WOMEN: BLEEDING DURING PREGNANCY
March 30th, 2009Bleeding from the vagina at any time during pregnancy is a symptom that must be reported immediately to the doctor. In the early stages of pregnancy it could indicate an impending miscarriage.
But from the twenty-eighth week on, it could mean a serious complication which demands instant and expert medical care.
1. Placenta Praevia. Placenta praevia means that the placenta (later to become the afterbirth at the confinement) is located low down in the womb. Usually it is high up in the upper part. But sometimes it settles in this abnormal situation. Problems can occur if any parts of the placenta encroach on the outlet from the womb.
This means that when labour commences and it is time for baby to be born, the placenta must come first. This, of course, is quite impossible, and serious haemorrhaging, jeopardizing the life of both infant and mother, could result.
Therefore any bleeding occurring from the twenty-eighth week on must be regarded with care and suspicion. Usually there is no pain.
The doctor will admit you to hospital at once. If pregnancy is in the time segment between the twenty-eighth and thirty-sixth weeks, every effort will be made to let the pregnancy continue before any interference is made. This gives baby an improved chance of survival. Bed rest and medication is the regular method of treatment. Many cases settle down until the vital thirty-sixth or thirty-seventh week has been reached.
At this stage, the patient is taken to the theatre, given a general anaesthetic, and the pelvic area is examined. It is then frequently necessary to deliver the baby by means of a surgical operation called Caesarean section. This is through an incision in the lower part of the abdomen. The results of this operation are usually excellent, and it can be a life-saving measure for both mother and her baby. A blood transfusion is generally given, but recuperation afterwards is generally rapid.
2. Accidental Haemorrhage. This occurs very occasionally, in about 2 per cent of pregnancies, compared with the frequency of placenta praevia which is around 1 per cent.
The placenta (afterbirth) is located in the normal situation. For reasons that are not clearly understood, the placenta starts to come away from its usually firm adhesion to the wall of the womb. As this happens, bleeding must occur. Some appears via the vagina as a haemorrhage.
The degree varies, and the treatment also varies accordingly. In mild cases, if the pregnancy has not advanced to the thirty-seventh week, hospital care is given and every effort made to let the pregnancy continue. Blood transfusions are given, and medication ordered according to the patient’s condition.
When the thirty-seventh week has been reached and baby has a fair chance of surviving, labour may be induced, and a happy result is often the outcome. Sometimes, in more urgent cases, surgical intervention and a Caesarean section operation become essential.
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