Bleeding during pregnancy

introduction

Bleeding during pregnancy is vaginal bleeding similar to menstrual bleeding, which occurs in varying degrees and frequency and can have different causes.

Bleeding during pregnancy must always be clarified by a gynecologist, as there can be a variety of causes.

They range from harmless intermenstrual bleeding to impending and imminent abortion.

Bleeding must be presented to a specialist at any time, regardless of the stage of pregnancy, in order to identify and treat possible dangerous processes for the child as early as possible.

Also important in this context is how often the bleeding occurs, how severe it occurs and whether it occurs too Pain or whether the Pain in pregnancy accompanied by other symptoms.

The gynecologist will, after reviewing the Mother pass, in which the stage of pregnancy and previous examination values ​​are noted, carry out further examinations that also include a Ultrasound scan of the uterus and the child includes.
Here you can quickly find out whether the bleeding is just simple spotting, or maybe even that Child's life is threatened.

Is bleeding dangerous during pregnancy?

It is not easy to say whether bleeding during pregnancy is dangerous. There are many causes that are not dangerous and that occur frequently.

So is one Spotting in early pregnancy very common and harmless. It occurs in around 20-25% of pregnant women.
The cause is a change in the body from normal menstrual bleeding to Pregnancy metabolism.
Spotting is usually not severe and not with Concomitant symptoms, such as. Discomfort or pain associated.
They can be quickly assessed as harmless by the gynecologist.

As dangerous cause bleeding during pregnancy is considered threatening Miscarriage. Here it mostly happens larger amounts of blood and bleeding. Sometimes this bleeding is also with pulling uncomfortable pain connected to the mother.

Placental insufficiency and Placenta dissolution lead to profuse bleeding during pregnancy and are also dangerous. They must be treated urgently, otherwise Danger to life for mother and child consists.

How long can bleeding last?

How long bleeding lasts during a pregnancy depends entirely on who triggered the bleeding.

Spotting may last for one or more days, with some symptom-free days in between.

Dangerous abortion or placenta bleeding are usually so severe that they let the patient go to the doctor.
The bleeding is then usually stopped by treatment.

There is so-called implantation bleeding that can be regarded as harmless. They occur during the time when the egg is implanted in the lining of the uterus. The duration is about one to two days.

The so-called withdrawal bleeding, which leads to a miscarriage (Abortion), the bleeding will usually be shorter and sudden.
Sometimes the blood and tissue debris is discovered in the toilet. This can then be followed by minor spotting.

However, in order to determine whether there is still tissue in the uterus, a gynecologist should definitely be consulted for an ultrasound examination.
The uterus may need to be scraped off.

In principle, it should be noted that a gynecologist should be consulted for all bleeding regardless of the length.

Bleeding in the 1st trimester of pregnancy

There are some dangerous and harmless causes in the first trimester and early pregnancy.

One of the dangerous causes is miscarriage (Abortion), which is very often introduced by bleeding in early pregnancy.
Approx. 70% of all pregnancies end prematurely in a miscarriage.
Before the 4th week of pregnancy, the pregnant woman usually does not notice this, after the 4th week of pregnancy it is usually noticed.
In addition to vaginal bleeding, the pregnant woman often feels pulling pelvic pain (see also: Abdominal pain during pregnancy)
However, a completely asymptomatic miscarriage can also occur (missed abortion).

In the event of a miscarriage, no other measures other than bed rest are necessary besides the ultrasound examination.

Read more on the subject at: Signs of a miscarriage

Another cause of first trimester bleeding is ectopic pregnancy. Here the fertilized egg has implanted itself in one of the two fallopian tubes. This can lead to heavy bleeding, which is usually associated with severe to very severe pain in the lower abdomen and side pain.
Ectopic pregnancy, also known as ectopic pregnancy (EUG), is a gynecological emergency because there is a risk of the fallopian tube tearing.
With the EUG, circulatory instabilities and shock to the mother can also be associated with life-threatening situations. EUG is diagnosed using an ultrasound and treatment is carried out through immediate emergency surgery.

