Bleeding during pregnancy is considered one of the most alarming symptoms or warning signs of pregnancy. Spotting is most common among pregnant women during the first trimester and about 1 in 5 women experience some bleeding in early pregnancy. It’s important to know that even the slightest pregnancy bleeding shouldn't be overlooked, must be investigated as early as possible and treated appropriately.
The causes of bleeding during pregnancy can be classified into two categories; physiological and pathological.
Bleeding during early pregnancy may be physiological as a result of the process of implantation after conception, when the fertilized egg or blastocyst implants itself into the uterine wall of the pregnant mom. The walls of the uterus are highly vascular and when the blastocyst (your newly formed baby) erodes through the uterine wall, some vaginal bleeding popularly referred to as implantation bleeding may occur.
This pregnancy bleeding is totally physiological and often occurs even before the time any newly pregnant woman would miss her period. Most women confuse this bleeding for a kind of early menstruation. In addition, the formation and growth of placenta after implantation sometimes present with bleeding as well.
Bleeding while pregnant may also occur due to physical trauma in the vaginal lining, which could result from physical intercourse, irritation of cervical or vaginal pimple, rigorous exercise or physical fall during pregnancy.
Bleeding during the latter part of pregnancy is mostly pathological and, is associated with increased risk to the baby. This category covers causes that include:
· Placental abnormalities
In a number of situations, placenta may be implanted in an abnormal point within the uterus or cervix. This factor increases the risk of vaginal bleeding during pregnancy and it may be provoked or unprovoked. The conditions of placenta abnormality that present with blood discharge during pregnancy include:
- Placenta previa: In this case, the placenta is lying low and may either cover the cervix partially or completely. As a result bleeding occurs whenever pelvic pressure is increased.
Pelvic pressure or heaviness can be increased while you’re having sex or lifting heavy weight or even during forceful coughing. However, placenta previa is very uncommon and when it does occur bleeding is inevitable.
- Placenta abruption: This abnormal situation is the separation of placenta from the wall of the uterus and may lead to life-threatening vaginal bleeding. At least 70 percent of all cases of placenta abruption presents with bleeding.
· Abortion, Miscarriage, Molar and Ectopic Pregnancy
Abortion or miscarriage may lead to mild or moderate vaginal bleeding. Evidently, loss of fetus or pregnancy before the period of viability (24 weeks of gestation) is characterized with vaginal bleeding.
Ectopic pregnancy typically occurs in the early first trimester of pregnancy and has a more serious presentation than abortion or miscarriage. Ectopic pregnancy describes the implantation of fertilized egg outside of the uterus (usually in the fallopian tube). This kind of pregnancy doesn’t survive and is usually characterized with excessive blood loss.
· Premature Labor or Preterm Labor
Pre-mature labor or pre-term labor also present with abdominal pain and mild to moderate vaginal bleeding that may or may not be followed by rupture of membranes. Bleeding during pregnancy, particularly during the latter part of pregnancy is an indicative risk factor for preterm delivery.
In some situations, bleeding is mild or just limited to spotting without any harm whatsoever to your pregnancy (baby). To take care of mild bleeding, the first step should focus on identifying the cause of such bleeding, and then avoid the risk factors that are responsible for it.
The tips of suggestion below can help to prevent bleeding in pregnancy:
· Maintain regular intake of oral Iron and Folic acid supplements throughout pregnancy.
· Avoid intercourse in case of placenta previa or other placenta abnormalities.
· Avoid lifting heavy weight or riding stairs excessively when you’re pregnant
· Take ample bed rest and avoid standing , strenuous exercising or walking
· Don’t take over-the-counter medication as it may not make a difference and possibly aggravates the condition.
Desist from using medications with adverse effect on pregnancy. For instance, taking Aspirin during pregnancy has been proven to increase bleeding because it causes changes in platelets – which aid blood clotting.
How to treat bleeding during pregnancy varies with the severity of bleeding and probable cause of bleeding. For each case however, it’s best advised you manage it at the hospital especially because of the clinical diagnosis or investigation that may be required.
If bleeding while pregnant is mild, an ultrasonographic examination must be performed to confirm the viability of the fetus and see any indicative cause of bleeding. Other test and examination that may possibly be carried out include:
· CBC (complete blood culture, especially of hemoglobin) to assess the degree of blood loss.
· Fetal heart rate to confirm the fetus or baby is unharmed and progressing fine.
· Fetal movement examination.
Bleeding during pregnancy is one of the problems expecting moms encounter. Even though bleeding may not be harmful to you and your baby but an expert evaluation is essential to prevent any possible complications. Whether it’s minor or severe get in touch with your healthcare provider or antenatal clinic as soon s as possible and you’ll be advised on what to do.