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Pathological and physiological causes of bleeding during early pregnancy

The gestation period is a complex process that does not always go well. Every second woman has various complications. Most often, women go to the doctor with complaints of spotting. Why does bleeding occur during early pregnancy, how dangerous is it?

Causes of bleeding in pregnancy

Blood in the first trimester of pregnancy in the vaginal secretion is observed in 30% of expectant mothers. Bleeding can be weak, spotting, plentiful.

Most often, blood during early pregnancy is observed during implantation of the fetal egg. When the egg is attached, the vessels are often damaged, which leads to the appearance of blood secretions. They are similar to menstruation, last 1-2 days. This process is considered natural, does not indicate any pathologies.

Any bloody discharge during early pregnancy is a reason for an urgent appeal to a gynecologist. Even if there is no additional discomfort. At a remote consultation, our doctor will collect an anamnesis, draw up a clinical picture in order to identify the cause of bleeding. And he will select effective methods to eliminate the problem.

Blood during pregnancy - other common causes

In addition to the main ones, there are some other reasons why pathology can develop.

Bleeding in the first trimester can be caused by causes that appear at any gestational age. These are fibroids, polyps in the uterus and cervical canal, cardiovascular pathologies that are associated with a weakening of the endothelium.

Physiological or pathological bleeding during gestation - differences

Clinical manifestations of bleeding in pregnant women depend on the causes. Physiological discharge of blood from the genital tract in the early stages of gestation proceeds without deterioration in well-being. With bleeding caused by erosion, fibroids and polyps, there are also no additional discomfort. In this case, only a few drops of blood are released, it bleeds for a short time.

Abundant bleeding, similar to menstruation, against the background of a general satisfactory condition, occurs with a deficiency of progesterone.

Bleeding with spontaneous interruption is accompanied by constant or periodic pain in the lumbar region, abdomen. Disturbed by nausea, bouts of dizziness, slightly increased body temperature. Bleeding can be weak or intense, and clots are often observed in the discharge.

When a fertilized egg is fixed outside the uterus, internal bleeding often occurs, and discharge from the genital tract may appear much later. Characteristic manifestations - acute pain in the abdomen radiates to the anal region, right or left side, blood pressure decreases, cold sweat appears, fainting is possible. Significant blood loss leads to the development of a state of shock with a high probability of death.

Learn more about implantation bleeding

Why does it bleed at the initial stages of gestation? Most often, the appearance of spotting during pregnancy is associated with the implantation of the embryo. They occur 6-12 days after conception and are often one of the first signs of conception.

Usually, the appearance of spotting at the beginning of pregnancy coincides with the time of the onset of menstruation, if the cycle is regular. But discharge in pregnant women is not as abundant as menstrual bleeding. Duration - from several hours to three, with the first pregnancy up to 5 days.

How does implantation bleeding manifest?

• weak, pulling pain in the lower abdomen;
• headache, dizziness;
• sudden change of mood;
• bouts of nausea;
• increased sensitivity, swelling of the mammary glands;
• fatigue, drowsiness.

Important! When the embryo is implanted, little blood is released, usually these are small spots. The discharge may be pink, brown, orange, and there should be no clots.

Possible causes of early bleeding by week

The first months of pregnancy are the most difficult and dangerous. It is in the early stages that various pathologies and complications often appear.

Why blood may appear in the early stages during pregnancy:

1. At the 4th week of pregnancy, discharge with an admixture of blood may appear - this is implantation bleeding. Heavy bleeding is a dangerous sign, most often indicates a miscarriage. Spontaneous abortion can be caused by exercise, fever, infections, drugs or alcohol. Such bleeding is profuse, painful, blood clots are present.
2. The appearance of sanious discharge at the 5th week of pregnancy may be a sign of a missed pregnancy. The reasons are overwork, Rh conflict, bad habits, bacterial and viral diseases of the reproductive system, genetic disorders in the embryo. Symptoms - causeless fever, severe pain in the lower back and lower abdomen, the disappearance of signs of toxicosis.
3. Blood in the discharge at the 6th week of pregnancy appears with an ectopic attachment of the fetal egg, fetal fading, Rhesus conflict. Discharge with blood at 6 weeks of pregnancy is a reason for an urgent visit to the gynecologist.
4. At the 7th week of pregnancy, discharge with blood is not the norm. May indicate a miscarriage, missed or ectopic pregnancy.
5. From the 8th week of pregnancy, one of the most dangerous periods of pregnancy begins. The formation of the placenta begins, the hormonal background changes. Bloody discharge appears with the threat of miscarriage or spontaneous abortion. Pregnancy is often not saved.

