"Hey, Dr. Li, I’m sorry to disturb you so late. My wife just got up to go to the toilet and found that the underwear flowed blood. May I have a miscarriage? Or …", bleeding during pregnancy is always shocking, my heart is small, my heart is small, my heart is small, and my heart is small.The theater began to imagine various possible reasons.How to judge that bleeding is something or okay?Want to observe or seek medical examination at home?Come and listen to what the experts say …
Reason for bleeding in the middle of pregnancy
Possible reasons: Cervical atresia is incomplete
Symptoms & Symptoms: Excessary a lot of blood, some people have symptoms of small amounts of secretions or lower abdomen pain before bleeding.
Reason and risk factors: The incomplete cervical atresia refers to the spontaneous expansion of the cervix when the cervix does not shrink, which causes the amniotic fluid sac to fall into the vagina due to gravity. This situation usually occurs after 4 months of pregnancy.The main cause of miscarriage.Because the first child is more difficult to detect the incomplete cervical atresia, patients usually find that they have relevant symptoms after bleeding, and they have the risk of premature birth, early water break or abortion.
How to deal with: early discovery can be used as rescue cervical rings to suture cervix, but the effect is usually not too good; after symptoms, the cervical rings should be used with contraction inhibitors to settle the tire.Take a break and avoid getting out of bed and walking. Preparation (36-38 weeks) will be removed.If there is a history of incomplete cervical atresia, it is best to perform preventive cervical ring tie operations in the next 12 to 14 weeks.
Cervical atresia is not full high risk group
There is a history of cervical atresia.
Condition uterus is abnormal, such as the two -horn uterus, a single corner uterus, and the cervix length is too short or too thin.
Once undergoing electrical and cone resection surgery for cervic lesions.
Cervical expansion has been performed many times.
After many artificial abortion surgery.
The first child produced cervical laceration.
Too much amniotic fluid.
Bleeding after a long time … It may be a low -level placenta
Although it can only be diagnosed with a pre -placenta in 32 weeks, the placenta position of the placenta of more than half of the pregnant woman in the second trimester is low. This low -level placenta has a distance from the cervix and may not bleed during contraction, but there are someIt may be bleed because of standing or moving heavy objects for a long time.The bleeding of the low -level placenta is similar to the front placenta, and it will also flow out of painless blood, but there is not as much as the front placenta, probably more than the amount of menstrual flow. Doctors usually use tires or hemostatic drugs as dependent.The post -pregnancy is closely tracking whether the placenta is gradually moved to the correct position.Basically, the placenta will gradually move up 32 weeks. During this period, as long as the abdominal action is avoided and the house is not excessive.
Reasons for bleeding late pregnancy
Possible reasons 1. Pre -placent
Bleeding form & Symptoms: Exile a large amount of blood and accompany contractions.
Reason and risk factors: The front placenta refers to the placenta covering the cervical mouth, and according to the amount of coverage ratio, it is divided into Major and minor.It is also located in the lower section of the uterine, but the lower edge of the placenta is not covered with the inner cervix.When the cervix is contracted, some placenta will be separated from the cervix and bleed with the frequency of contraction.
Although the front placenta will bleed a large amount of bleeding as long as the cervix contraction is slightly contracted, but because of this, it can usually be discovered and processed in time as soon as possible.Due to the wide area covered by the placenta, only some bleeding will not have much impact on the fetus. As long as the hemostasis can be stopped in time, there will be no problems. Unless a large amount of bleeding is not treated, the rapid decrease in blood pressure of the maternal body will cause anemia or shock.It will have a significant impact on the baby.
It is worth noting that because the front placenta is closer to the cervix and the bed is not as stable as the bottom of the uterine bottom, it is often easy to combine implant placenta (placenta implanted in the muscle layer).Nearby, the chance of merging implant placenta is higher.
How to deal with: Determine the fetal or caesarean section depending on the bleeding status.Generally speaking, as long as the contraction is relieved, the bleeding will improve. At this time, as long as the mother and baby have no other condition, the fetus can be hospitalized.If the mother’s blood flow is not stopped, the blood pressure drops, and the manifestation of anemia or shock occurs, an emergency caesarean section needs to be arranged to ensure the safety of the mother and baby.
Possible reasons 2. Early divestiture of placenta
Symptoms & Symptoms: Excessary a large amount of bright red or dark red blood. The larger the peeling range, the more the amount of bleeding. It is also accompanied by strong contractions, and the abdominal pain has hardly hardened.
