Bleeding in pregnancy is a very scary symptom and most women will run to the doctor at the slightest trace of blood during pregnancy.
However not all bleeding is dangerous and a knowledge of the types and causes of bleeding in pregnancy will save the woman a lot of pain and unnecessary emergency visits to the doctor.
Before we discuss the various causes of bleeding in pregnancy let us know a few general facts about bleeding in pregnancy.
1.
Contrary to perceptions, bleeding during pregnancy is fairly common during pregnancy.
Nearly 20 women out of 100 will experience some bleeding during pregnancy.
2.
Bleeding most commonly occurs in the first 12 weeks of pregnancy followed by second and the lowest rates of bleeding in third trimester.
However bleeding in the third trimester is often dangerous and should be attended to immediately.
3.
Most bleeding in the first trimester is trivial in nature and does not require any specific management.
However bleeding during the second and third trimesters indicates serious pathology and should be investigated immediately.
The top causes of bleeding in pregnancy include (These causes are listed trimester wise) 1st Trimester A.
Implantation Bleeding: It is often sight bleeding or spotting seen immediately after implantation of the blastocyst in the uterus.
It is often so slight that woman may not notice it at all.
B.
Threatened abortion: This is often the most common and most serious cause of bleeding in the first trimester of pregnancy.
I say most serious cause because in threatened abortion, the baby is still alive and can be salvages with appropriate care, while in a complete abortion the baby is dead and all that needs to be done is to evacuate the products of conception from the uterus.
C.
Complete abortion: A complete abortion is another important cause of bleeding in early pregnancy.
One hallmark of complete abortion is the amount of bleeding which is seen.
The bleeding is usually copious and increases with the gestational age of the pregnancy.
It may be associated with passage of bits of flesh through the vagina.
2nd Trimester A.
Abortion (Threatened or complete):Abortion is once again an important cause of bleeding during the second trimester, but its incidence reduces greatly as the pregnancy progresses.
The symptoms are similar to that seen in the first trimester, but the quantum of bleeding is often quite high.
B.
Abruption of Placenta: This is an important condition which causes bleeding in the second trimester.
The blood is typically dark brown in colour and may be associated with severe pain over the lower abdomen and uterus.
This is a serious condition and needs early diagnosis and management.
C.
Placenta Previa: This is one of the most serious conditions which cause bleeding in pregnancy.
The hallmark of this condition is profuse painless bleeding.
In fact this condition may cause women to bleed to death.
In this condition the placenta, which normally should be occupying the upper part of the uterus, lies in the lower part, often overlying the cervix.
This leads to painless torrential bleeding if the placenta separates from the uterus due to underlying sheering stress.
3rd Trimester The two common causes of bleeding in the third trimester are placenta previa and abruption.
Any bleeding (even the slightest) in the third trimester is dangerous to both the mother and the baby and prompt medical attention should be sought.
This was a brief discussion about bleeding in pregnancy.
Please visit my web site for a more detailed discussion of the causes, presentation and management of bleeding in pregnancy.