Pay attention! In the second trimester, bleeding occurs only in 5-10% of women. Most often this is due to late spontaneous abortion, isthmic-cervical insufficiency. The appearance of blood in the third trimester mainly occurs with presentation, placental abruption.

Early bleeding after IVF

The appearance of blood discharge during pregnancy on the 8-10th day after IVF is not considered a pathology, provided that the woman feels normal. After the introduction of the embryo into the uterine cavity, minor damage to the small uterine vessels often occurs. Brown, dark cream, pale pink, odorless discharge most often indicates a successful transplant, pregnancy.

If spotting after IVF is observed for 1-2 days, slight pulling pains in the lower abdomen are disturbing, this may be due to a progesterone deficiency. After the examination, the doctor will adjust the hormonal maintenance therapy.

Pink discharge on the 16th day after the transfer is a dangerous symptom. It may be a sign of detachment of the fetal egg, the threat of termination of pregnancy.

According to studies, uterine bleeding in the first trimester is a common occurrence in pregnancy after IVF. Discharge does not affect the incidence of adverse reproductive outcomes. The number of embryo rejections in women with and without uterine bleeding is approximately the same. Consult with our doctors by phone for more details.

Diagnostics

If blood has gone from the genitals of a pregnant woman, the doctor conducts an external and gynecological examination.

Analyzes and examinations:

• general and biochemical blood test;
• general urine analysis;
• tests for hCG, other hormones;
• Ultrasound of the pelvic organs;
• CTG is performed to assess the vital activity of the fetus.

Treatment

Methods of treatment depend on the results of the examination.

Bloody discharge in the first trimester - causes and therapeutic measures:

Complications and consequences

It is impossible to ignore bloody impurities in vaginal discharge during pregnancy. Without proper and timely assistance, the following complications may occur:

• miscarriage;
• intrauterine fetal death;
• the development of an infectious process, sepsis due to the remainder of dead tissues in the uterine cavity;
• profuse blood loss can lead to death.

Important! Urgent medical attention is needed in case of heavy bleeding, discharge of bright scarlet blood, presence of blood clots in the discharge. In life-threatening and fetal conditions, severe pain in the abdomen, lower back, convulsions, profuse cold sweat, and loss of consciousness are disturbing.

Methods of prevention

If there is blood in the first trimester, it is important to remain calm. Stress and anxiety will only exacerbate the situation. But any health problem is easier to prevent than to treat.

How to avoid bleeding during childbearing - recommendations from a gynecologist:

• eat right and balanced, give up junk and junk food, eat more fresh vegetables and fruits;
• observe the drinking regime;
• in the absence of contraindications, moderate physical activity is indicated - yoga, swimming, special gymnastics for pregnant women;
• more time to walk in the fresh air;
• avoid stress, overwork, observe the daily routine, get enough sleep;
• give up bad habits, do not be in smoky rooms;
• timely visit a gynecologist;
• according to the doctor's prescription, take vitamin complexes for pregnant women;
• do not self-medicate.

The prognosis for bleeding during gestation depends on the causes and timely visit to the doctor. Properly provided medical care can save the life of the fetus and the woman.

FAQ

Why is there blood from the genital tract during gestation?

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The causes of bleeding in early pregnancy are different. Most often, spotting appears when the fetal egg is fixed, progesterone deficiency, with erosion of the cervix and polyps. Dangerous causes - ectopic, molar, miscarriage, miscarriage.

What to do if there is bleeding during pregnancy?

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Much depends on the amount of blood released, general well-being. If the bleeding is not strong, not for long, the general condition is normal, it is enough to lie down and rest. Write down the date of the attack, inform the doctor at the next visit. But if even slight spotting during early pregnancy lasts more than 72 hours, is accompanied by cramping or acute pain, fever, you should immediately visit a gynecologist or call an ambulance.

How can you recognize a miscarriage?

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With the threat of interruption, spotting is scanty, pain in the lower abdomen is absent or may be dull, aching. The condition is considered reversible, with timely treatment, pregnancy can be saved. If a miscarriage has begun, bleeding intensifies, cramping pain appears. The general condition is satisfactory. Urgent hospitalization is required, the probability of maintaining pregnancy is decided on an individual basis.

Expert opinion:

Bleeding during pregnancy is a dangerous symptom. Sometimes spotting can be caused by physiological reasons. But often such a symptom appears in life-threatening conditions for the woman and the fetus.

