Jun 21, 2024

Unusual bleeding during and after pregnancy

When should pregnant women be concerned?

Awareness of the dangers associated with abnormal bleeding during pregnancy and after childbirth can be lifesaving for both women and their babies.

Dr. Mzuvele Archwell Hlabisa, an obstetrician and gynaecologist at Netcare Kingsway Hospital, emphasizes that while many people are unaware that over a third of pregnant women may experience bleeding for various reasons, it is crucial to determine the exact cause.

"Although some bleeding is normal in the postpartum period, excessive bleeding can be life-threatening. It is often difficult for women to discern if their bleeding is normal or not, but a good rule of thumb is to have any bleeding during pregnancy checked by a healthcare professional," says Dr. Hlabisa.

He notes that around 35% of women experience bleeding in the first trimester. "As the pregnancy progresses, the likelihood of bleeding decreases, so it's reassuring when women reach the mid-trimester, from 13 to 28 weeks of gestation."

Bleeding could indicate a miscarriage or a threatened miscarriage, and severe pain with bleeding could be related to placental abruption, a serious condition where the placenta prematurely separates from the womb. These conditions require immediate medical assessment.

Spotting In early pregnancy, some women may experience spotting, known as implantation bleeding, when the embryo implants in the uterine wall. Spotting is typically minimal, usually less than a teaspoonful, and can also result from a cervical infection, urinary tract infection, or even hemorrhoids during pregnancy. Sexually transmitted infections can also cause bleeding.

Cause for Concern Dr. Hlabisa warns that heavier bleeding is more concerning and warrants immediate medical attention. "Any pregnant woman experiencing bleeding lasting an hour or severe pain in her upper or lower back should seek immediate assessment by a healthcare worker," he says.

Symptoms like headaches, weakness, and dizziness may indicate anemia, necessitating prompt medical care. Reduced blood flow to the placenta could be life-threatening for the baby, and even mild bleeding can have long-term neurological effects.

What to Expect at the Hospital When seeking medical care for bleeding during pregnancy, expect an internal examination to determine the cause. Urine and blood tests may be conducted to check for anemia or underlying bleeding disorders. A basic ultrasound may assess fetal well-being.

Treatment can range from bed rest and abstinence from sex to antibiotics for infections. Anemic mothers might receive iron supplements or transfusions. In cases of placental abruption, immediate delivery is necessary. Treatment for placenta previa, where the placenta is low in the uterus, depends on the gestation and severity of the bleeding.

After Birth Postpartum bleeding is normal as the uterus contracts back to its normal size, often described as similar to a moderate menstrual period. Bleeding typically decreases over the first week, though some women may experience intermittent bleeding for several weeks.

During the first six weeks postpartum, bleeding is normal, but symptoms of anemia such as headaches, weakness, or dizziness indicate abnormal bleeding. Bleeding can also result from an episiotomy, a tear, retained placental fragments, or infections.

Risk factors for abnormal blood loss after childbirth include having a large baby, twins, a difficult delivery, or prolonged labor. Conditions like uterine fibroids, hypertension, underlying blood disorders, or the use of blood thinners increase the risk of bleeding.

Dr. Hlabisa urges women experiencing abnormal bleeding to seek immediate medical attention. "Monitoring the rate of bleeding and noting symptoms like weakness, fast heartbeat, or light-headedness can help your doctor distinguish between normal postpartum bleeding and bleeding that requires medical intervention," he advises.

"When in doubt, seek help from your medical practitioner without delay."

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Netcare Hospitals
Telephone: (011) 469 3016
Email: connect@mnapr.co.za