Bleeding During Pregnancy: Key Signs and When to Seek Help

It will be easier for your health consultant to know the quantity and quality of bleeding if you remember the number of pads used during this period and the type of blood clots.

Excessive fatigue, excessive thirst, dizziness or fainting are signs of anemia. Apart from these, if you are sleeping and experience rapid heart rate or dizziness when you suddenly stand up, then these conditions are a sign of anemia or bleeding.

(Read more - Bleeding After Delivery)

There can be many reasons for vaginal bleeding in the first trimester of pregnancy. About 20-30 percent of pregnancies are affected by bleeding. Bleeding during pregnancy also increases the risk of miscarriage. Not only this, in 2% of pregnancy cases, the baby slips out of the uterus. This situation can also arise due to vaginal bleeding. This situation can pose a threat to the life of you and your child. Consult a doctor if there is any kind of vaginal bleeding during early pregnancy.

• Bleeding after implantation in the uterine wall is normal. When the embryo is implanted to the uterine wall, a very small amount of bleeding occurs in the form of spotting. This bleeding occurs with or before menstruation. It is a little difficult to understand whether it is menstrual bleeding or spotting, but it is very important to understand because it is a sign of you being pregnant. This is a normal stage of pregnancy, there is nothing to worry about. 
• If you are bleeding or having cramps during pregnancy, then one of the reasons for this can be miscarriage. If you have a urinary tract infection or any other type of uterine infection, if you are dehydrated, due to the use of wrong medicines, due to physical injury, or if the fetus is abnormal, then a situation of miscarriage can arise. Apart from all these reasons, there is also a possibility of miscarriage due to lifting heavy things, wrong sex or mental stress. Most of these miscarriages happen in the early stages of pregnancy.

(Read more – Anemia in Pregnancy)

• If your egg is spotted (there is no fetus formed in it) but in ultrasound it shows a normal pregnancy. In this condition, the fetus does not develop and it remains in its proper place because it is an abnormal fetus.
• If the fetus dies in the womb itself [intrauterine fetal death (IUFD)], then bleeding also occurs. This can happen anytime during pregnancy and can be detected by ultrasound. That is why bleeding during the second and third trimesters is abnormal. 
• If your pregnancy is an ectopic pregnancy (tubal pregnancy), then in that case also you may bleed. This is the first risk if bleeding occurs during the first trimester of pregnancy. When the fertilized egg is implanted outside the uterus (mostly in the fallopian tube), that condition is called ectopic pregnancy and when this egg grows, the fallopian tube ruptures and bleeding occurs. This bleeding can be fatal. In about 3% of pregnancies, the child dies during this time due to lack of necessary nutrients. 
• If you have previously had problems like pelvic inflammatory disease, fallopian tube surgery, infertility etc., then ectopic pregnancy can occur. This condition also arises due to smoking and inserting contraceptive devices in the uterus. 
• Vaginal bleeding also occurs during molar pregnancy (also called gestational trophoblastic disease). When this happens, abnormal tissue is seen inside the uterus in ultrasound instead of the developing fetus. Actually, this is a type of tumor. Usually it is not fatal, but sometimes it causes cancer in which it penetrates the wall of the uterus and comes out and spreads throughout the body.
• Bleeding can also occur after intercourse during pregnancy, which is a normal condition.

(Read more - How To Take Care During Pregnancy)

Bleeding can occur in the last days of pregnancy due to a problem in the umbilical cord. Sometimes bleeding can also occur due to abnormal cervix and vagina.

• The umbilical cord (placenta) connects your baby to the womb. It is fully or partially extended in the cervical opening which is the path from the womb to the vagina and when bleeding occurs due to this, it is called placenta previa. When the cervix is ​​ready for delivery, some blood vessels of the umbilical cord burst due to pulling. In about 20% of cases, bleeding occurs due to this reason. This happens with 1 pregnant woman out of 200. There can be many reasons for placenta previa such as, multiple pregnancy (more than one child or twins growing in the womb at a time), if placenta previa has occurred in the past, if there has been a cesarean delivery in the past.
• If the umbilical cord gets separated from the uterine wall before the birth of the child, then the blood gets collected between the uterus and the placenta which comes out of the body in the form of vaginal bleeding. This happens due to high blood pressure, accidents, use of tobacco and cocaine.
• Uterine rupture is an abnormal process due to which the child shifts towards the abdomen. This also causes bleeding. This is a very rare condition but it is very dangerous for both the mother and the child. This can happen before or during delivery. Other reasons for this are as follows: Having more than four children in the womb at a time, due to accidents.
• Excessive bleeding also occurs due to rupture of the blood vessel of the fetus. Apart from the placenta, the blood vessel of the child is the membrane through which blood is transmitted from the mother to the child.
• There are other reasons for bleeding in the last days of pregnancy such as: injury or wound in the cervix and vagina, cyst and cancer etc. Genetic bleeding problems like hemophilia etc. are also the cause of this but this is a very rare condition. About 1 in 10,000 women suffer from this. But if you are suffering from it, then contact the doctor. 