We publish only verified information

Article author

Menshikova Maria Viktorovna obstetrician-gynecologist

Experience 38 years

Consultations 1816

Articles 46

Specialist with extensive practical experience. He has a certificate of a mammologist, a certificate of professional certification. Participates in foreign business trips and individual training programs (Los Angeles).

• 1982 - 1986 NPO MONIIAG - obstetrician-gynecologist
• 1987 - 1989 VNITs OZMIR - obstetrician-gynecologist
• 1989 - 1992 departmental polyclinic st. Moscow - Kurskaya - obstetrician-gynecologist
• 1992 - 2001 NPO MONIIAG - obstetrician-gynecologist
• 2007 - 2008 NP KMIKM - doctor administrator
• 2009 - 2013 Pereslavl Central District Hospital, women's consultation - obstetrician-gynecologist
• 2020 to present Teledoctor24 LLC - doctor - consultant (gynecologist)

Bleeding during pregnancy. What is Bleeding During Pregnancy?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Bleeding during pregnancy is a sign that can occur regardless of the period of embryogenesis and indicates ongoing changes in the woman's body. 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.

• Causes of bleeding during pregnancy
• Classification and symptoms of bleeding during pregnancy
• Diagnosis and treatment of bleeding during pregnancy
  • Prognosis and prevention of bleeding during pregnancy
• Prices for treatment

General

Bleeding during pregnancy is an obstetric symptom, indicating the possible development of a number of disorders, the cause of which can be both physiological changes in the woman's body after conception, and pathological conditions. Only an obstetrician-gynecologist can finally find out the etiology of such a manifestation after a complete examination. Bleeding during pregnancy occurs in about one in five patients. In 50%, they indicate pathological changes and end in spontaneous miscarriage. In half of the patients, the symptom is physiological in nature. Bleeding occurs more often in the first and third trimester of embryogenesis.

The danger of bleeding during pregnancy lies in the fact that a variety of factors can provoke them, including those that pose a threat to the mother and fetus. In some situations, there are no other pathological signs. Any bleeding during pregnancy should be a reason for immediate medical attention. Only a specialist is able to assess the danger to the health of a woman and the fetus, as well as decide on further tactics. Timely assistance provided even with an abnormal course of pregnancy allows you to continue its management and save the life of the child.

Bleeding during pregnancy

Causes of bleeding during pregnancy

Bleeding during pregnancy can occur at any time of embryogenesis, develops both against the background of physiological changes in the woman's body, and as a result of the formation of a certain obstetric pathology. In the early stages, half of the women have a slight separation of blood due to the implantation of the fetal egg in the uterine cavity. Such bleeding during pregnancy is often regarded by the patient as menstrual, so she does not seek medical help, which in the future may make it difficult to determine the timing of embryogenesis. A similar symptom is possible with insufficient production of progesterone in the early stages of gestation.

The most common cause of abnormal bleeding during pregnancy in the first trimester is spontaneous miscarriage. This symptom appears both with a just-started and with a complete abortion. Approximately 6 weeks after conception, the symptom occurs with an ectopic attachment of the fetal egg. Also, bleeding during pregnancy at this time may indicate an Rhesus conflict, fetal fading. Similar manifestations are characteristic of women suffering from varicose veins that feed the uterus. In this case, bleeding during pregnancy is due to increased blood supply to the tissues.

Bleeding during pregnancy in the second trimester is diagnosed much less frequently, in about 5-10% of all cases of gestation. As a rule, the symptom is caused by pathological changes and in most cases indicates spontaneous late abortion or isthmic-cervical insufficiency. Sometimes the separation of blood from the genital tract is observed during intrauterine death of the fetus. Bleeding during pregnancy in the third trimester also always speaks of the development of gestation pathology. The most common cause is placenta previa. In this case, the embryonic organ completely or partially covers the uterine os, while due to the high load on the lower segment, placental micro-ruptures occur, which causes a similar sign.

Less commonly, bleeding during pregnancy in the third trimester is due to premature detachment of a normally located placenta. In this situation, there is a high threat to the life of the fetus. The danger also lies in the fact that initially internal bleeding develops during pregnancy or the formation of a hematoma, and only then the blood flows out. The rarest, but most dangerous for the life of the mother and child, the cause of the development of this symptom is uterine rupture. Such a complication is diagnosed in the presence of a scar on the myometrium and tissue overstretching, provoked by polyhydramnios, large fetuses or multiple pregnancies. It is extremely rare that bleeding during pregnancy occurs due to a violation of the integrity of the membranes or umbilical cord vessels.

