Causes of bleeding in pregnancy

Bleeding in pregnancy is common during the first trimester and it is usually no cause for concern. About 20 percent of women are thought to bleed in the first trimester; however, because bleeding while pregnant is sometimes very serious, it is important to see the doctor to make sure that the pregnancy progresses normally. Some known causes include:

Implantation Bleeding
This type of bleeding or spotting may occur in the first six to 12 days after conception as the egg implants itself in the lining of the uterus. This bleeding sometimes makes a woman unaware that she is pregnant. The bleeding may last for a few hours to a few days.

Miscarriage
Miscarriage happens most of the time at the first three months of pregnancy. But all bleeding that occurs at this time does not lead to a miscarriage. Up to 90 percent of women who bleed at the first trimester will not miscarry, experts assure us.

Ectopic Pregnancy
A pregnancy is said to be ectopic when the fertile egg implants outside the uterus. Most of the time, it implants itself in the fallopian tube. The growing embryo can cause the fallopian tube to burst and pose a threat to a pregnant woman’s life. It occurs in only about 2 percent of pregnancies. Symptoms of ectopic pregnancy are also strong cramps or pain in the lower abdomen or dizziness.

Molar Pregnancy
Which is also called gestational trophoblastic disease, is a rare condition where abnormal tissue grows inside the uterus instead of a baby. In rare cases, the tissue is cancerous and can spread to other parts of the body. Other symptoms are severe nausea and vomiting and rapid enlargement of the uterus.

Placenta Previa
According to March of Dimes, Placenta Previa is a condition where the placenta lies very low in the uterus or covers all or part of the cervix; one in 200 pregnant women are known to have this condition. This condition may not pose a serious challenge at the first trimester but it is known to cause serious bleeding and other complications at the later stage.

Explains March of Dimes Foundation: Under normal circumstances, the placenta develops in the upper part of the uterus wall without touching the cervix until the baby is born.

But when there is Placenta Previa, when the cervix begins to efface or thin out and dilate for labour, the blood vessels which connect the placenta to the uterus may tear to cause severe bleeding thereby putting the lives of mother and baby at risk.

Symptoms
The most common is painless bleeding from the vagina during the second half of pregnancy. See the doctor if you experience bleeding at any time during pregnancy; if it is severe, you may need hospital admission. But it has been observed that about one-third of pregnant women who have this condition do not know that they have it because they may experience no symptoms.

Diagnosis
The most effective test is through an ultrasound; even when there is no vaginal bleeding, a routine ultrasound done at the second stage could tell if it is there. Having seen this early, the condition is not threatening because it can take care of itself in most cases, these experts say.

Treatment
Treatment may depend on how far gone the pregnant woman is, how serious the bleeding and the health of mother and baby. The goal is to take pregnancy closer to delivery date as far as possible but caesarian section is always advised to prevent severe bleeding.

When there is a bleeding, hospital admission may be the only option. If mother and baby are found to be doing well in spite of the threat, treatment which ensures that pregnancy is preserved for as long as possible may also be given.

Severe bleeding may need blood transfusion and with medicines in the form of corticosteroids to help build up baby’s lungs and other organs. You may even need to stay in hospital until the birth of the baby.

If placenta previa is the cause of bleeding at 34 or 36 weeks of pregnancy, immediate caesarian section is advised. Between 34 to 37 weeks, a test of the amniotic fluid around the baby may be taken to see if the lungs are fully developed. If they are, immediate caesarian section should be done to avoid the risk of bleeding.

Causes
Causes are not known yet but women who have been seen to be at higher risk are those who smoke, use cocaine or are 35 years or older.

Others are women who have been pregnant before or are carrying twins, triplets or more babies in their wombs. Those who have had surgeries like caesarian section or Dilation or curettage (D&C). D and C includes procedures whereby a doctor removes tissue from the lining of a woman’s womb. It can be done after a miscarriage.

Prevention
There is no known prevention apart from avoiding the risk factors mentioned above. And the chance of it happening to the same woman is about three out of 100.