Blood loss

BLOOD LOSS BEFORE 14 WEEKS

In one in five pregnancies (20%) vaginal bleeding occurs in the first trimester (up to the 14th week of pregnancy). This can be experienced as alarming. Often the thought of a miscarriage is immediately raised. Only half of these pregnancies actually involve a miscarriage.

POSSIBLE CAUSES

There are a number of innocent situations in which blood loss may occur. This is not a miscarriage. Some examples are:

  • Penetration bleeding: The ingrowth of the foetus into the endometrium can cause bleeding. This usually occurs between the 4th and 6th week of pregnancy.
  • Contact bleeding: As soon as you are pregnant, the cells on the outside of the cervix are extra sensitive. The cervix is located inside the vagina. Mechanical pressure can cause these cells to bleed rapidly. This can happen, for example, after intercourse (making love), pressing hard stools, physical exertion, or excessive coughing.
  • Hemorrhoids: It may be that the blood loss is from hemorrhoids.
  • Undetected cut after shaving.
  • Sometimes a person has a bleeding without the pregnancy being at risk, but there is no obvious reason.

BLOOD LOSS AFTER 14 WEEKS

If you are more than 14 weeks pregnant, bleeding is rarely a sign of a miscarriage. Vaginal bleeding then has another cause:

  • Contact bleeding: As soon as you are pregnant, the cells on the outside of the cervix are extra sensitive. The cervix is located inside the vagina. Mechanical pressure can cause these cells to bleed rapidly. This can happen, for example, after intercourse (making love), pressing hard stools, physical exertion, or excessive coughing.
  • Hemorrhoids: It may be that the blood loss is from hemorrhoids.
  • Peripheral bleeding: This is innocent bleeding in a blood vessel at the edge of the placenta. This will go away on its own.
  • Polyps on the cervix, or other problems on the cervix. If there is repeated bleeding, the gynaecologist will take a smear test.
  • A low-lying placenta: When the placenta is close to the uterine outlet, bleeding can occur more easily there. This is not a problem in small amounts. During the ultrasound scan, the position of the placenta will be examined and discussed with you. During the pregnancy the placenta usually grows upwards and is therefore further away from the uterine outlet. Bleeding will then no longer occur.
  • Premature birth: If in addition to the bleeding you also have (painful) contractions of the uterus, it may be a sign that you are going to give birth too early. In this case, always contact the midwife on duty at the Birth Centre.
  • Solutio placentae: A very rare complication is that the placenta becomes (partially) detached from the uterine wall. In this case, a pregnant woman loses bright red blood and at the same time has a hard abdomen. This hard abdomen may be continuous, or it may come and go. The hard abdomen often hurts. In this situation it is important to intervene quickly, so always contact the staff member on duty at the Birth Centre.
  • Unknown cause: In most cases, bleeding has no obvious cause. As long as the pregnancy is developing well, the bleeding can be considered harmless.