Normal physiological during pregnancy should not be accompanied by bleeding. This is an important clinical symptom in terms of the development of serious complications that can lead to the termination of pregnancy on different terms. Bleeding during pregnancy is a threat to women and the developing fetus, therefore, in such a situation requires urgent action.

Why develop uterine bleeding in the second trimester

A serious complication of pregnancy is uterine bleeding. This pathology is the cause of high maternal morbidity and mortality, and perinatal losses. The causes of bleeding during pregnancy is placental abruption and its presentation.

Among pregnant placenta previa it is relatively rare (up to 0, 8% of the total number of births). Bleeding in this pathology is found in 34% of cases, and maternal mortality is almost 23%. One of the complications is previa premature termination of pregnancy, which can be observed in 20% of cases. So far, there is no clear understanding of the causes of such complications, but secrete factors that contribute to this (called maternal causes):

• pathological processes that caused structural changes of the endometrium. This occurs after an inflammatory lesion with multiple layers of the uterus (endomyometritis), and after the intervention tool. Diagnostic procedures (separate curettage) made abortion deferred surgery (conservative myomectomy, surgical delivery) may be complicated by the formation of scar tissue in the endometrium;
• malformations or anomalies of the uterus;
• women having uterine fibroids Uterine fibroids - without symptoms, but with big problems ;
• more than two parity. It is proved that in multiparous women placenta previa occurs in about 80% of cases;
• presence of inflammatory or septic complications after giving birth;

For a certain period it is repeated many times, so this leads to a change in the general condition of the pregnant woman - she has anemia and increases progressively deteriorating health. If placenta previa is not severe clinical data inspection showed no increased tone or uterine tenderness on palpation.

Bleeding can be caused by placental abruption Placental abruption - why is it so dangerous to a woman's life? That comes early and occurs with a frequency of up to 1, 4%. The intensity of bleeding depends directly on the amount of detachment and on this basis can judge the severity of the condition of the patient.

You must select a group of factors that lead directly to premature detachment. This is primarily a traumatic impact factor. Trauma can be immediate (or holding a blow gross external studies) or indirectly (eg, anatomical length of the umbilical cord, rapid delivery). Separately isolated injury due to neuro-psychological effects (effects of fright or stress). Bleeding occurs against the backdrop of severe pain syndrome, which is an important diagnostic feature.

Bleeding due to complications in the first trimester

The complications that develop in the early stages or in the first trimester of pregnancy, related to the problem of spontaneous abortion Abortion - is always a risk . In most cases, abortion occurs at the beginning stage of abortion or abortion in the course. This is accompanied by uterine bleeding, cramping and contractions of the myometrium. Bleeding is sometimes intense, it can be stopped only with the help of instrumental intervention (holding scraping the uterine cavity).

The causes of the disease state referred to as immunologic, infectious, anatomic, endocrine and other problems. In half of all clinical cases of abortion in early pregnancy due to chromosomal or gene disorders. Pathology from the chromosomes can be very diverse, but the most common abnormality is an autosomal trisomy (diagnosed in 52%) and polyploidy, which are diagnosed in 22%.

There is an increasing bleeding from the genital tract, the appearance of regular uterine contractions. From the cervix undergo structural changes on the basis of which it is possible to judge the severity of a pathological condition of the process. On stage in the course of the abortion can determine the elements of the ovum directly into the vagina or cervix. Excessive bleeding in this case, you must stop using instrumental evacuation of the uterine cavity. Under intravenous anesthesia produce a full removal of accumulated blood clots and tissue elements. In the period after curettage should be performed to shrink, anti-inflammatory therapy.

To prevent the development of severe complications such should promptly appoint a treatment in order to maintain the pregnancy when the first symptoms of the disease. If a pregnant woman complains about the appearance of bleeding from the vagina, then it should be given the most attention, treatment accordingly, since in the future it could be completed clinical spontaneous abortion.

Marina Solovyov

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