when they should have had their period. Thus, such discharges appear at 4, 8, 12 weeks, respectively. They are often accompanied by the sensations that you usually experience with your period, such as back pain, cramps, heaviness in the lower abdomen, feeling bloated and low on energy.

Of course, due to the fact that you are pregnant, your period does not occur, although you think that you should. During pregnancy, hormones prevent discharge, but sometimes, when hormone levels have not yet reached their peak and cannot stop periods, there is a "breakthrough" - breakthrough bleeding.

This can last up to 3 months, and after that the placenta takes responsibility for the production of hormones by the ovaries. There are women who have breakthrough bleeding almost all the time during pregnancy, and being under the constant supervision of doctors, they freely give birth to healthy babies.

Threatened miscarriage or miscarriage

According to studies, a third of all pregnancies end in miscarriage (the medical term is spontaneous abortion). Sounds daunting, but don't despair, as this number includes very early miscarriages, the first 12 weeks, when a woman may not even realize she was pregnant at all.

A miscarriage of this type often occurs due to damage to the fetus, that is, the woman's body rejects the non-viable fetus.

If you have crossed the mark of 14-16 weeks, you can calm down.

It is best to refrain from announcing your pregnancy to the world before reaching 2 months. Naturally, you may be bursting with emotions and joy, but if a miscarriage occurs, it will be twice as painful for you to report a failed pregnancy again. Empathy is important, but sometimes it can only add to your grief over your shattered dreams of being a mom.

Signs of a miscarriage are bleeding, cramps, pain in the lower back and abdomen. Women often say they "do not feel pregnant" when they have a miscarriage or bleeding. The main signs of pregnancy disappear - nausea, breast tenderness and a swollen belly.

If you are bleeding and feel all of the above, there is a risk that you have lost your baby. If you're experiencing bleeding but don't feel like the pregnancy has ended, there's a good chance it is, but overall, the baby is fine.

A miscarriage can also happen without bleeding, which is often referred to as "" when the fetus dies but is still held by your body inside. Signs of pregnancy in this case will disappear, but cardiac arrest in the fetus can only be determined thanks to ultrasound. A curette may be needed to remove a dead fetus.

Bleeding after intercourse

Bleeding after sex is one of the most common causes of bleeding during pregnancy. It is completely harmless and is due to increased blood supply and softening of the cervix. Although such bleeding is not a serious cause for concern, you should still report it to your doctor. Be prepared for a very personal question about whether you've had sex recently.

This does not mean that you should stop having sex, but you may need to reassure your partner that he will not harm the baby, that he is well protected in the uterus, which is much higher than the vagina.

Ectopic pregnancy

Occurs when a fertilized egg attaches not in the uterus, but outside, usually in the fallopian tube.

You may experience severe pain in the lower abdomen on one side, or twisting pain, as well as weakness and nausea. The pain may suddenly disappear if the tube ruptures, but will return after a few hours or days, and the sensations will be even worse.

This situation is quite dangerous. An ectopic pregnancy can rupture the fallopian tubes and cause internal bleeding, which can lead to infertility. You may have to remove the fallopian tube and end the pregnancy, but this does not mean that you will have problems conceiving in the future, provided that your second ovary and fallopian tube are healthy.

placental bleeding

Another question you might hear at your doctor's appointment is if you've had a scan and where the placenta is located.

Painless vaginal bleeding may result from abnormal placement of the placenta. Sometimes the placenta is located very low on the wall of the uterus, and sometimes right above the cervix. This is called placenta previa and occurs in about 0.5% of pregnancies.

Will inevitably lead to bleeding at some point in your pregnancy - usually after 20 weeks. There are varying degrees of severity of this condition, but they all require repeated ultrasounds for an accurate diagnosis. To prevent endangering the baby, you may be advised to stay in bed, offer induction, or have a caesarean section if the placenta continues to attach to the cervix.

Another cause of bleeding later in pregnancy is placental abruption, when the placenta partially or completely separates from the uterine wall. It occurs in about 1 in 200 pregnancies. Symptoms include general severe pain and heavy bleeding. The bleeding may be visible or hidden in the uterus, which will be tight, hard, hard to the touch, and very painful.

If you smoke, have high blood pressure, kidney problems, or preeclampsia, you are at high risk for placental abruption. This condition requires urgent hospitalization, and depending on the severity of the bleeding, you may be prescribed bed rest, induction, or a caesarean section.

uterine fibroids

Uterine fibroids are masses of hardened muscle and fibrous tissue that can be found inside or outside the walls of the uterus. They can be both problematic and non-problematic during pregnancy - this primarily depends on the location of the fibroid and whether it is enlarged or not.

There is no consensus among doctors on this matter, but it is known that the hormones produced during pregnancy can cause both a decrease and an increase in fibroids.

Fibroids are best removed before pregnancy, as there is a chance that they will lead to ectopic pregnancy, heavy bleeding during pregnancy, or miscarriage.

However, many women give birth without any complications. If you have fibroids, it is important to see a specialist to understand your specific situation and determine the next steps. Avoid Internet self-medication as the matter is serious and should not be left to armchair experts.

What to do if I'm bleeding

If you are more than 20 weeks pregnant, contact your doctor immediately if you have bleeding. Never use tampons if you experience bleeding during pregnancy; always take a pad.

If the bleeding is light and you don't have any pain, still talk to your doctor or nurse. If the bleeding is heavy (in a stream or clots) and is accompanied by abdominal cramps, back pain, and period-like pain, call an ambulance immediately.

It is understandable that you are upset, but try to remain calm and remember that bleeding occurs during pregnancy, this is not an anomaly.

The blood belongs to you, not to the baby, so continuing a perfectly healthy pregnancy and having a healthy baby is possible and most likely. Do not be surprised if with such complaints in the early stages (up to 12 weeks) you are advised to simply watch and wait.

What to do if a miscarriage occurs

If you are experiencing a miscarriage, unfortunately, nothing can stop or prevent this process. Losing a child is always painful, disappointing, and overwhelming, but the best thing you can do is take care of yourself physically and emotionally. It's not your fault that you lost your baby and you can't change anything, but there are things that can help you feel more comfortable physically:

1. Bed rest
2. Paracetamol/Panadeine (medicine used to relieve period cramps)
3. Heating pad or bottle of warm water on stomach
4. Tea and partner support

Together with the secretions, various lumps of tissue, an undeveloped fetus, can also come out, but soon the bleeding will stop. If the bleeding does not stop, you should immediately seek medical attention.

Remember that in most cases, bleeding in early pregnancy occurs spontaneously, and after that, the pregnancy continues healthy and unharmed.