Threatened miscarriage in early pregnancy - symptoms and treatment

Causes

30% of women in labor experience bleeding. The character can be different - weak, smearing, strong, abundant. This could be due to several reasons:

• Attachment of the fertilized egg to the uterine walls - implantation, at the beginning of pregnancy. The process can damage blood vessels and cause bleeding. Similar to menstruation, but lasts for 1-2 days, then usually stops. This is natural and is not considered a deviation;
• Due to hard work, physical activity, or deep penetration during sexual intercourse, the cervix of the uterus can be damaged. The result is bleeding, which usually goes away within a couple of hours;
• low levels of hormones in the body. Sometimes the ovaries do not produce enough progesterone and because of this, the body begins to start the process of menstruation, as a result, the lining of the uterus is detached and discharge appears. This may affect the implantation of the fertilized egg;
• Breakthrough bleeding occurs due to hormonal imbalance. May appear in the first trimester and in the second;
• the most common reason is a threatened miscarriage or spontaneous abortion. Accompanied by pain with increasing intensity. This can happen due to a variety of circumstances: infections, developmental defects, dehydration, mechanical injuries to the abdomen, use of medications and much more. Doctors still cannot identify all the causes of miscarriage; each case is considered individually;
• Another common phenomenon is an ectopic pregnancy, that is, the fertilized egg is not fixed in the uterus, but remains in the fallopian tube and begins to develop there. This condition is dangerous for a woman and urgent hospitalization is necessary;
• bleeding can occur due to a stop in the intrauterine development of the child, that is, during a frozen pregnancy. The discharge is spotting, accompanied by pain in the abdominal area;
• premature placental abruption - can occur at any time, most often in the second and third trimester. It can lead to the death of the baby, so at the first symptoms you need to consult a doctor;
• an infection in the body can cause bleeding, it is necessary to be treated, if ignored, then serious complications are possible, including the death of the child;
• cervical erosion - occurs in half of women; during pregnancy, the disease is not dangerous, but requires regular medical supervision.

For any bleeding or suspicious discharge, you should contact a gynecologist.

Implantation bleeding - when does it happen?

Implantation bleeding is caused by the implantation of the embryo into the endometrium (in the anterior or posterior wall). This occurs between 8 and 12 days after the fusion of the egg and sperm. A woman may notice a small amount of blood on her underwear, but this symptom disappears within 3 days - usually lasting only a few hours. It is worth remembering that bleeding after conception does not occur in every pregnant woman.

Implantation bleeding during pregnancy may be mistaken for menstruation because it occurs around the expected date of your period. However, experienced women consider it as the first sign that fertilization has occurred and conduct a pregnancy test. If the result is positive, it is recommended to visit a gynecological clinic, lead a careful lifestyle and take folic acid.

Diagnosis and treatment

The doctor will conduct an examination, take a smear from the vagina, and prescribe an ultrasound of the pelvis. The woman also needs to donate blood for general and biochemical analysis and group determination. Based on the results, the gynecologist will prescribe further treatment.

In case of a miscarriage, you will need to clean the uterus; if an ectopic pregnancy is detected, then a diagnostic laparoscopy is performed. If the cause of bleeding is the threat of miscarriage, then the woman will be prescribed medications to maintain pregnancy and bed rest, and hospitalization is possible.

Bleeding after intercourse during pregnancy

Some pregnant women experience bleeding after intercourse. Usually it is very weak and is not accompanied by any other ailments. The process is caused by irritation of the vaginal walls, since the reproductive organs after fertilization are very well supplied with blood and are very sensitive.

Bleeding after intercourse during pregnancy is not a contraindication to sexual activity unless your doctor recommends abstinence. However, with such a symptom, you should change your position and be more careful.

MAKE AN APPOINTMENT

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Abortion and contraception clinic in St. Petersburg - department of the medical gynecological association "Diana"

Make an appointment, tests or ultrasound via the contact form or by calling +8 (812) 62-962-77. We work seven days a week from 09:00 to 21:00.

We are located in the Krasnogvardeisky district, next to the Novocherkasskaya, Ploshchad Alexander Nevsky and Ladozhskaya metro stations.

The cost of a medical abortion in our clinic is 3,300 rubles. The price includes all pills, an examination by a gynecologist and an ultrasound to determine the timing of pregnancy.

Prevention

Prevention measures are simple and consist of stabilizing and maintaining a calm state:

• good nutrition;
• moderate exercise, if there are no contraindications;
• walk more in the fresh air;
• to refuse from bad habits;
• eliminate stress;
• avoid heavy physical work and stress;
• Visit your doctor in a timely manner and follow the recommendations.

It is useful to do gymnastics and special exercises for pregnant women. But sometimes heuristics can be prohibited by high activity; more often this applies to women with a threat of miscarriage, they are prescribed bed rest.

