Bleeding during pregnancy: specialists & information

Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

Bleeding during pregnancy is a scare for many expectant mothers. However, light bleeding is often no cause for concern, especially at the beginning of pregnancy. Nevertheless, take the bleeding seriously and have yourself examined.

Here you will find further information and selected specialists for bleeding during pregnancy.

ICD codes for this diseases: O20

Recommended specialists

Article overview

Definition: What is bleeding during pregnancy?

Bleeding during pregnancy refers to vaginal blood loss. It is often harmless, especially in the first three months of pregnancy. It is often so-called spotting, which is much weaker than menstrual bleeding.

It can be accompanied by mild to severe pain or be completely painless. The blood looks reddish to brownish.

Symptoms in addition to bleeding

Particularly in early pregnancy, slight blood loss can indicate that the fertilized egg is implanting in the uterine lining. Implantation bleeding lasts around one to two days, the blood is usually bright red and can occasionally be associated with slight, pulling pain.

In addition to the loss of blood from the vagina, the following symptoms may occur:

  • Pallor,
  • restlessness,
  • Tachycardia (increased pulse),
  • hypotension (low blood pressure),
  • cold sweats and
  • Clouding of consciousness.

Depending on how far the pregnancy has progressed and the underlying cause, you may experience

  • Drawing pains (in the first trimester),
  • painless bleeding (in the second trimester) or
  • heavy bleeding and
  • a hard, aching uterus (in the third trimester)

symptoms.

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Bleeding during pregnancy usually has harmless causes, but should still be clarified @ bilderzwerg | AdobeStock

Causes and risk factors

If the bleeding is not due to the implantation of the egg, other causes are possible.

Lack of corpus luteum hormone

Vaginal bleeding in early pregnancy can also be a sign of a lack of corpus luteum hormone. Substitution with progesterone is then necessary.

Abortion bleeding

Despite successful fertilization of the egg, abortion bleeding may occur: The egg could not implant in the uterine lining and normal menstruation begins.

Early abortion

The loss of the embryo in the first trimester of pregnancy is known as early abortion and is accompanied by bleeding.

Tubal or ectopic pregnancy

An ectopic or abdominal pregnancy refers to implantation of the fertilized egg in the fallopian tube or another (unwanted) location in the abdomen.

In addition to spotting, it is also characterized by severe pain in the abdomen and can be life-threatening.

Contact bleeding

The tissue is very well supplied with blood during pregnancy. Small wounds can therefore lead to bleeding more quickly, for example after

  • sexual intercourse,
  • an examination or
  • exertion.

This bleeding is known as contact bleeding.

Cervical cancer

Cervical cancer can manifest itself in the early stages through light contact or spotting bleeding. If a tumor is detected during pregnancy, treatment can be tailored to this situation.

The further course of the pregnancy is carefully monitored by the relevant specialists.

Placenta previa

If the placenta is located in front of the cervix, sudden, painless bleeding often occurs later in the pregnancy. This is referred to as placenta praevia or anterior wall placenta.

Heavy bleeding from the placenta can pose a risk to mother and child. For example, a premature birth is possible, i.e. a delivery before the 37th week of pregnancy.

In this case, the unborn child is usually delivered by caesarean section from the end of the 36th week of pregnancy. In this way, doctors prevent severe bleeding and possible fetal death during birth.

Uterine rupture

A uterine rupture is when the uterine wall tears. There is a risk of death for the mother and her unborn child due to the large loss of blood with signs of shock!

Uterine rupture is also accompanied by severe pain and contractions, which suddenly stop after the rupture. Uterine rupture requires an emergency caesarean section.

Premature placental abruption

The dark red bleeding caused by premature placental abruption is a pregnancy complication. It can vary in severity and be painful. However, premature placental abruption does not always have to be accompanied by vaginal bleeding. The uterus hardens permanently.

Premature placental abruption means an acute lack of oxygen for the unborn child. An emergency caesarean section is then necessary.

Drawing hemorrhage

Drawing bleeding with discharge of the mucous plug often indicates that the birth is approaching. There is a risk of premature birth before the 35th week of pregnancy.

Premature birth

Bleeding in the last trimester of pregnancy can indicate a premature birth. It is often accompanied by pain in the abdomen similar to contractions and amniotic fluid leakage.

If there are signs of a premature birth, you should go to a clinic or perinatal center as soon as possible. This is particularly important if the expected date of birth is still a long way off.

Examination & diagnosis

Especially during pregnancy, it's better to go to the doctor once too often than once too little! Always discuss any bleeding with your gynecologist. If the pain is severe, go to hospital or call an ambulance.

Even if the cause is usually harmless, you should have yourself examined. Once the diagnosis has been confirmed, the gynecologist or an obstetrics specialist can explain what you should do in the further course of the pregnancy.

After a discussion about the symptoms and previous illnesses of the pregnant woman, a physical and sonographic examination will be carried out. Only if a placenta praevia is suspected should a vaginal examination not be carried out.

The blood can also provide information about the cause of the bleeding. If an ectopic or ectopic pregnancy is suspected, blood is taken from the patient and the HCG level is tested. A pregnancy outside the uterus can be assumed if

  • the HCG level is very high and
  • no embryonic structure is visible in the uterus.

General information on treatment

Depending on the diagnosis, there are different treatment methods for bleeding during pregnancy.

If the cause is harmless, such as implantation or contact bleeding, rest and abstinence from sexual intercourse and exercise are sufficient.

If there is a threat of premature birth or miscarriage

  • the administration of luteal hormone,
  • a cervical collar,
  • a cervical pessary or
  • labor-inhibiting medication

can help.

In the event of premature placental abruption or uterine rupture, a caesarean section must be performed to save the lives of mother and child.

An ectopic or ectopic pregnancy usually has to be surgically terminated or removed.

Progression & prognosis

The prognosis depends on the individual case due to the various causes.

Take all bleeding seriously and have yourself examined - even if the causes are very rare and serious. Depending on the cause of the bleeding, the pregnancy can continue calmly and normally with the appropriate measures.

In the case of the causes described with a higher risk for mother and child, the pregnant woman will usually receive immediate clinical care. A caesarean section may be performed promptly.

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