Bleeding In Pregnancy - What Does It Mean?

September 23, 2008

Alarming as it is, bleeding during pregnancy may or may not be something serious. It can occur at different times during pregnancy; however, there are some factors which determine its seriousness. The cause may be determined to some extent by pain accompanying the bleeding and if there is significant bleeding.

When Bleeding Happens During Pregnancy

First trimester bleeding is not uncommon and may be caused by a variety of things, including miscarriage, ectopic pregnancy, infection and the implantation of the placenta in the uterus. When bleeding occurs late in the pregnancy, in the late second and early third trimester, the cause could be placenta previa - when the placenta is near the cervical opening. Placental abruption - the premature detaching of the placenta from the uterus can cause serious bleeding.

Placenta Previa - The Cart Before the Horse

Placenta previa happens in about one in 200 live births. It is described in three different ways. Total placenta previa is when the placenta completely covers the cervix; partial placenta previa is when the placenta is partially covering the cervix; and marginal placenta previa is when the placenta is near the edge of the cervix.

The cause of placenta previa is unknown. There are certain conditions which are associated with the condition, such as scarring of the uterine wall from previous pregnancies, fibroids or other abnormalities in the uterus, previous surgeries or c-sections and women who conceive over the age of 35. Different races tend to have higher incidences, such as African-Americans or other minority races. Smoking is a major contributor to the problem as well. If a previous pregnancy was placenta previa, then there is the potential for the following pregnancy to be the same.

Risks of Placenta Previa

The greatest risk of placenta previa is hemorrhage. Bleeding most frequently happens during the third trimester of the pregnancy when the lower part of the uterus thins in preparation for labor. This causes the part of the placenta that is covering the cervix to bleed and the more of the placenta covering the cervix, the greater the amount of blood. As a rule, there is no associated abdominal tenderness or pain. However, each woman experiences and exhibits the symptoms of placenta previa in a different way. It is necessary to have a doctor diagnose the problem rather than make assumptions.

An Abrupt Disconnect

Placenta abruption is when the placenta separates prematurely from its implantation in the uterus. There are many blood vessels within the placenta which are vehicles to transfer nutrients to the baby from the mother. Should the placenta separate during pregnancy there is bleeding from these blood vessels. The larger the area of detachment, the more blood there will be.

The cause of placenta abruption is not known, but there are some factors which are associated with the situation. If a woman had a previous placental abruption she may be likely to have another. Hypertension (high blood pressure), smoking and multiple pregnancy are all possible contributors. The risk of uncontrolled bleeding makes this condition very dangerous to both mother and baby.

There is no treatment to stop placental abruption nor is there any way to reattach a detached placenta. Depending upon the condition of both mother and baby, usually a caesarean section is performed.

 

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