Reason and risk factors: Early placental peeling refers to the placenta separated from the uterus before childbirth. At this time, the connected tissue will bleed due to peeling; depending on the divestitudation position, the impact on the mother and the fetus will not be the same: the placenta central centerThe stripping caused by arterial hemorrhage is called a hidden placenta stripping, and the probability of occurrence is about 1/3. The long -term accumulation of blood in the middle of the placenta and the uterine cavity will consume a lot of coagulation factors to cause abnormal coagulation function, forming a diffuse vascular intravascular coagulation (DIC)At this time, the mother’s blood flow is endless, which will cause abnormal fetal heart sound; the divestitudes caused by venous bleeding around the placenta are relatively small, and the course of the disease is relatively slow, but the risk of decreased amniotic fluid and delay in fetal growth will still produce.If the placenta is stripped in a small area, the fetus can also obtain nutrients from the remaining placenta. The large -scale placenta stripping will make the fetus unable to obtain sufficient oxygen and nutrients, and then embarrassed, premature or fetal abdomen.
How to deal with: first to allow the contraction to ease the contraction, then decide to be available or induced according to the bleeding status and fetal state.If the bleeding gradually decreases or stops, the fetus is less than 36 weeks, and the heartbeat blood pressure of the mother and baby is normal without other complications. It is recommended that the pregnant mother is hospitalized until the baby is produced in full month.If the blood flow is not stopped and the absence of coagulation in the vascular vascular occurs, an emergency cesarean section will be adopted to let the baby come out.
Possible reasons 3. The uterine rupture
Bleeding form & Symptoms: Excess of a large amount of blood and accompanied by severe abdominal pain.
Reason & Risk Factors: The rupture of the uterine refers to the uterine surface or lower section rupture. Most of them occur in the childbirth stage, and it is relatively rare in the late pregnancy.The uterine rupture in the late pregnancy mainly comes from the scars of the uterine surgery. Whether it is an uterine abnormalities (such as uterine fibroids, uterine adenomia), or scarred scars of caesarean section may be cracked when the uterine cavity pressure is elevated or the uterus is strongly contracted.The uterine rupture caused by this kind of scar is usually completely ruptured. At this time, the uterine muscle layer is completely ruptured, and the uterine cavity and abdominal cavity are connected.On the top, the baby may slow down the heartbeat because of the lack of blood flow and the fetus is dead; the crack is in the lower section of the uterus, because there is not much blood vessels there, and the impact on the baby is relatively small, but even if the baby is born smoothly, it is usually due to the placenta because of the placenta.Loss of functional hypoxia is damaged.For pregnant mothers, if the rupture position is just in the arterial blood vessels, it may cause blood loss to cause life.
How to deal with: first inject drugs in intravenous to suppress the contractions, and then immediately take out the baby to take out the baby.During surgery, the uterus will be preserved according to the degree of uterine rupture and infection and the maternal wishes.Although the uterine rupture is relatively rare in the late pregnancy, it is likely to occur after the migrants are launched. If a cesarean section or a history of uterine surgery is given naturally, the doctor must inform the doctor early to avoid the uterus suddenly rupture when the delivery is ready to give birth., Can’t deal with it in time.
Possible cause 4. Premature birth
Bleeding form & Symptoms: Blood or dark brown blood that is excreted than menstrual flow and mixed mucus, accompanied by regular contractions, as the number of contractions becomes more and more dense, it may cause abdominal pain.
Causes & Risk Factors: Premature bleeding is similar to falling red, which is also a cervical contraction that causes blood vessel rupture and bleeding. Because the amount of bleeding is not much, as long as the contraction can be successfully relieved, the fetus will not be too affected.Unless the uterus continues to shrink strongly, or a large amount of bleeding causes the decreased blood pressure of the maternal body to affect the supply of placenta oxygen, it will cause premature risk.Vaginal infection, urinary tract infection, and intrauterine infection may cause strong cervical contraction.
How to deal with: first evaluate the degree of cervical expansion, then use the fetal medicine to relax the contraction, wait for the reduction of bleeding, the cervix stops contraction, take oral eardoral drugs, observe or return home to recuperate as depending on the situation.If the contraction cannot be relieved and the risk of premature birth is high, preventive steroids and magnesium sulfate can help the lungs mature in the fetus, and avoid the baby’s birth of cerebral palsy.Doctors in the checkup usually measure the risk of premature birth in the middle of the pregnancy. If the cervix length is less than 2.5 cm, the cervical ring is surgery to prevent premature birth.
As far as clinical observations, most premature contractions will not be too strong. Rest or take a fetal medicine to stabilize. It is not too nervous to find that contractions during pregnancy to avoid emotional fluctuations.
Possible reasons 5. Placental edge blood sinus rupture
Symptoms & Symptoms: Excessary a small amount of dark brown blood.
Cause & Risk Factors: Once the blood sinus formed by the edge of the placenta, it will bleed once it is ruptured.Because the placenta is not stripped, the amount of bleeding is usually not much, and it will not affect the fetus, and most of them will be relieved by itself.
How to deal with: whether the amount of bleeding can affect the health of maternal and infants. If the mother and baby are healthy, you can wait until the monthly reproduction; if the monthly and the number of pregnancy weeks are 37 weeks, production can be considered.