Throughout pregnancy, it is necessary to carefully monitor your well-being and discharge, and if bleeding begins, you should immediately consult a doctor.

Causes of heavy bleeding and the likelihood of continuing pregnancy

Bleeding during pregnancy is not in all situations a sign of fetal death. A woman should not give in to panic - she needs to urgently consult a doctor.

Severe blood loss can be caused by the following reasons:

• infectious diseases;
• uterine fibroids;
• placental abruption;
• uterine rupture (a very rare anomaly that occurs during a hydatidiform mole or after a previous delivery by cesarean section);
• rupture of the fallopian tube;
• lack of hormones;
• spontaneous abortion.

Most often, if the patient is hospitalized in a timely manner, doctors can continue the pregnancy. If there is a high risk of miscarriage, she is admitted to the hospital. Doctors always strive to preserve the life of the baby, but if there is a choice, it is made in favor of the health and life of the mother. However, the consent of the woman (or her relatives when the expectant mother is unconscious) is mandatory.

Early in gestation, it is important to stop bleeding and prevent miscarriage. For this purpose the following are assigned:

• means for increasing the secretion of progesterone (Utrozhestan and Duphaston);
• vitamins (E, B6);
• sedatives (valerian tincture);
• hemostatic medications (Ditsinon);
• antispasmodics (No-Shpa).

When the first positive results of treatment appear, the woman is prescribed rest, bed rest and cessation of intimate life until the time of birth. The drugs are often prescribed over a long period of time and must be taken even in the absence of bleeding. Having crossed the threshold of the 12th week of gestation, you can calm down - the risk of miscarriage is significantly reduced.

Therapy for placenta previa depends on the amount of discharge. If there is little blood and the time of delivery is close, a puncture of the amniotic sac is performed. If there is copious discharge, a cesarean section is indicated, even if the fetus is not full term. Surgical delivery is also required in case of blood loss due to placental abruption.

If bleeding occurs as a result of pregnancy outside the uterus, a frozen fetus or a miscarriage, then one cannot be under any illusions - it is impossible to save the child in these situations. Surgical treatment: the woman undergoes removal of the embryo (or fallopian tube) or curettage of the uterus, respectively.

Recommendations from experts

It would be good for every expectant mother to know how to behave correctly in emergency situations. For example, what recommendations do experts give regarding when bleeding starts at 6 weeks of pregnancy, what should be done, and what should be avoided. Taking into account the various causes of such conditions, you should contact the hospital immediately, while observing some rules:

• With minor spotting that goes away painlessly, you can get to the hospital on your own, if it is located near your place of residence.
• Excessively massive bleeding and the bright color of biological fluid are reasons to call an ambulance at home and under no circumstances go to the doctor without waiting for her.
• While the doctor arrives, you need to take some measures: lie down on a flat surface, take a horizontal position and place a pillow under your feet.
• It is strictly forbidden to take any medications before the ambulance arrives. This can blur the symptoms and complicate the gynecologist’s task in establishing the correct cause of what is happening.
• Even at the initial stage of bleeding, you should not shower or wash with too hot water. This will only increase pathological discharge.
• Signs such as cold sweats, fainting and intense pain may indicate an ectopic pregnancy. In this case, every minute counts because a pipe rupture may occur.

What can I do to prevent miscarriage?

A woman cannot stop a miscarriage on her own. The main thing is to calm down and call a doctor. The doctor will prescribe the necessary tests, which will tell you about the cause of the miscarriage and the possibility of continuing the pregnancy.

Very rarely, the cause of miscarriage is the mother's wrong actions. The main thing that future parents should do when planning a pregnancy is to undergo a medical genetic examination to find out genetic compatibility. There you can also obtain information about the risk of a genetic disease in a child, if one occurred in the family of one or both parents.

Complications

Let us highlight possible complications of individual pathologies. Doctors consider the consequences of ectopic pregnancy to be the most difficult of them:

• There is a possibility that when a pipe ruptures, blood will flow into other organs, which often leads to death.
• Another serious consequence of tubal abortion is peritonitis (purulent inflammation). It occurs as a result of parts of the fertilized egg entering the abdominal cavity.

Failure to go to the hospital in a timely manner during a miscarriage leads to the loss of the child. For a woman, this primarily threatens nervous shock and prolonged depression. And sometimes more complex mental disorders. Other complications include:

• endometritis;
• infertility;
• formation of adhesions;
• difficulties with subsequent conception, as well as bearing a child;
• salpingo-oophoritis;
• large blood losses.

A frozen pregnancy is fraught with the following consequences:

• embryo decomposition can cause sepsis;
• provoke the occurrence of peritonitis;
• Another undesirable consequence of a frozen fetus is endometritis.

