How common is breakthrough bleeding during pregnancy?

Bleeding during pregnancy

Bleeding During Pregnancy: From the vagina with various causes; especially occurring in the first and second trimester of pregnancy. Bleeding in the last trimester of pregnancy is rare, but must be taken very seriously as the cause can be life-threatening for the child, e. B. a rupture of the placenta.

Leading complaints

Depending on the cause of the bleeding:

  • Menstrual bleeding with drawing pains in the first trimester of pregnancy
  • Recurring, painless bleeding, especially in the second half of pregnancy
  • Heavy bleeding and hard, painful uterus, especially in the second half of pregnancy.

When to the doctor

In the next few days if the bleeding is light and painless and stops within 2-3 minutes.

The next day, if light bleeding lasts 5-10 minutes before it stops or light bleeding recurs regularly

Immediately to the women's clinic, if the bleeding is heavy (as in the first two days of your menstrual period) or painful, and blood clots come off or you have severe cramps.

The illness

First of all, it is important to know that by no means all bleeding, especially in early pregnancy, is “bad”. Every fourth pregnant woman experiences light spotting in the first trimester of pregnancy. The bleeding can have different causes. It is not uncommon for light spotting after irritation of the already sensitive vaginal and cervical mucosa. This can e.g. B. occur after sexual intercourse during pregnancy or with vaginal infections.

Nevertheless: During pregnancy, every bleeding from the vagina requires clarification by the doctor, because what is dangerous and what is not cannot be decided without his or her help.

In every third of pregnancy there are typical causes that lead to bleeding.

In the first third these are mainly:

Miscarriages - with bleeding of varying degrees, molars - with only slight bleeding, ectopic pregnancies - usually with spotting and pelvic pain.

In the second trimester of pregnancy, bleeding is often due to:

Premature detachment of the placenta from the uterine wall (placenta detachment) - the amount of bleeding varies from person to person, usually painful A placenta that is in front of the uterine outlet (placenta previa); the bleeding is usually moderate and painful. Disturbances in maternal blood coagulation; the bleeding varies in intensity.

Bleeding may also have nothing to do with pregnancy: for example, polyps in the cervix, bladder infections or hemorrhoids can lead to bleeding without endangering the mother or child.

If a doctor is not available, e.g. B. When traveling, a hand mirror or another person should check whether the bleeding is actually coming from the vagina.

The doctor does that

The doctor first asks about the severity of the bleeding, when it started and about any pain. He then performs a gynecological examination during which, however, he does not feel the uterus, but only holds the vagina open with the speculum so that he can see the cervix and check whether the blood is coming out of the uterus. This procedure is important: If the placenta is in front of the uterine outlet (placenta previa), the doctor would damage the placenta when palpating the uterus. This would increase the bleeding.

The doctor uses ultrasound to check the position of the placenta and whether there are any bruises. In order to observe the child's heartbeat over a longer period of time, he can also do a cardiotocography of the child in the second trimester of pregnancy.

In the case of heavy bleeding, the doctor will usually arrange for the pregnant woman to be transported to a clinic for supervision. There, the bleeding and circulation (pulse, blood pressure) of the pregnant woman and the condition of the unborn child are monitored

Authors

Dr. med. Katja Flieger, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 10:47


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.