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I saw blood while pregnant what does that mean?

Bleeding during pregnancy can happen at any point in pregnancy and is a sign of a problem. Bleeding after the 28th week of pregnancy which is also known as antepartum hemorrhage (APH) complicates about 3-5% of pregnancies.

APH can be secondary to multiple causes, the two most common being Abruptio placenta and placenta previa.

AP(Abrubtio placenta)

Placental abruption is when the placenta separates from the inner wall of the uterus before the delivery of the baby. This happens in 1 in 100 births.

Some risk factors include:- 

  • Having more than one child(increasing parity) and advanced maternal age, Maternal substance use (Cigarette smoking, Cocaine abuse), Trauma (e.g blunt trauma, motor vehicle accident), Maternal diseases (Hypertension, Hypothyroidism, Asthma)
  • Preterm premature rupture of membranes i.e when the membranes rupture before the onset of labor and even before the woman reaches term and Rapid uterine decompression, a sudden loss of amniotic fluid from the uterus. Possible causes include the birth of the first twin (or multiple) or rupture of amniotic membranes when there is excessive amniotic fluid.
  •  Previous history of abruption has about a 5-15% risk for the current pregnancy and the risk would be as high as 25% if a woman had two previous consecutive abruptions.

Clinical symptoms include vaginal bleeding, abdominal pain, and uterine contractions. The amount of bleeding in abruptio placenta poorly correlates with severity as about 10-20% of bleeding can be concealed. 

 

Placenta previa (PP)

   Normally, the placenta attaches toward the top of the uterus, away from the cervix(opening of the uterus). Placenta previa is when a pregnant woman’s placenta blocks the opening to the cervix that allows the baby to be born.

   Placenta Previa can be True Placenta Previa in which the opening of the uterus(cervix) is completely covered by placental tissue, and low-lying placenta, in which the placenta lies within 2 cm of the cervix but does not cover it. The overall incidence is 1 in 200 births.

    Risk factors are mostly the same as those for placenta abruption and include increased parity and maternal age, maternal substance use like cigarette smoking or cocaine abuse, infertility treatments, a pregnancy with more than one fetus, male fetus.

  If the previous history of placenta previa risk increased by eightfold, Prior uterine surgery and cesarean delivery (1-4% risk in previous cs).

    Clinical presentations include painless bright red vaginal bleeding, and about 70-80% have at least 1 bleeding in the 2nd or 3rd trimester. You should visit health care when any of the above symptoms are seen as the conditions are serious and may progress rapidly to cause fetal distress and death.

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Dr. Blen Tesfu

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