Hydatidiform mole can lead to the following complications:

• there is a high risk associated with problems during childbirth;
• in a malignant course, the disease promotes the formation of metastases;
• almost all women experience absence of menstruation;
• various anomalies of generic functions;
• sepsis.

As you can see, the complications are very serious, therefore, if blood appears at least a little during pregnancy 6 weeks or at another stage, you should not hesitate to go to the doctor.

Treatment for threatened miscarriage

The implementation of therapeutic measures depends largely on when the expectant mother went to the hospital, how severe the blood loss was and whether the pregnancy was maintained. In any case, she must stay in a medical facility for some time and follow all the gynecologist’s instructions. The complex of treatment measures necessarily includes bed rest. Important rules for a expectant mother who is predicted to be at risk of miscarriage are proper rest and emotional peace.

The therapeutic course involves infusion therapy. To restore the body and prevent further complications, corrective treatment is carried out using the infusion of drugs into the systemic bloodstream. The concentration and volume of solutions is prescribed individually by the attending physician in each individual case. Since treatment is aimed at reducing uterine tone, tocolytic drugs and sedatives may be recommended.

Sometimes hormonal medications are prescribed, for example, Utrozhestan, Duphaston or Progesterone. If it was possible to eliminate the reason why blood began to bleed at 6 weeks, and the pregnancy can be maintained, then the expectant mother should be observed by a gynecologist until the very birth.

What symptoms require immediate medical attention?

It must be remembered that at the initial stage of bearing a baby, the same secretion is produced as before - the discharge is transparent, white or yellow. If a woman notices any sudden change in their character, it is worth informing the doctor about it. The faster help is provided, the more favorable the prognosis. A woman should not make compresses, drink pills or decoctions on her own - this will lead to unpredictable consequences.

Urgent help will be needed in the following situations:

• discharge of bright scarlet blood;
• heavy bleeding;
• release of blood clots;
• strong pain;
• cold sweat;
• loss of consciousness;
• convulsions;
• pain in the abdomen and lower back.

When bleeding, you can only use pads. While waiting for the doctors to arrive, the woman should lie down and elevate her legs. It is better not to use medications, so as not to “lubricate” the symptoms.

What improves pregnancy?

In order for the pregnancy to develop normally, the child in the womb to grow strong and healthy, you should follow some tips:

• limiting smoking and drinking alcohol by the mother herself and people living next to her;
• prohibition of drug use;
• ban on the use of tampons, they can cause infectious-toxic shock.

It is worth talking to your doctor about additional medications that have a beneficial effect on pregnancy. Folic acid is usually prescribed. However, both low and high folate status can trigger the development of complications. Therefore, the use of this drug should be strictly under the supervision of the attending physician.

Frozen fetus: causes, treatment tactics

This pathology can appear during pregnancy at 6-7 weeks. Blood is released in small quantities, and all signs characteristic of pregnancy suddenly disappear. The mammary glands become soft, the uterus does not correspond to the proper period during a gynecological examination. Along with these symptoms, pain is felt in the lower abdomen with increasing severity and a temperature of 37 to 37.5 degrees is observed.

The causes of the pathological condition include:

• genetic disorders in the fetus;
• acute infections suffered by a woman before or during pregnancy;
• lack of hormones in the mother's body.

Under the influence of any of the above factors, the embryo suddenly stops its development. Ultrasound and hormonal tests will help determine the pathology.

It is important to know that such a condition at the first stage can be asymptomatic for a pregnant woman, therefore, at the slightest such signs, you should immediately undergo a diagnostic examination.

How will the doctor determine the cause of my bleeding?

Vaginal bleeding, spasms and pain are a reason for additional examinations. First of all, the gynecologist who is managing the pregnancy will prescribe an ultrasound examination, blood and urine tests.

If the cause of ongoing bleeding is not a serious pathology, then the doctor will limit himself to the following recommendations:

• rest;
• bed rest;
• ban on having sex.

For more serious causes of vaginal bleeding, hospitalization and further diagnostics will be required.

Your doctor will want to know the answers to the following questions:

• Have you had any bleeding during this or a previous pregnancy?
• When did the bleeding start?
• Is the bleeding heavy or is it blood spots?
• Does the bleeding start and stop or go on and on?
• Approximately how much blood was lost?
• What color is the blood (bright red or dark brown)?
• Is there any discharge along with blood?
• Does blood have a smell?
• Any cramping or pain?
• Are you feeling weak, tired or dizzy?
• Have you had vomiting, nausea or diarrhea?
• Has your temperature risen?
• Have you had any recent injuries (such as a fall or car accident)?
• What was your last physical activity?
• Was there any additional stress?
• When was the last time you had sexual intercourse? Was there any blood after sex?
• Do you have a bleeding disorder? (women with bleeding disorders are at risk of complications during and after pregnancy - iron deficiency anemia, postpartum hemorrhage and bleeding during childbirth; before planning a pregnancy, a woman with bleeding disorders should consult a doctor, in addition, you can undergo special genetic testing, so how this pathology is often inherited).
• What is your blood type and Rh? (if a woman has a Rh-negative blood type, additional treatment with Rho (D) immunoglobulin will be required. This prevents complications in future pregnancies).

