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Are nosebleeds common in pregnancy


What causes nosebleeds in pregnancy, and tips to manage them | Your Pregnancy Matters

Pregnant women are more likely to get nosebleeds due to increased blood volume, which may cause vessels in the nose to rupture.

Pregnancy is full of quirky side effects – including nosebleeds. One in five patients get nosebleeds during pregnancy (epistaxis), compared with 6% of women who get them when not pregnant.

Over the course of pregnancy, your total blood volume doubles to support the growing baby. To accommodate this extra blood, the blood vessels in your body dilate. The pressure of the extra blood can sometimes cause the more fragile vessels to rupture and bleed more easily.

Your nose is rich in tiny blood vessels that can get dried out from normal breathing, which can lead to breakage and bleeding. For most pregnant patients, the occasional minor nosebleed is no cause for alarm. It’s mostly just annoying.

I've invited my colleague, Ashleigh Halderman, M.D., an ear, nose, and throat specialist from UT Southwestern's Otolaryngology Department, to talk about what causes nosebleeds during pregnancy, how women can prevent them, and how to stop them when they do occur.

Colds, medications, and unruly sinuses

Dr. Ashleigh Halderman

Even when you aren't pregnant, you're more likely to get a nosebleed with a cold, sinus infection, or allergies. But approximately 20% of women experience pregnancy rhinitis – inflammation and swelling of the mucous membranes in the nose.

Pregnancy rhinitis causes congestion, postnasal drip, and runny nose. And when you're constantly blowing your nose, you're more susceptible to having a bloody nose.

Certain medical conditions such as high blood pressure or clotting disorders can cause nosebleeds as well.

You may also get a nosebleed if the membranes in your nose dry out and crack due to cold weather, dry air, or intense air conditioning.

Pregnancy tumor: A rare cause of nosebleeds

Also known as a pyogenic granuloma, a pregnancy tumor is a noncancerous, rapidly growing mass of capillary blood vessels that bleeds easily. Research suggests the masses form due to the influx of hormones during pregnancy.

Approximately 5% of pregnant women develop pregnancy tumors, which typically form in the gums between the teeth but can also form in the nose. The masses can appear anywhere on the body and generally disappear after the baby is born.

Treatment usually consists of either a medicated gel or nasal spray, which helps control bleeding. Some women need to have the tumor removed if it is causing breathing problems or excessive nosebleeds. The exact procedure to remove the tumor depends on where the tumor is located. For pregnancy tumors of the nose, most can be removed endoscopically without any external incisions or stitches.

Related reading: 5 weird pregnancy symptoms you might not know about

How can I prevent nosebleeds during pregnancy?

While it’s not possible to prevent all nosebleeds, there are few things you can do to avoid irritating the sensitive blood vessels in your nose.

● Moisturize the inside of your nose: Use a bit of saline nasal gel to lubricate dry or irritated nasal passages.

● Use a humidifier: Because dry air increases the risk of nosebleeds, adding a little moisture to the air can do wonders.

● Drink plenty of fluids: This keeps your mucous membranes well hydrated and less likely to dry out and crack.

● Treat colds and allergies: Talk to your doctor about which over-the-counter medications may be best.

Be especially gentle after a nosebleed. Your nose needs to heal, so don’t blow it too hard or stuff tissues in the nostrils, which can prolong bleeding.

How to stop a nosebleed and when to see your doctor

If you do get a nosebleed during pregnancy (or any other time):

● Sit or stand up to keep your head higher than your heart

● Lean forward slightly to stop the blood from running down the back of your throat into your mouth

● Pinch both nostrils and maintain pressure for 10 to 15 minutes

● To help constrict the blood vessels and slow bleeding, you also can apply a cold pack or ice over the bridge of your nose or use a nasal spray such as Afrin before pinching the nostrils together

Call your health care provider if you experience more than a couple nosebleeds during pregnancy, or if:

● Bleeding doesn’t stop after 30 minutes

● Blood flow is heavy

● You have trouble breathing

● You become lightheaded or disoriented

Pregnancy can cause strange things to happen to your body. While nosebleeds generally are nothing to be overly concerned about, talk to your doctor if you are worried. We're always available to help you feel more comfortable during pregnancy.

