Bleeding during pregnancy, especially in the first trimester, is more common than you might expect. Blood spots occur in almost one third of all pregnancies, often not causing a threat to the mother or baby. Thus revealed by Alyssa Stephenson-Famy, M.D., a specialist in maternal and child medicine at the University of Washington, Seattle, reported by Parents.
However, bleeding during pregnancy, no matter how little, can be an indication of a variety of dangerous complications, including miscarriage, ectopic pregnancy, and placenta previa, so it should not be ignored. So, when to call a doctor when there is bleeding during pregnancy?
Normal bleeding characteristics
It's natural for a woman to experience bleeding spots after sex during pregnancy, or after undergoing internal tests conducted by an obstetrician or midwife, for example. Reasons for other bleeding may not be related to pregnancy at all, such as yeast infections, urinary tract infections, or hemorrhoid - a problem commonly encountered by pregnant women - or breakthrough bleeding, namely false periods due to hormone levels that are not high enough to stop your menstrual cycle.
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Bleeding during pregnancy is still considered normal if there is only a small amount of blood coming out, sometimes in the form of blemishes or smudges, similar to the bleeding spots that you experience at the beginning or end of your period. The color of bleeding can vary, ranging from shades of pink, dark red, to brown (dry blood color) - but never bright red.
Most incidences of bleeding during pregnancy occur between the fifth and eighth weeks, and in most cases, lasting no more than three days. Try not to worry too much if you experience spots like this. The risk of complications is less than five percent, reported from My Pregnancy Baby.
What kind of bleeding should you immediately see a doctor or midwife?
All bleeding during pregnancy should be reported to a doctor or midwife, even if bleeding seems to have stopped. Even though it may be a minor cause, the next action taken by your obstetrician /midwife will depend on your situation. Causes of abnormal bleeding include:
1. Suborionic hemorrhage
Suborionic bleeding is bleeding around the placenta. Most suborionic bleeding can heal on its own, but makes the mother's risk higher for other complications such as preterm labor.
Therefore, even though it is possible for the mother to resume a normal pregnancy after this type of bleeding has occurred, the right diagnosis and treatment is very important. In rare /rare cases, suborionic bleeding can also result in the release of placenta from the uterine wall so that it can increase the risk of miscarriage.
Immediately contact your doctor if you experience large amounts of bleeding during pregnancy and are bright red, also accompanied by abdominal cramps and feeling of urge.
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2. Chemical pregnancy
Chemical pregnancy is a miscarriage that occurs early in the pregnancy. It generally occurs at less than 5 weeks of gestation where ultrasound cannot see signs of pregnancy at all. In this condition fertilization occurs but the cell cannot survive in the womb and eventually miscarriage.
Many women experience this chemical pregnancy but do not realize it, because the bleeding that occurs is similar to late menstruation but is slightly more severe (accompanied by abdominal pain and more bleeding).
Miscarriage is the loss of a sudden pregnancy in the first 20 weeks. Often, severe bleeding that occurs during a miscarriage will be accompanied by other symptoms, such as cramps or abdominal pain. This kind of miscarriage is often the result of a damaged fetus; this means a woman's body rejects a pregnancy that cannot survive.
Women generally say that they no longer 'feel pregnant' when they have experienced miscarriages and bleeding. Signs of pregnancy disappear - no longer nauseous, chest pain, or feeling bloated. But it's also possible to experience a miscarriage without bleeding. Miscarriage like this is called a silent miscarriage, where the fetus in the womb has died but is still maintained by your body. Pregnancy signs must have disappeared if they occur, but the absence of a baby's heartbeat can only be detected by ultrasound.
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After you have passed the gestational age of 14-16 weeks, you can breathe a sigh of relief that your pregnancy is safe.
4. Ectopic pregnancy
Ectopic pregnancy aka pregnancy outside the womb occurs when a fertilized egg attaches to a place other than the uterus, most often in the fallopian tube. Mild vaginal bleeding and pelvic pain are usually the initial symptoms, but can be followed by nausea and vomiting with pain, sharp abdominal cramps, pain on one side of the body, dizziness or weakness, and /or pain in the shoulders, neck, or rectum.
An ectopic pregnancy can cause rupture of the fallopian tube. If that happens, you can have extreme pain and heavy bleeding. Ectopic pregnancy cannot walk normally and may be life threatening for the mother if left undiagnosed.
5. Molar pregnancy
Molar pregnancy or grape pregnancy occurs when the tissue that normally becomes a fetus actually develops into abnormal growth in your uterus. Although not an embryo, molar pregnancy causes early symptoms that resemble normal pregnancy, such as late menstruation or morning sickness.
Molar pregnancy is usually also followed by several other symptoms, which may include vaginal bleeding, a larger than normal uterus, nausea and vomiting, signs of hyperthyroidism (feeling nervous or tired, heart pounding or not regular, and profuse sweating), uncomfortable sensations in the pelvis, and vaginal discharge that resembles the shape of a grape. This is usually a sign of a molar pregnancy.
Molar pregnancy must be treated immediately to ensure that all tissues are removed. This tissue can cause serious problems in some women.
6. Placenta previa
Sometimes the placenta implements itself very low under the uterine wall, or sometimes just above the cervix, which interferes with labor. This condition is called placenta previa and occurs in about 0.5% of pregnancies.
Placenta previa will definitely produce bleeding at some point in your pregnancy - usually after 20 weeks. The most common sign is bright red bleeding from the vagina during the second half of your pregnancy. Bleeding can range from mild to severe, and often painful. Some women also have contractions that follow bleeding.
7. Placenta abruptio
Abruptive placenta, or placental release, is a serious condition in which the placenta is partially or completely separated from the uterus before your baby is born. This condition can decide the nutritional and oxygen pathway for your baby, and cause severe bleeding that endangers you both.
If you have abrupt placenta, you may see one or more warning signs. Call your doctor immediately if you are pregnant and are aware of the following symptoms: moderate to moderate vaginal bleeding, a painful or painful uterus (which may also feel hard or stiff), have signs of early labor (including regular contractions and lower back /abdominal pain ), fetal activity in the womb decreases normally.
8. Premature labor
Premature labor is defined as routine uterine contractions that result in cervical opening that starts too early - before 37 weeks of gestation. One sign is mild vaginal bleeding, accompanied by cramps or contractions, diarrhea, pelvic pressure, or back pain before pregnancy reaches 37 weeks. Premature labor can have serious consequences for the baby if it is not managed properly. After 37 weeks, these symptoms can be a trigger for a normal delivery.
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In conclusion, No matter when bleeding occurs, bleeding during pregnancy guarantees an emergency phone call or visit to a doctor or midwife, even if only to make sure everything is fine. Be prepared to answer questions in detail about the color, amount, and when bleeding starts and stops, and whether it is accompanied by a fever, to help the doctor determine the cause.