Vaginal bleeding is usually blood without clots. If clots are released along with the blood, they must be collected in a separate container and then shown to the attending physician.

An additional test will be to determine the level of human chorionic gonadotropin (hCG). This is a specific pregnancy hormone that rapidly increases every two days after conception. During an ectopic pregnancy, hCG is greatly reduced, which may alert the doctor. Then he will send the patient for further examinations.

What kind of discharge can be normal during pregnancy?

Discharge itself during pregnancy is absolutely normal and expected. It's all about the dominant hormone progesterone in the body during this period.

It is part of the mandatory set of hormones that correct the menstrual cycle and, together with estrogen, shares the main role in this process.

Estrogen dominates in the first half of the cycle - before ovulation, and progesterone - in the second.

Each hormone has a specific effect on the secretion produced by the cervix during the cycle:

• Bleeding in the middle of the cycle: causes

1. In the first half, it is slimy and more transparent, but not very abundant.
2. During ovulation, the color changes to a shade of white or beige, with a viscous and viscous consistency.
3. Starting from the middle of the cycle, under the influence of a new hormone (progesterone), the amount of discharge increases, and the structure becomes thicker and creamier.
4. Immediately before the onset of menstruation, due to a decline in progesterone levels, the volume of vaginal secretion becomes completely insignificant.

Progesterone is produced by the corpus luteum, formed after ovulation in one of the ovaries. The main task of this entire process is to prepare the body for possible conception. If this does not occur, the corpus luteum dies and progesterone levels plummet. This is when your period begins.

Pregnancy has occurred

If fertilization of the egg has taken place, the opposite effect occurs. The corpus luteum continues to function and produce progesterone for several months, supporting the development of the embryo until the placenta is formed.

This becomes possible thanks to another hormone - human chorionic gonadotropin (hCG). It is formed already in the first hours of pregnancy, and prevents the death of the corpus luteum and the cessation of its production of progesterone.

Naturally, due to the increasing amount of the hormone, discharge when menstruation is delayed due to pregnancy does not decrease in volume as before menstruation, but on the contrary, it becomes larger.

After the death of the corpus luteum, the same hormonal set continues to be produced by the placental membrane. For this reason, the first and second trimesters of pregnancy are accompanied by heavy vaginal discharge. And only in the third trimester is it considered healthy when a small amount of secretion is released.

Normally, the appearance of the discharge does not differ from usual. It is either transparent or takes on a whitish tint and looks like viscous mucus.

Normal discharge during pregnancy
Bloody shades are not included in the absolute norm. However, they do not always indicate the presence of complications and a threat to the fetus. This is especially true for bleeding during early pregnancy.

General information

The period when a woman does not get her period is usually indicated by her going to see a doctor. As a rule, this occurs during the 6th week of pregnancy. Whether he smears blood or not at this time is not important. In any case, the expectant mother needs to undergo a gynecological examination. After this, she will be given all the necessary recommendations for leading a correct lifestyle for the duration of her interesting situation.

In order for the embryo to develop normally, it needs oxygen and nutrients already at the initial stage of its existence. Since it does not yet have its own blood vessels, then, as was originally intended, it merges with the mother’s body into one whole and uses the mother’s blood flow throughout the entire period of intrauterine stay. To provide itself with everything it needs, the embryo needs to implant itself into the walls of the uterus. The processes occurring inside the fetus at the first stage of its formation play a decisive role in its further development and growth. During the period of organogenesis, organs and systems begin to develop, without which it simply cannot exist. Even minor negative effects on the vital structures of the fetus can lead to irreversible consequences. Expectant mothers need to remember this throughout the entire period of bearing a child.

Placental bleeding

Placenta previa will inevitably lead to bleeding at some point in your pregnancy - usually after 20 weeks. There are varying degrees of severity of this condition, but all require repeat ultrasounds for an accurate diagnosis. To prevent the baby from being at risk, you may be advised to remain on bed rest or offered an induction or caesarean section if the placenta continues to attach to the cervix. Another cause of bleeding later in pregnancy is placental abruption, which is when the placenta partially or completely separates from the wall of the uterus. This occurs in about 1 in 200 pregnancies. Symptoms include general severe pain and heavy bleeding. The bleeding may be visible or hidden in the uterus, which will be tense, firm, hard to the touch and very painful.

If you smoke, have high blood pressure, kidney problems or preeclampsia, you are at high risk of placental abruption. This condition requires urgent hospitalization, and depending on the severity of the bleeding, you may be prescribed bed rest, induction or caesarean section.