To visit with an Ob/Gyn, call 214-645-8300 or request an appointment online.

Nosebleeds during pregnancy | Pregnancy Birth and Baby

Nosebleeds during pregnancy | Pregnancy Birth and Baby beginning of content

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Nosebleeds during pregnancy are fairly common. Although they can be alarming, in most cases there's no need to worry and you should be able to treat a bleeding nose yourself.

Why are nosebleeds common during pregnancy?

During your first trimester the amount of blood circulating in your body increases and your heart works harder. This means that the lining of your nasal passage (inside your nose) also receives more blood. You have tiny blood vessels inside your nose so the increased blood volume can sometimes damage those blood vessels and cause them to burst, resulting in a nosebleed.

Changes in your hormones during pregnancy can also contribute to nosebleeds.

These changes can make your nose feel congested (stuffy) and it might get more blocked up than usual. Your gums may also feel swollen and may bleed.

A nosebleed may last for a few seconds or a few minutes, and can flow from one or both nostrils. The blood flow can be light or quite heavy. If a nosebleed happens at night, while you’re sleeping, you may wake up feeling the blood going down the back of your throat before you sit up. It will then come out of your nose.

Are nosebleeds during pregnancy a cause for concern?

Nosebleeds can give you a fright or be a nuisance, but as long as you don’t lose a lot of blood, they are generally nothing to be worried about. In most cases, a nosebleed won’t harm you or your baby.

How do I stop a nosebleed if I have one?

  • Sitting or standing, keep your head upright. This reduces the pressure in the blood vessels inside your nose and will help to slow down the bleeding.
  • Pinch the soft part of your nose, underneath the bony ridge, between your thumb and forefinger. Once you have done this, the two sides of your nose should be pressed together.
  • Keep pinching, without releasing, for 10 minutes.
  • If your nose is bleeding a lot, you may want to lean slightly forward and breathe through your mouth so the blood runs out of your nose, rather than down the back of your throat.
  • Spit out any blood that is in your mouth.
  • You may also want to suck an ice cube or put an icepack on the back of your neck or forehead, or the bony part of your nose.
  • After 10 minutes, gently release your pinch to see if the bleeding has stopped.
  • If your nose is still bleeding, try this procedure again for another 10 minutes.

How can I avoid a nose bleed?

If you are blowing your nose, do so gently and try to avoid large sneezes. You should also avoid picking your nose. You could be more likely to get nosebleeds in winter months when the air is dryer, so you may like to use a dehumidifier in your home to moisten the air.

If you’ve recently had a nosebleed:

  • Sneeze with your mouth open.
  • Try to avoid bending down or vigorously exercising for at least 12 hours afterwards.
  • Avoid hitting your nose on anything.

When should I see a doctor?

Let your doctor know straight away if your nosebleed happens after bumping your head.

You should also contact your doctor if:

  • you have high blood pressure
  • you have taken the steps above and your nosebleed hasn’t stopped after 20 minutes
  • you have trouble breathing through your mouth
  • there seems to be a large amount of blood
  • you are getting nosebleeds frequently
  • you have swallowed a lot of blood and vomited
  • you have a fever or chill

For more information, or to discuss any concerns you might have about nosebleeds, call Pregnancy, Birth and Baby on 1800 882 436.

Sources:
Healthy WA (Healthy WA - Nose bleeds), Mater Mothers Hospital (Pregnancy information for women and families), NHS Choices (Nosebleeds in pregnancy), Raising Children Network (15 weeks pregnant), St John Ambulance Australia (First aid tip: nosebleeds)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2021


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Nosebleeds - MyDr.com.au

What causes nosebleeds? How can I prevent them? What first aid measures can I use to stop a nosebleed? Find out here.