Bleeding during pregnancy

At six month of pregnancy Susan started bleeding. After a week the blood flow increased but she did not feel that she was in any form of danger. Being a first time mother she thought this was a normal occurancy in pregnancy.

Casually she mentioned what she was experiencing to a colleague at work. The friend informed her that bleeding during pregnancy was a bad sign. She advised her to report to the nearby health centre and have a checkup done. It was discovered that Sarah had a low lying placenta and she was at risk of losing her baby. She was put on medication and immediate bed rest.

 Dr. Haruna Mwanje a gynecologist based at Mulago hospital says although bleeding during pregnancy is a common complaint, most times it is an indication that all is not well. “A mother experiencing bleeding at any stage during pregnancy must see a doctor immediately,” he says.

Major causes of bleeding during pregnancy

1.       Miscarriage or ectopic pregnancy: During the first three months of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy (when the fetus starts to grow inside your fallopian tubes instead of your womb). Dr. Haruna Mwanje says miscarriages occur during the first twelve weeks of pregnancy.  Ectopic pregnancies are much less common than miscarriages, but they also cause a woman to bleed.

2.      Low lying placenta (Placenta previa): occurs when the placenta lies low in the womb, partially or completely blocking the baby's path to the cervix. The placenta should usually move gradually upwards during pregnancy, but if it is still low then it poses a danger of bleeding to the mother.

3.      Placental abruption is the separation of the placenta from the uterine lining. This condition usually occurs in the third trimester but can occur any time after the 20th week of pregnancy. This condition can be successfully treated depending on what type of separation occurs. The signs and symptoms of placental abruption include one or more of the following, vaginal bleeding, uterine tenderness, Rapid contractions, abdominal pain, and fetal heart rate abnormalities.

4.       Preterm labaour: Normal pregnancy should last about 40 weeks. Occasionally, labor may begin prematurely before the 37th week of pregnancy because uterine contractions cause the cervix to open earlier than normal. When this happens, then the pregnant woman experiences bleeding. Peterm labour  can lead to premature birth . The baby may be born underweight and with a number of complications. 

 

How bleeding is managed

The way bleeding is managed during pregnancy depends on what is causing the bleeding and what the stage of the woman’s pregnancy is.

“When bleeding occurs, we look for the cause of the bleeding and then manage it according to the gestation period of the mother. If it is early before 12 weeks, then the mother may be experiencing a miscarriage and in such a scenario the mother will be allowed to go through the process s of expelling the contents of the pregnancy and then the womb cleaned afterwards” he says.

Some times when the bleeding is caused by an infection, the mother will be given the necessary treatment.  The way bleeding is handled depends much on what is causing it and the age of the pregnancy” Mwanje says.