With the seldom occurring moles, vaginal bleeding can also occur in the first trimester. A mole of bladder is a benign and non-spreading tumor that developed in the area of ​​the uterus and the fertilized egg during pregnancy.

The mole of the bladder results from a fertilization disorder with chromosomal changes.
The treatment is done by scraping the uterus. The pregnancy is thus terminated, as normal development of the child cannot be guaranteed.

Read more about this under Spotting in early pregnancy

Bleeding in the 2nd trimester of pregnancy

In the so-called Placenta previa If the placenta is not in its intended place in the uterus, it is near the inner cervix.
In this case, however, the pregnancy can continue to be maintained.

But it can then become too during childbirth heavy bleeding come and the bleeding occurs before the rupture of the bladder. During pregnancy, bleeding can occur again and again, but it then disappears.
When a Placenta previa is known, the gynecologist must carry out appropriate blood count tests and check whether the Iron and hemoglobin levels is possibly in need of treatment.

Pregnant women with a placenta previa must also be particularly observed during childbirth, as it can also lead to a Circulatory collapse of the mother and bleeding very heavily after giving birth.

Sometimes it may be necessary to have one Caesarean section must be carried out. However, this also depends on the exact location of the placenta and cannot always be done.
A caesarean section would be more likely to be considered if there is heavy bleeding during pregnancy and the 36th week of pregnancy has been exceeded.

Bleeding in the 3rd trimester of pregnancy

In one in 200 to 500 births there is premature placental detachment, which leads to heavy bleeding in the pregnant woman and represents an absolute emergency, as the supply of the embryo is no longer guaranteed in this case.

The causes of premature placental detachment are pre-eclampsia (high blood pressure during pregnancy), trauma or alternating pressure conditions within the uterus (e.g. after rupture of the bladder and the birth of a twin).
The sometimes extremely heavy bleeding is usually combined with severe pelvic pain. The uterus is as hard as a board, the heartbeat of the child can hardly be detected. There is also the risk of shock to the pregnant woman with circulatory instability and a drop in blood pressure.

Premature placental detachment is diagnosed by an ultrasound scan and must be treated immediately.
A caesarean section is performed before the 34th week of pregnancy if the mother's condition allows it.
The pregnancy must thereby be terminated. After the 34th week, a caesarean section is also performed, here the premature child is usually placed on a premature baby ward.
Read more about this under: Premature placental detachment

There is also profuse bleeding, which is caused by rupture of the blood vessels that run over and supply the membranes. This clinical picture is also known as Insertio velamentosa. This bleeding can be very heavy, usually occurs after the rupture of the bladder and leads to an immediate caesarean section operation.

Read more on the subject at: Diseases of the placenta

What to do in case of bleeding during pregnancy

There is a lot of bleeding during pregnancy, which can have very different causes. When bleeding occurs, it is normal for pregnant women to be startled and frightened.

But it is important to remain calm first. The majority of bleeding during pregnancy is harmless.

Nevertheless, all bleeding must be clarified by a gynecologist. How quickly you should see a specialist depends on the amount of blood lost and the accompanying symptoms.

So set large blood loss with accompanying pelvic pain an emergency and should be immediately checked by a gynecologist (possibly also in the emergency department) be seen.

Simple and weak spotting without abdominal pain can also be examined by a resident gynecologist the next day.

In addition to the amount of blood and the accompanying symptoms, it is also important when the bleeding occurs.

In the Early pregnancy and the first few months of pregnancy light bleeding is common. The causes are mostly harmless and there is usually no danger to the child.

As the pregnancy progresses, i.e. in the second or third stages of pregnancy, the cause of the bleeding can and must have more dangerous causes urgently clarified by a gynecologist become.
Here, too, it should be noted whether there are accompanying symptoms such as Lower abdominal pain comes.

With strong Bleeding associated with pulling pelvic pain a gynecologist should be consulted as soon as possible.

If spotting occurs, regardless of the cause and until a gynecologist is consulted, physical restraint should be observed. This does not mean that the pregnant woman has to stay in bed, but she shouldn't exercise or exercise.