Bleeding late in pregnancy (the second and third trimesters) is a severe complication, as a threat to the life of the fetus and the mother. The frequency of complications is up to 3%. With a relatively low incidence of disease observed quite a high percentage of maternal morbidity. In some clinical cases it reaches 23%. The main causes of uterine bleeding is placenta previa and placental abruption.

"The migration of the placenta" and the risk of complications

At physiological pregnancy the placenta takes a certain position in the uterus and is attached to one of its walls. If the placenta for various reasons overlaps partially or completely internal os region, we speak of the development of placenta previa. Thanks to the dynamic ultrasound scanning during pregnancy has been shown to exist, the so-called phenomenon of "placental migration".

In the second trimester placenta lower edge may be located in the region of the internal os, but in the future it "rises" and, in most cases this is towards the bottom of the uterus. From the viewpoint of the title itself is lying anywhere placenta, but is formed of the lower segment of the uterus, and this contributes to a kind of movement of the placenta. If migration is rapid, almost half of the clinical cases, this can be complicated by abortion. The optimal rate of "placental migration" are considered as the process lasts for up to ten weeks and ends on the thirty-fifth week of pregnancy.

Bleeding often repeated, leading to a sharp anemizatsii pregnant, and the pain a woman does not feel. Also, during the physical examination no tenderness of the uterus. The opposite is observed clinical picture during abruption. The intensity of bleeding will correspond to the embodiment of the detachment. If the detachment is an edge, it will be characterized by the development of external bleeding and pain. In the case of central retinal detachment bleeding embodiment can be omitted, thus greatly pronounced will pain.

Medical tactic is at a bleeding

The whole complex of medical measures to stop the bleeding late in pregnancy should be carried out in the Department of Pathology obstetric hospital. If there are no indications for urgent surgical treatment, treatment should begin with non-drug of mandatory measures:

• complete elimination of all negative factors and exercise
• compliance with bed rest
• exclusion of sexual activity

If the blood loss exceeds 250 ml, is shown holding an urgent delivery (cesarean section). Most dangerous are bleeding with placental abruption Placental abruption - why is it so dangerous to a woman's life? . One-third of pregnant women are a source of massive bleeding, which often are the cause of maternal mortality, as well as the cause of the suffering of the fetus. In this regard, it is so important to the appearance of a pregnant bleeding of any intensity and pain, it is required to be hospitalized and to decide on the method of stopping bleeding (using conservative or surgical methods of hemostasis).

Marina Solovyov

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