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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. Two serious causes of early pregnancy bleeding are miscarriage and ectopic pregnancy.

Miscarriage is the most common serious cause of early bleeding and occurs in 15 to 20% of all pregnancies, usually within the frst 3 months. Most miscarriages cannot be prevented. They are nature’s way of dealing with pregnancies that are not developing properly. A mis­ carriage is characterized by bleeding more than a heavy period and associated with cramping.

An Ectopic pregnancy , or the fertilization of an egg 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 frst signs of labor. This is caused by the thinning of the cervix and is usually associated with thick mucous. 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 fnal 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 if fetal intolerance is detected by the fetal monitor, a Cesarean may be required. Most bleeding is the result of minor causes that require no treatment. It is important, however, for you to know that bleeding can indicate serious problems. You should report all bleeding to your healthcare provider immediately.


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


Placenta Previa

Placental Abruption

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