Page 40 - Great Expectations

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40 – Great Expectations
Early Pregnancy Bleeding
There are many causes of bleeding during pregnancy. Possible causes vary depending upon when it occurs. There are
2 serious causes of early pregnancy bleeding – miscarriage and ectopic pregnancy.
Many times the bleeding will be
temporary and will resolve with the pregnancy progressing normally.
Miscarriage
is the most common serious cause of early bleeding and occurs in 15 to 20% of all pregnancies, usually within
the first 3 months. Most miscarriages cannot be prevented. They are nature’s way of dealing with pregnancies that are
not developing properly. A miscarriage is characterized by bleeding more than a heavy period and associated with
cramping.
Ectopic pregnancy
, a pregnancy located outside the womb (usually in a fallopian tube), is another serious cause of
early bleeding. Ectopic pregnancies occur in less than 1% of all pregnancies and are almost always associated with
severe pain. Most of the bleeding is internal, which can be life-threatening because of its hidden nature.
Late Pregnancy Bleeding
Bleeding late in pregnancy can be serious, but the most common cause is “bloody
show,” one of the first signs of labor. This is caused by the thinning of the cervix
and is usually associated with thick mucus. Cervical irritation and pelvic exams can
also cause bleeding. The most serious late-pregnancy bleeding is caused by either
placenta previa or placental abruption. These conditions occur most often in the
final 3 months of the pregnancy.
Placenta previa
results when the placenta partially or completely covers the cervix.
As your cervix thins in preparation for labor, massive bleeding occurs. The other
serious cause of late bleeding,
placental abruption
, occurs when the placenta
prematurely detaches from the inner lining of the womb. This is usually accompanied
by abdominal pain. Either condition may lead to the demise of the unborn baby and
other possible serious problems.
If bleeding is serious or a non-reassuring fetal tracing is detected by the fetal monitor,
a cesarean birth may be required. Most bleeding is the result of minor causes that
require no treatment. However, late pregnancy bleeding can indicate a serious
problem.
You should report all bleeding to your healthcare provider immediately.
Problems
During Pregnancy
If You Experience Bleeding:
Early in your pregnancy
Your healthcare provider may perform a pelvic
exam and sonogram to determine the cause.
Late in your pregnancy
You may be hospitalized for observation and
evaluation.
Placenta Previa
Placental Abruption