Advertisement
PregnancyNewbornInfantToddlerPreschoolerSchool AgeHealth & Medical
November 08, 2009 SEARCH drSpock 
Ask Our ExpertsMessage BoardsToolsConsumer AlertsTelevisionBooksA-Z Topics
DrSpock.com

HOT TOPICS
*Pregnancy Symptoms
*Read with Your Kids -- It's Fun!
*Take Our Quizzes
*Play with Your Baby
TOPICS
health-
Allergies
Antibiotics
Asthma
Birth Defects
Breathing and Respiratory
Colds and Flu
Colic
Constipation
Crying
Dental Care
Diapering Baby
Diphtheria
Ear Infections
Ear Problems: Miscellaneous
Eyes
Fever: Overview
Fever: Treatment
Fifth Disease and Parvovirus B19
GI Problems: Miscellaneous
Genital Issues
Getting Good Care
Health Promotion
Immunization Myths
Immunizations: General
Immunizations: The Shot Visit
Infections of Childhood
Insects: Bites and Stings
Medicines
Menstruation
Mononucleosis
Mouth and Throat Problems
Newborn Care
Newborns: Problems
Nose and Sinus Problems
Pneumonia
Rashes and Skin Care
Safety
Seizures
Sexually Transmitted Infections
Sickle Cell Disease
Strep Infections
Sudden Infant Death Syndrome (SIDS)
Urinary Tract Problems
Vomiting and Spitting Up
-----------
feeding+
-----------
behavior+
-----------
families+
-----------


Parents are talking about their children.
Join the discussion.



Different Causes of Bleeding During Mid to Late Pregnancy

by Elisa Ross, MD
reviewed by Marjorie Greenfield, M.D.
Brisk, red bleeding may be a sign of something serious at any time during pregnancy and always warrants a call to your practitioner. Most of the time, however, the cause of the bleeding is never discovered. Usually it stops on its own and poses no real danger.

Spotting, brown mucus discharge, or dark blood also should be evaluated, but the need to do so typically is not as urgent as when bright red bleeding or passing clots is involved.

It's helpful to note that not all blood found on toilet paper is from the vagina. It's extremely common to experience bleeding from the rectum during pregnancy. Most of the time it comes from small tears in the rectal lining that are caused by constipation. Sometimes hemorrhoids bleed, and you may occasionally have blood in the urine because of a bladder infection. In any case, your practitioner can help you sort these factors out.

Vaginal bleeding
If the vagina is definitely the source of the bleeding, sometimes the situation can provide some hints to the cause. Bleeding happens, not uncommonly, after intercourse, a pelvic exam, or a Pap smear. Some lighter bleeding at the end of pregnancy, near the due date, can be normal. Pink or brown mucus discharge is sometimes called "bloody show" and can signal cervical dilation and passage of the mucous plug.

Heavy bleeding
Heavy or brisk, bright red bleeding that fills up a sanitary pad, or the passing of clots, needs to be reported promptly. This type of bleeding could account for two potentially serious conditions of pregnancy, called placenta previa and placental abruption. Most of the time, though, the bleeding is caused by neither.

Placenta previa occurs when the placenta implants low in the uterus, covering the cervical opening. This usually can be seen by ultrasound. If the placenta is disturbed by contractions, intercourse, or pelvic examination, it can start to bleed. Keep in mind that this is the mother's blood, not the baby's. Usually the bleeding will stop on its own, but it can be quite heavy. Depending on the exact situation--the maturity of the baby and the degree of the bleeding--a decision may be made for delivery by caesarean section. Often when placenta previa is seen on ultrasound early in the pregnancy, it never causes bleeding and the situation resolves itself by the time the baby needs to be born.

In placental abruption (abruptio plactentae), the placenta becomes dislodged from the wall of the uterus, allowing the mother's blood to collect behind it and eventually make its way to the vagina. This collection of blood often irritates the uterus, causing contractions. Surprisingly, the baby can remain healthy using only the part of the placenta that is still attached. If the detachment continues, certain warning signs that your doctor will screen for might call for delivery, even if it's early in the pregnancy.

Bleeding in Rh negative mothers
Mothers with Rh negative blood type should get a RhoGam shot whenever there is the chance that significant mixing of fetal blood into the mother's circulation has occurred. This may happen if any significant vaginal bleeding takes place in pregnancy.
 RELATED INFORMATION
*  Bed Rest in Pregnancy
*  Diagnosing Preterm Labor
*  Rh Negative
*  The Developing Fetus, Weeks 25-40
*  Pregnancy-Related Bleeding


Created December 14, 2000
Reviewed April 15, 2003
OUR ADVERTISERS



OUR ADVERTISERS

About Us | Contact Us | Our Partners
Privacy Policy | Ethics | Advertising Policy | Terms of Service

© Copyright 2004 The Dr. Spock Company. All Rights Reserved.

THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The information drSpock.com provides is for educational purposes only and is not a substitute for professional medical advice. Always seek the advice of your health care professional if you have a specific health concern. Mention or advertisement of any product, service, or brand does not constitute endorsement, guarantee, or recommendation by The Dr. Spock Company. Please read our full Terms of Service.