Pregnancy and Bleeding - III

Bleeding in Late Pregnancy

The causes of bleeding in the second half of pregnancy differ from those in the first half. Common problems that cause light bleeding include an inflamed cervix or growths on the cervix. These may be treated with medication.

Heavy bleeding usually involves a problem with theplacenta. The two most common causes at this time are placental abruption and placenta previa. Preterm labor also can cause such bleeding.

Late bleeding may pose a threat to the health of the woman or the fetus. It may require treatment in a hospital or delivery.

Placental Abruption

The placenta is attached to the uterine wall. It may detach from the wall before or during labor. This may cause vaginal bleeding. It often causes pain, even if bleeding is light or not seen.

When the placenta becomes detached, the fetus may get less oxygen. This can pose a danger.

Only 1% of pregnant women have this problem. It usually occurs in the last 12 weeks before birth. Those at high risk include women who

have already had children are older than 35 years have had abruption before have sickle cell anemia

Placental abruption has been linked to

• high blood pressure
• injuries to the abdomen
• cocaine use
• smoking

Placental abruption is serious. It poses a risk to the woman and the fetus. Prompt care is needed.

Placenta Previa

When the placenta lies low in the uterus, it may cover the cervix. That means it partly or completely blocks the opening. This is called placenta previa. It may cause vaginal bleeding. This type of bleeding often occurs without pain.

Placenta previa occurs in 1 in 200 women. It is more common in those who

• have had more than one child
• have had a cesarean birth
• have had surgery on the uterus
• are carrying twins or triplets

Like placental abruption, placenta previa is a serious condition that needs to be treated quickly.

Labor

Late in pregnancy, vaginal bleeding may be a sign of labor. A mucus plug that covers the opening of the uterus is passed just before or at the start of labor. A small amount of mucus and blood is passed from the cervix. This is called “bloody show.” It is common. It is not a problem if it happens within 3 weeks of your due date. If it happens earlier, you may be going into preterm labor. You should contact your doctor right away.

Other signs of preterm labor are

• vaginal discharge
• change in type of discharge (watery, mucus, or bloody)
• increase in amount of discharge
• pressure in the pelvis or lower abdomen
• low, dull backache
• stomach cramps, with or without diarrhea
• regular contractions or uterine tightening

Taking Action

Call your doctor immediately if you have bleeding in late pregnancy. You may need to be admitted to the hospital to find its cause. Ultrasound may be advised. You may have to stay in the hospital for a few weeks. A blood transfusion may be needed.

Conditions that cause bleeding in late pregnancy pose a risk to both mother and fetus. If the risk is serious it may require early delivery, sometimes by cesarean birth.

Finally...

For many women, bleeding while they are pregnant is a minor annoyance. It may need no treatment. For other women, bleeding can be a sign of a serious problem. You should tell your doctor right away if you have bleeding at any point—early or late. Your health and that of your baby may depend on getting prompt treatment.

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