Are you at the end of pregnancy and have bleeding? If so, hopefully the following text will answer any questions you have and help you as much as possible.
What is bleeding at the end of pregnancy?
When we talk about bleeding in this case, we mean that just before the end (that is, from the 37th week of pregnancy) of pregnancy, blood leaks from the vagina. This bleeding is also called drawing bleeding. However, this does not necessarily have to result in a pathological course. The bleeding can be just as harmless. They can be a sign that labor is about to begin and indicate the opening of the cervix. However, it is important that the pregnant woman remains calm in this situation, informs a doctor or midwife, lies down and starts on the way to the maternity ward. Because this bleeding can also be a sign of serious complications, therefore, in any case, it should not be underestimated.
Causes
If the abdomen feels hard and the pregnant woman has pain, it indicates that the placenta is detaching from the uterus. However, the bleeding may also indicate that some blood vessels in the fetus have ruptured. Another cause of bleeding at the end of pregnancy is the proximity of the placenta near the inner cervix. However, it could also be that the placenta is not only close to the cervix, but covers it completely. In this case, physicians speak of a “placenta praevia”. If the bleeding is painless, sudden and very heavy, it strongly suggests that the pregnant woman is suffering from shock. But the reason for the bleeding does not necessarily have anything to do with the pregnancy. On the one hand, the bleeding may indicate an injury or even an infection of the vagina, on the other hand, the trigger may also be malignant tumors in the cervix.
Symptoms, complaints and signs
Bleeding at the end of pregnancy occurs mainly from the 37th week of pregnancy. Drawing bleeding is manifested by bleeding that is usually mixed with mucus and tends to be dark in color. The amount of blood that comes out is usually rather small. Heavy bleeding may occur if placenta praevia is present. Occasionally, drawing bleeding is also manifested by abdominal pain that may radiate to the gastrointestinal tract and legs. In addition, severe malaise may occur, which is due on the one hand to the bleeding anemia and its consequences and on the other hand to the cramps that accompany bleeding. As a result of heavy bleeding, circulatory problems may occur, which are manifested by sweating, dizziness and palpitations. If the bleeding is due to an injury to the cervix or fetus, additional symptoms and discomfort may occur. If the cervix is involved, there is pressure pain and heavy bleeding, which can intensify as it progresses and lead to circulatory problems relatively quickly. If the bleeding originates from the fetus, contractions and further discomfort are conceivable. The symptoms depend on the cause and the course of the bleeding, which is why a doctor must always be consulted in case of corresponding complaints.
Diagnosis
It is important in the diagnosis that palpation examinations directly on the vagina should be avoided as long as the cause of the bleeding is unclear, because in some circumstances they can aggravate the reason. It is also imperative that the physician refrain from these examinations. In order to find the reason for the bleeding, a doctor usually first performs an ultrasound examination. This sometimes reveals the reason, for example, if there is a placenta near the cervix or something similar. Then the doctor usually examines the vagina and the cervix. This is done by unfolding the vaginal walls with the help of a speculum in order to see the cervix. In addition, it is possible for the doctor to find out how much of the leaked blood comes from the fetus itself through a test called the Kleihauer test.
Complications
Bleeding at the end of pregnancy can be a sign of serious complications. One threatening complication at the end of pregnancy is unexpected detachment of the placenta. This can be accompanied by severe bleeding. These threaten both mother and child.Without an intact placenta, the baby cannot survive in the abdomen for long. At the same time, the mother is at risk of circulatory failure due to severe blood loss, which can be fatal. Therefore, in the event of bleeding at the end of pregnancy, a doctor should always be consulted immediately, regardless of the intensity of the bleeding. In case of heavy bleeding, it is recommended to go immediately to a clinic with a maternity ward. Depending on the cause of bleeding at the end of pregnancy, complications can only be avoided by ending the pregnancy by immediate cesarean section. If the placenta detaches prematurely, the baby will no longer be supplied with sufficient oxygen. If it is not then delivered within a short time, the baby will die or at least be cerebrally damaged due to the interruption of oxygen supply in the abdomen. Heavy bleeding can lead to circulatory instability and iron deficiency in the pregnant woman. To prevent further complications, the expectant mother may receive intensive medical care and may also receive blood supplements.
When should you see a doctor?