Also, bleeding during pregnancy can be triggered by causes that appear at any stage of embryogenesis. Such reasons include benign neoplasms - fibroids, polyposis growths in the cervical canal and uterine cavity. Often bleeding during pregnancy occurs in women with cervical erosion. Sometimes a sign occurs due to increased blood circulation in the pelvic organs. The risk of developing a symptom is also present with violent sexual intercourse, significant physical exertion, concomitant cardiovascular diseases associated with a weakening of the endothelium.

Classification and symptoms of bleeding during pregnancy

Depending on the origin of bleeding, two groups can be distinguished:

• Physiological bleeding during pregnancy - occurs due to the restructuring of the body, does not pose a threat to the health and life of the fetus or mother.
• Pathological bleeding during pregnancy - indicate its abnormal course, may be accompanied by a risk to the life and health of the woman and baby, require immediate medical attention.

The clinic of bleeding during pregnancy directly depends on the cause of this symptom. Isolation of blood from the genital tract in the early stages of embryogenesis, provoked by physiological changes, proceeds against the background of general well-being. Bleeding during pregnancy, which has developed due to the presence of polyps, erosion, fibroids in most cases also does not cause disturbances in well-being. In this case, there is a slight release of biological fluid - just a few drops, the symptom is of a short-term nature. More abundant, similar to menstrual, will be bleeding during pregnancy associated with a deficiency of progesterone.

In the case of bleeding during pregnancy associated with its spontaneous interruption, the patient is worried about constant or cramping pain in the lumbosacral region, abdomen. Additionally, nausea, dizziness, malaise, and a slight increase in body temperature may occur. Bleeding during pregnancy in this case can be of varying intensity, often in the discharge there are pieces of tissue. With an ectopic attachment of the fetal egg, as well as with a rupture of the uterus, a serious threat to the life of a woman arises. In such a situation, internal bleeding initially develops during pregnancy, and only then do pathological discharges from the external genital tract appear. There is acute pain in the abdomen with irradiation to the anal region, the lateral parts of the body. With significant blood loss, a state of shock occurs with a threat of death.

Bleeding during pregnancy in the later stages is also not always accompanied by a detailed clinical picture. In the case of placenta previa, this is the only symptom that should cause alertness in a woman and become a reason for contacting an obstetrician-gynecologist. As for the premature detachment of a correctly attached placenta, in this case, bleeding during pregnancy develops against the background of uterine hypertonicity, there is pain in the abdomen, deterioration in general well-being. During cardiac monitoring of the fetus, there is a violation of the heart rate, motor activity.

Diagnosis and treatment of bleeding during pregnancy

To identify the cause of bleeding during pregnancy, a gynecological examination of a woman is performed. With changes in physiological origin, no deviations from the norm can be detected. With pathological bleeding during pregnancy against the background of spontaneous abortion, an opening of the cervix is ​​observed. An increase in the tone of the myometrium may indicate the onset of placental abruption. Of the laboratory diagnostic methods, an analysis is used to determine the concentration of hCG (human chorionic gonadotropin). With ectopic pregnancy and bleeding, this figure will be reduced. Instrumental diagnosis of bleeding during pregnancy is to conduct an ultrasound scan. Using this method, it is possible to assess the state of the myometrium and the embryo, the level of blood flow in the vessels, the exact localization of the placenta and (possibly) its incipient detachment. Using CTG, the diagnostician can make a conclusion about the vital activity of the fetus.

Treatment of bleeding during pregnancy also depends on the cause of the symptom. If there are no pathological changes or the manifestation is provoked by damage to the polyp, medical attention is not required. In rare cases, the doctor recommends its removal. Expectant tactics are also used in case of cervical erosion. Her cauterization is carried out after childbirth. Bleeding during pregnancy against the background of the threat of miscarriage and placenta previa requires immediate hospitalization in an obstetric hospital, followed by the appointment of drug treatment. To reduce uterine tone, sedatives, tocolytics are used. Pregnancy management in this case requires careful monitoring by a specialist.

Bleeding during pregnancy caused by ectopic attachment of the ovum, scar rupture, or completed spontaneous abortion requires hospitalization and surgical treatment. After removal of the remnants of fetal tissues or emergency delivery, antibiotic therapy is prescribed. In this case, stopping bleeding during pregnancy is carried out in different ways, depending on its intensity, often ligation of the uterine arteries is performed. With premature detachment of the placenta, an emergency caesarean section is indicated.

Prognosis and prevention of bleeding during pregnancy

Bleeding during pregnancy is usually accompanied by a favorable prognosis.

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