(Read more - Every Mother Should Know : Pregnancy Problems)

If you are bleeding in the early days of pregnancy and there is no one around to take care of you or you are unable to go to the doctor immediately, then do not worry and follow these instructions:

• Take a rest.
• Do not lift weights or do any strength-intensive work.
• Stay away from sex. 
• Use tampons.
• Drink as much water as possible and avoid dehydration.

Bleeding in the last days of pregnancy cannot be treated at home in any way. 

(Read more -Bleeding After Abortion)

If you see serious symptoms during pregnancy, the doctor recommends an ultrasound or laboratory test because he wants to make sure that this is not happening due to ectopic pregnancy. If you have anemia during pregnancy, then IV fluids will be injected into your veins or you will have to undergo surgery.

(Read more - Abnormal Uterine Bleeding)

If there is bleeding during pregnancy, the doctor asks you to get some tests done for your and your baby's health. So do not ignore the doctor's advice at all. Urine test, complete blood count (CBC), serum test, Rh (blood type) test etc. are the main ones among these tests.

• Urine test detects urinary tract infection or any other type of infection. This is important because urinary tract infection can cause miscarriage. Later this infection also causes kidney infection.
• Your blood type is tested to see whether your blood type is Rh negative or positive. Because if you are negative and the child's father is positive, then your body can make antibodies against the child's blood cells. If treatment is not done and this situation arises, then the next time you are going to become a mother, these antibodies will harm your child. Therefore, if it is detected in the first pregnancy, it is treated with an injection called RhoGAM which prevents the formation of antibodies in your body.
• BHCG level is a measure of the amount of tissue in pregnancy. BHCG ​​level is present in both ectopic and normal pregnancies. Normal and abnormal pregnancy can also be detected by measuring the difference in its amount.
• In ultrasound, the picture of the fetus is seen on the screen through sound waves, by looking at which the condition and age of the fetus is detected. It is different from X-ray. Ectopic pregnancy, placenta previa, uterine rupture, rupture of the blood vessel of the fetus and urinary tract infection etc. are ascertained through ultrasound.

(Read more - bleeding vs periods)

• If ectopic pregnancy is detected in ultrasound, then you have to undergo surgery. This is done by laparoscopic procedure. In this, the ectopic pregnancy is removed from the fallopian tube by making an incision in the abdomen.
• If bleeding occurs due to miscarriage, the doctor advises you to rest until the bleeding stops. Also, during this period, you are advised not to have sex for three weeks and not to use tampons.
• If miscarriage is confirmed and no tissue of the fetus is visible in the ultrasound, then the doctor discharges you from the hospital and advises you to rest at home.
• If bleeding occurs in the last days of pregnancy, you will be given IV fluids or blood transfusion. At this time your treatment depends on the amount of your bleeding, your physical condition and the age of your child.
• If your child is in any kind of danger, then cesarean delivery is done at that time. Although usually vaginal delivery is given priority, in emergency situations, mother and child are saved only by doing cesarean delivery.
• Cesarean delivery is also done in case of placenta previa, uterine rupture and rapture of the blood vessel of the fetus. If the uterus ruptures, your uterus is removed but if you want more children, the surgeon can also repair the uterus.

(Read more - Can heavy bleeding during periods cause anemia?)

The best way to prevent any complications during pregnancy is to maintain a close relationship with your health counselor so that he is ready to help you if you suddenly need it during this time. Give up risky things and habits like not consuming tobacco and cocaine. If your blood pressure remains high, ask your health counselor about the way to reduce it.

Bleeding during pregnancy is not normal at all. Inform your health advisor about any type of vaginal bleeding during pregnancy, as well as give them details of how much and what kind of bleeding is happening. Talk to the doctor if the following situations arise:

• If you are experiencing severe bleeding or cramps.
• If there is vaginal bleeding for more than 24 hours during pregnancy.
• If you faint or feel dizzy.
• If you get a fever of 100.5 Fahrenheit during bleeding. 
• If you are experiencing more pain than the abdominal pain during menstruation.

(Read more - Bleeding During Pregnancy)

Bleeding during pregnancy can be a worrying condition that may occur for a variety of reasons. Light spotting is common in early pregnancy and may be due to the embryo implanting itself in the uterus after fertilization, called implantation bleeding. However, heavy or persistent bleeding may be a sign of serious problems, such as miscarriage, ectopic pregnancy (pregnancy outside the uterus), or placenta previa (abnormal location of the placenta in the uterus). Bleeding in the second and third trimesters may be a sign of placental abruption (separation of the placenta from the uterine wall), which can be dangerous for both mother and baby. It is important to seek immediate medical attention in case of any bleeding to get proper diagnosis and treatment and ensure the safety of both mother and baby.