Very light bleeding at the end of pregnancy may herald the birth. This is not real bleeding, but the discharge of the mucus plug, which may resemble light bleeding. Even though light bleeding at the end of pregnancy can be harmless, it should always be examined by a doctor. This is because bleeding at the end of pregnancy can also be a medical emergency. Complications such as placental abruption threaten the life of both mother and child. However, if detected in time, rescue is possible. Accordingly, a pregnant woman should have any type of bleeding clarified by a doctor. Especially in case of very heavy bleeding and circulatory weakness, an emergency doctor should be called immediately. If the bleeding is heavy, it is not advisable to go to a gynecologist or family doctor, as this could waste valuable time before arriving at an obstetrics clinic. So it is better to alert an ambulance immediately in case of heavy bleeding at the end of pregnancy.
Treatment and therapy
Depending on why the pregnant woman suffers from the bleeding, it is of course decided how to proceed. On the one hand, the treatment is based on how the baby and the mother are doing and how much blood she has lost so far. If the mother has already lost a lot of blood, delivery is usually induced immediately. Under certain circumstances, this may mean that the mother needs blood units or other infusions. If the bleeding is weaker, the mother is usually kept in the hospital for observation of further progress. Depending on the cause of the bleeding, an immediate cesarean section may also be necessary to ensure the well-being of the baby and the mother. However, this is usually avoided, as it is obviously best for the baby to remain in the mother’s womb as long as possible to develop well.
Outlook and prognosis
Regarding the outlook and prognosis for bleeding at the end of pregnancy, it is imperative to distinguish between the so-called drawing bleeding and other bleeding. The former are present in most cases when the bleeding occurs shortly before the due date. In such cases, they indicate an imminent birth, which should be initiated accordingly. Accordingly, the drawing hemorrhages pass with the birth. The prognosis is usually worse for other types of bleeding at the end of pregnancy and depends on the cause. For example, the blood supply to the growing baby may be damaged or there may be a defect (detachment, rupture) in the placenta. Both mean a concrete supply risk for the child. If the bleeding is very severe and acute, and is also associated with pain, it is a matter of getting medical help quickly to determine what the outlook is. For example, prolonged and severe blood loss can, under certain circumstances, lead to shock for the affected person, even to the point of circulatory failure. In such cases, the growing child is also severely damaged and may die. In addition, there are still cases of bleeding due to infections or slight tearing in the vaginal area. These are usually treatable and considered harmless. They have no effect on the expectant child.
Prevention
To prevent bleeding at the end of pregnancy, there are no special instructions that can be followed.However, the pregnant woman should in any case follow the usual things that should be observed during any pregnancy. This includes, for example, that the pregnant woman does not smoke, nor drink alcohol. In addition, heavy objects should not be carried and the expectant mother should get enough rest and relaxation, even though the time of a pregnancy can sometimes be quite stressful and exciting.
Prevention
In the vast majority of cases, bleeding at the end of pregnancy does not require any special aftercare measures. However, this depends mainly on the cause. Since the bleeding is mostly related to the upcoming birth, affected women should usually receive close follow-up care from a midwife or gynecologist anyway. If there is any uncertainty, those affected should definitely contact them. In a few cases, such as the presence of a uterine rupture (tearing of the uterine wall) or premature placental abruption, a cesarean section must be performed. In this case, intensive postoperative follow-up is required. Rarely, the cause remains unknown in cases of bleeding at the end of pregnancy. As during the entire period of pregnancy, affected women should completely avoid alcohol and cigarettes in such cases. In addition, it is advisable not to carry heavy objects. After bleeding in late pregnancy, affected women should always ensure relaxation and rest to prevent recurrence. In some cases, it is also recommended to refrain from sexual intercourse with penetration for a few days.
What you can do yourself
What an expectant mother can do for herself in the area of self-help when bleeding occurs at the end of pregnancy depends largely on the underlying cause. Rest, relaxation and especially physical rest can often calm down especially light bleeding. When lying down, the muscles relax, small tissue injuries are not further stimulated to bleed by physical stress and any premature contractions, which are often associated with light bleeding, sometimes come to a halt through physical rest. These processes can be additionally promoted by taking magnesium. Magnesium preparations are available over-the-counter in various strengths, both in pharmacies and drugstores. Apart from possible abdominal pain and possibly diarrhea, no significant side effects are to be expected when taking a commercially available magnesium preparation. However, bleeding at the end of pregnancy can be life-threatening for mother and unborn child. Premature detachment of the placenta, for example, can be responsible for bleeding toward the end of 40 weeks and is a life-threatening emergency. Since bleeding can rarely be reliably assessed in terms of its cause by the expectant mother, a medical examination is generally advised. Only when a gynecologist deems the situation harmless can measures such as physical rest and magnesium be considered.
