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Bleeding in pregnancy is more normal than we might think. One in five women has some blood loss during pregnancy, without this causing any problems for the fetus or the mother. However, of course they are cause for great concern and always deserve a consultation with your doctor.
Many women have small losses, especially during the first trimester, and this does not mean that they are going to have a miscarriage or their baby is at risk. As long as they are minor losses, not a big loss that involves going to the hospital urgently. We will then talk about blood loss during pregnancy and what it may be due to in each trimester .
Blood loss in the first trimester of pregnancy
Blood loss in the first trimester of pregnancy is quite frequent and having them does not mean the loss of pregnancy .
It is important that you learn to recognize them, observe the color, the amount and if the losses are accompanied by abdominal pain or any other symptoms.
There are several reasons why mild or severe vaginal bleeding may occur in this trimester:
Many women experience slight bleeding between the fourth and sixth week of pregnancy when the implantation of the fertilized ovum occurs in the walls of the uterus. This is known as implantation bleeding and it is often confused with the arrival of menstruation.
It is a slight loss of brownish or pink color that lasts one or two days, at most three, similar to what you may have when your menstruation begins or ends. It is not accompanied by pain.
Natural or spontaneous abortion
Miscarriage causes more abundant blood loss (such as menstruation) and usually accompanied by abdominal cramps. If you suffer vaginal bleeding, the doctor will do an examination to control the opening of the cervix and an ultrasound to verify that the embryo is inside the uterus and has a heartbeat. If all goes well, he will surely tell you to rest until the bleeding subsides.
It is very disappointing to have a miscarriage, but if it is any consolation it is much more frequent than we think. Half of all conceptions are believed to end in miscarriage, some unknowingly. The answer to why a miscarriage occurs is very complex. The causes can be a combination of multiple factors, but most of the time it is due to genetic failures in the early stages of embryo formation.
If vaginal losses are scarce but intense pain, it may be one of the symptoms of ectopic pregnancy or extrauterine pregnancy, which occurs when the embryo implants outside the uterus, usually in the fallopian tube, and has very few chances of reaching term.
The losses are usually light and brown in color (except if the fallopian tube breaks, which are abundant) and can appear several days or weeks before the pain appears.
Molar pregnancy is very rare but one of its symptoms is vaginal bleeding. There may be intermittent bleeding or brownish losses accompanied by an overgrowth of the uterus that does not correspond to the weeks of gestation.
Molar pregnancy is the result of an abnormal fertilization of the ovum that produces a deformed growth of the embryonic tissue (hydatidiform mole). In no case does it survive, producing a spontaneous abortion accompanied by dark and watery bleeding, although it is generally not accompanied by pain.
A bruise inside the uterus can also cause bleeding. It is an accumulation of blood inside the endometrial cavity, something common in women during the first weeks of pregnancy. The bleeding is abundant (as if it were a rule) but is not usually accompanied by abdominal pain. Most of the time, with rest, the hematoma is reabsorbed and the losses disappear.
On the other hand, maternal infections , such as candidiasis or sexually transmitted infections, although they have nothing to do with pregnancy itself, can also cause blood loss in the first months. You may also notice a small leak or a pink or brownish discharge after intercourse .
Blood loss in the second and third trimesters of pregnancy
One in 10 women has some vaginal bleeding in the second part of pregnancy.Consult your gynecologist if you observe bleeding, and pay attention to the amount, duration and appearance (if it is dark or bright red), as well as other possible symptoms such as abdominal pain, vomiting, fainting, etc.
bleeding in the second and third trimesters can occur for various reasons, such as:
After having sex
As we mentioned before, after having penetrative sex you may notice a slight loss of blood. It is due to the friction that occurs on the vaginal walls, and that, due to the congestion of the tissues typical of pregnancy, causes a small rupture of the blood vessels.
These losses are not dangerous, nor do they pose any danger to the baby. They occur in a timely manner and disappear after a few hours. If not, check with your doctor.
After a medical examination
For the same reason, the congestion of the vaginal walls, it is possible that after a gynecological examination you will observe slight vaginal bleeding.
The rupture of a blood vessel can cause an accumulation of blood in some part of the placenta, forming a hematoma. Depending on the area of the placenta where it is located, it will be:
Retrochorial or retroplacental hematoma : behind the placenta and does not touch the gestational sac. More common in the first trimester.
Subchorionic hematoma : between the placenta and the endometrium. They usually appear in the second trimester.
Subamniotic or retroamniotic hematoma : the accumulation of blood does not affect the insertion of the placenta. They are the least frequent.
Diseases or infections of the vagina or cervix
It is important that you see your doctor if you notice vaginal bleeding, as it could also be due to an abnormality in the cervix. If so, any infection or illness should be treated to avoid complications during pregnancy or delivery.
One of the serious causes of blood loss in late pregnancy is premature detachment of the placenta, which occurs when there is partial or total detachment of the placenta before giving birth.
The most common symptoms are pain, abdominal tightening, dark vaginal bleeding, and back pain.
When the placenta implants in the lower part of the uterus and completely or partially covers the opening of the cervix, it is called placenta previa.
The symptom that makes one suspect the presence of placenta previa is bleeding without pain or other symptoms towards the second half of pregnancy.
In case of bleeding, you should go immediately to the doctor who, if he diagnoses the placenta previa, will indicate rest, avoid sexual intercourse and any type of effort.
A small amount of blood mixed with vaginal discharge can be a sign that labor has started. It is because the cervix begins to dilate in preparation for the baby to be born.
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