Bleeding in Pregnancy

BLEEDING IN PREGNANCY

Bleeding in pregnancy means bleeding per vagina after the ceasation of normal menstruation periods. This is a situation which make a woman very anxious and increase the concern of the future parents. But some knowledge regarding the same may help them to come out of the problem safely & not increase the problem till they don't get medical aid by their doctors.
The result of the incidence may depend upon the quantity or the colour of the discharge. Heavy bleeding with bright red colour is always a point of concern & is alarming sign. One should not ignore the bleeding even if it is very less or spotting. Timely treatment may reduce the anxiety & increase chance of the pregnancy to reach the term.

Causes of bleeding

Early pregnancy: Bleeding in early pregnancy is very common. 1 out of 4 woman face this problem .This can be normal or due to some serious cause. Most of the abortions (12-15%) occurs in this period. One should be careful in this period (upto12wks)

Molar pregnany: In this instead of fetus structure like bunch of grapes grows inside the womb. This has to be terminated.

Multiple pregnany: More than one fetus that is twin or triplets may cause bleeding which is most of the time is normal.

Ectopic pregnancy: In this the fertilized ovum embedded in the fallopian tube. The fetus doesn't get proper space to grow there. As it grows the fallopian tube may rupture , resulting in vaginal & abdominal bleeding. This is a life threatening situation for the mother also. This is followed by acute lower abdominal which is unbearable. An urgent operation is required to deal this situation. This is less common (1 in 300 cases ).

Structural defects: In baby some time chromosomal defect may occur which spontaneous lead to an abortion.

Incomplete abortion : Due to some trauma or habitual abortion may lead to heavy bleeding. In these cases some product of conception come out of the vagina with or without abdominal pain. Other remains in the uterus causing bleeding & this may increase the chances of catching infections.

Hormonal insufficiency : this may lead to abortion hormone like HCG& progesterone are required for the development and the maintenance of the pregnancy ,their shortage can be treated by giving hormones from outside in the form of tablets or injections.
Infections: Infections of the vagina or cervix may inflame them & cause bleeding. In pregnancy there is an increase in blood supply of the cervix and vagina in pregnancy. Any kind of irritation or infection may lead to bleeding or may be a cause of the recurrent abortion.

Thyroid dysfunctionAny kind of thyroid problem that may be hyper or hypothyroidism may cause bleeding .

Stress Any kind of mental or physical stress may interfere with hormonal channel.

Uterine fibroid
Any kind of structural defect in uterus these are mostly birth defect like bicornuate uterus,uterus with septum and hypoplastic uterus.

Late pregnancy .bleeding in late pregnancy is mostly due to placental defects .this situation is more dangerous than the early pregnancy .

Here the quantity & colour of discharge matters. Small amount ,pinkish ,brown or blackish discharge are common in placenta previa but a close monitoring about the placenta & the fetus is required in any discharge.

Investigations required

Sonographynow a days sonography is cheap,safe and best method of deciding the line of treatment.

thyroid profile

Management of bleeding

Bed rest or restricted movement.

D&C IF USG report shows any abnormality.

Hormonal therapy in case of hormonal insufficiency.

Laprotomy in case of ectopic pregnancy.

Placenta previa should be treated according to USG reports.

how to avoid this situation

Go for regular check-ups after the confirmation of pregnancy.

Try to avoid intercourse up to first 3 months.

Try to avoid stress.this may lead to hormonal imbalance.

Avoid long journey in early pregnancy.

Get treatment for any infection before planning for pregnancy.
get in touch with your doctor as soon as the bleeding or spotting starts.

Continue your thyroid medicine and keep in touch with your physician. He will monitor your thyroid level.

Bleeding in Pregnancy