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Home » Misc » Bleeding in the 3rd trimester

Bleeding in the 3rd trimester


Vaginal bleeding in late pregnancy: MedlinePlus Medical Encyclopedia

One out of 10 women will have vaginal bleeding during their 3rd trimester. At times, it may be a sign of a more serious problem. In the last few months of pregnancy, you should always report bleeding to your health care provider right away.

You should understand the difference between spotting and bleeding:

  • Spotting is when you notice a few drops of blood every now and then on your underwear. It is not enough to cover a panty liner.
  • Bleeding is a heavier flow of blood. With bleeding, you will need a liner or pad to keep the blood from soaking your clothes.

When labor begins, the cervix starts to open up more, or dilate. You may notice a small amount of blood mixed in with normal vaginal discharge, or mucus.

Mid- or late-term bleeding may also be caused by:

  • Having sex (most often just spotting)
  • An internal exam by your provider (most often just spotting)
  • Diseases or infections of the vagina or cervix
  • Uterine fibroids or cervical growths or polyps

More serious causes of late-term bleeding may include:

  • Placenta previa is a problem of pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix.
  • Placenta abruptio (abruption) occurs when the placenta separates from the inner wall of the uterus before the baby is born.

To find the cause of your vaginal bleeding, your provider may need to know:

  • If you have cramping, pain, or contractions
  • If you have had any other bleeding during this pregnancy
  • When the bleeding began and whether it comes and goes or is constant
  • How much bleeding is present, and whether it is spotting or a heavier flow
  • The color of the blood (dark or bright red)
  • If there is an odor to the blood
  • If you have fainted, felt dizzy or nauseated, vomited, or had diarrhea or a fever
  • If you have had recent injuries or falls
  • When you last had sex and if you bled afterward

A small amount of spotting without any other symptoms that occurs after having sex or an exam by your provider can be watched at home. To do this:

  • Put on a clean pad and recheck it every 30 to 60 minutes for a few hours.
  • If spotting or bleeding continues, call your provider.
  • If the bleeding is heavy, your belly feels stiff and painful, or you are having strong and frequent contractions, you may need to call 911 or your local emergency number.

For any other bleeding, call your provider right away.

  • You will be told whether to go to the emergency room or to the labor and delivery area in your hospital.
  • Your provider will also tell you whether you can drive yourself or you should call an ambulance.

Baeseman ZJ. Vaginal bleeding in pregnancy. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2021. Philadelphia, PA: Elsevier 2021:1227-1229.

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 18.

Hull AD, Resnik R, Silver RM. Placenta previa and accreta, vasa previa, subchorionic hemorrhage, and abruptio placentae. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 46.

Salhi BA, Nagrani S. Acute complications of pregnancy. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 178.

Updated by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Browse the Encyclopedia

Vaginal bleeding in late pregnancy Information | Mount Sinai

What Causes Bleeding Later in Pregnancy?

When labor begins, the cervix starts to open up more, or dilate. You may notice a small amount of blood mixed in with normal vaginal discharge, or mucus.

Mid- or late-term bleeding may also be caused by:

  • Having sex (most often just spotting)
  • An internal exam by your provider (most often just spotting)
  • Diseases or infections of the vagina or cervix
  • Uterine fibroids or cervical growths or polyps

More serious causes of late-term bleeding may include:

  • Placenta previa is a problem of pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix.
  • Placenta abruptio (abruption) occurs when the placenta separates from the inner wall of the uterus before the baby is born.

What to Tell Your Health Care Provider

To find the cause of your vaginal bleeding, your provider may need to know:

  • If you have cramping, pain, or contractions
  • If you have had any other bleeding during this pregnancy
  • When the bleeding began and whether it comes and goes or is constant
  • How much bleeding is present, and whether it is spotting or a heavier flow
  • The color of the blood (dark or bright red)
  • If there is an odor to the blood
  • If you have fainted, felt dizzy or nauseated, vomited, or had diarrhea or a fever
  • If you have had recent injuries or falls
  • When you last had sex and if you bled afterward

What Should Happen Next?

A small amount of spotting without any other symptoms that occurs after having sex or an exam by your provider can be watched at home. To do this:

  • Put on a clean pad and recheck it every 30 to 60 minutes for a few hours.
  • If spotting or bleeding continues, call your provider.
  • If the bleeding is heavy, your belly feels stiff and painful, or you are having strong and frequent contractions, you may need to call 911 or your local emergency number.

For any other bleeding, call your provider right away.

  • You will be told whether to go to the emergency room or to the labor and delivery area in your hospital.
  • Your provider will also tell you whether you can drive yourself or you should call an ambulance.

Baeseman ZJ. Vaginal bleeding in pregnancy. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2021. Philadelphia, PA: Elsevier 2021:1227-1229.

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 18.

Hull AD, Resnik R, Silver RM. Placenta previa and accreta, vasa previa, subchorionic hemorrhage, and abruptio placentae. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 46.

Salhi BA, Nagrani S. Acute complications of pregnancy. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 178.

Last reviewed on: 10/5/2020

Reviewed by: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A. D.A.M. Editorial team.

Medical advice for doctors | Remedium.ru

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Pregnancy and bleeding in early and late periods

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Bleeding during early and late pregnancy

Bleeding at various stages of pregnancy is a pathological symptom. Its appearance requires additional research methods aimed at clarifying the cause and selecting therapy.

Causes of bleeding during pregnancy

The only physiological cause of bleeding in the early stages may be the manifestation of implantation of the fetal egg in the uterine cavity. Pathological causes will depend on the gestational age.

In the early stages bleeding can be caused by:

  • Complete or partial detachment of the ovum.
  • Placenta previa.
  • Fetal death.
  • Pathology of hemostasis or Rhesus conflict.

Second trimester bleeding is rare. The reasons may be:

  • Placenta previa.
  • Spontaneous fetal death.
  • Isthmic-cervical insufficiency.

In the third trimester bleeding occurs as a result of:

  • Premature detachment of a normally located placenta.
  • Offers placenta.


Diagnosis

To clarify the cause of bleeding during pregnancy, it is necessary to find out the patient's complaints, the conditions for their occurrence, as well as possible provoking factors. The doctor evaluates the nature of menstrual and reproductive function.

After vaginal examination, additional examination methods are prescribed, which include:

  • Examination of the hormonal profile with the determination of the level of human chorionic gonadotropin, as well as progesterone. A discrepancy between the level of v-hCG and the term may indicate fetal death or an ectopic pregnancy.
  • Blood test for Rh factor, as well as the determination of antibodies. With a negative Rh mother, a threat may develop due to increasing antibodies against the fetal organism.
  • Coagulogram. The evaluation of the coagulation system is carried out in order to exclude pathologies of hemostasis.
  • Ultrasound . A non-invasive method is used to visualize the placenta, fetus, and determine the blood flow between the mother and fetus. With the help of ultrasound, it is possible to set the exact date, as well as exclude fetal growth retardation or malformations, and calculate the heart rate.
  • Cardiotocography. A non-invasive study is ordered to evaluate the vital signs of the fetus by recording the heart rate.


Treatment

If the disease is caused by fetal death, curettage of the uterine cavity or induction of labor is performed.

In case of partial detachment of membranes, hemostatic and hormonal treatment is prescribed.

Isthmic-cervical insufficiency involves surgical intervention with suturing of the cervix, as well as hormonal treatment with progesterone drugs.

Premature abruption of a normally located placenta, as well as uterine rupture, is an indication for emergency operative delivery.


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