Any bleeding during pregnancy is NOT normal except at the time of delivery. Some patients experience bleeding during early part of pregnancy that is upto 12 weeks, some can experience seventh month onwards. Here we will brief you about the conditions which can cause bleeding during pregnancy and how they can affect mother and the baby.
Bleeding in Early Pregnancy
Bleeding during the early stages of pregnancy may indicate risk of abortion or abortion I.e. there may be threat of abortion or the abortion is happening or happened. In rare cases, this bleeding may be due to an ectopic pregnancy. To diagnose the cause, healthcare professionals need check your condition and perform an internal examination and utilize ultrasound imaging.
Threatened Abortion
Some times during pregnancy, women notice little fresh spotting which may or may not associated with pain in abdomen. Bleeding usually stops immediately. This condition, known as threatened abortion,where there is threat of abortion but abortion has actually started, medical therapy often produces favorable results and pregnancy continues. It doesn’t cause any problem to mother or the baby. Although there is a minor risk of premature delivery later in the pregnancy, most patients can continue their pregnancies without any complications.
Inevitable and Incomplete Abortion
Inevitable or incomplete abortions can occur when the bleeding is more than spotting, usually associated with pain in abdomen and the loss of the pregnancy is unavoidable. It can results in significant bleeding which can affect mother as well. These situations may necessitate surgical procedures, commonly known as D & C or curetting, to ensure the abortion process is completed safely.
Complete Abortion
In few cases, body naturally expels the pregnancy contents completely, no surgical treatment is required known as complete abortion.
Missed Abortion
A missed abortion refers to a scenario in which the embryo or fetus has ceased to develop but remains in the uterus with out giving any signs except for minimal spotting or brownish discharge. Ultrasound shows ceasation of growth of baby with either embryo is not formed or absence of heart beat of the fetus. Typically, surgical intervention is necessary to address this situation as bleeding can occur at any point of time and can be significant to adversely affect the mother. .
Ectopic Pregnancy
Ectopic pregnancy is the condition where embryo is implanted outside of uterus. It may be implanted in the fallopian tube, previous cesarean scar or on the ovary. In such situations, these is no space for the baby to grow and the pregnancy can cause rupture in the organ causing profuse internal bleeding which is life threatening. Common symptoms are spotting , pain in abdomen , low bleed pressure, depending upon patient’s particular circumstances, the size of the ectopic tissue, and whether or not it has ruptured. Thus it requires immediate medical attention ad care as per the condition of the patient.
Bleeding in Later Pregnancy
As mentioned previously, bleeding may occur at the onset of labor pains and is often accompanied by cramp-like abdominal pain that becomes progressively more intense and prolonged. A small amount of bleeding in this context is common and normal.
If bleeding such bleeding happens before 37 weeks of gestation, it may signify preterm labor, where there is risk of premature delivery of the baby. Premature baby can have difficulty in breathing at birth or within few hours to days after birth and can require additional support for breathing. If delivery occur very early i.e. in 7th or 8th month, these are also likely to have difficulty in feeding, infections, etc.
In certain cases, bleeding could arise from an abnormal location of the placenta known as placenta previa, where the placenta lies low in the uterus. Many patients can have this picture on ultrasound in early part of pregnancy, but most of the times placenta migrates upwards due to growing uterus and doesn’t cause problem.However in few women, it can cause bleeding on & off. Initially, this bleeding tends to be minimal, painless, and often appears without any clear cause. These episodes may recur within a few days with subsequent episodes being heavier bleeding. If the episode doesn’t recure, pregnancy can contiue till term. However, it poses major risk for the mother at the time of delivery due to excessive bleeding at the time.
If the bleeding is associated with severe abdominal pain, darker in color, or associated with hypertension during pregnancy, it may indicate premature separation of the placenta, whereby the placenta separates from the uterus before childbirth. This scenario can have serious and life threatening consequences for both the mother and the baby, as the bleeding may be concealed, can be underestimated but it requires urgent delivery.
At some occasions, bleeding can also originate from the cervix or vagina, which may not be life threatening.
Life-Threatening Conditions
Excessive bleeding in incomplete abortion, ectopic pregnancy are life threatening. Both placenta previa and placental abruption are critical conditions that can lead to severe bleeding, posing risks to the health of both mother and baby. Cesarean section is also complicated in these cases, and both mother and baby may necessitate intensive care unit (ICU) management.
In conclusion, bleeding during pregnancy can be a distressing experience for expectant mothers and may indicate various underlying conditions, from harmless spotting to more serious complications. Early detection and thorough medical evaluation are crucial in managing these situations effectively. While some forms of bleeding, such as threatened abortions, may still allow for a favorable outcome, others, like ectopic pregnancy, placental abruption or placenta previa, require urgent medical attention. It’s essential for pregnant women to communicate any bleeding to their healthcare providers promptly to ensure both maternal and fetal health remain protected. All these conditions demand through examination and, if necessary, delivery in a specialized healthcare facility staffed with experienced obstetricians, anesthetists, pediatricians, and intensivists. Our expert Dr. Anuya has successfully managed such cases, ensuring positive outcomes for both mothers and their babies.
ABOUT DOCTOR
Accomplished Obstetrician with vast experience in high risk pregnancy and various gynaecological surgeries.
