Vaginal Bleeding Vaginal bleeding is probably the most important and frequent of the danger signals in pregnancy. Even so, bleeding does not always mean that some grave complication is in the offing. Frequently none is. But bleeding is never a good sign and cannot be ignored. Many women have slight, painless bleeding at the time of the first missed period. This is not in the least dangerous to mother or developing baby. Its only practical significance is that it can throw the predicted date of delivery of by a month if it is interpreted as a normal period.
pending. It is also one of the symptoms of a tubal pregnancy in which the pregnancy develops not in the uterus but in a Fallopian tube. In the middle pan of pregnancy bleeding that is no more than a slight brown show may indicate an incompetent cervix, requiring treatment. Minimal bleeding after sexual intercourse in pregnancy usually indicates the presence of a benign cervical polyp or merely a congested cervical erosion. In the latter part of pregnancy bleeding can become dangerous to both the mother and child and should be reported at once.
Heavy bleeding at this time indicates some abnormality in the attachment of the placenta. Either it is attached too close to the neck of the womb or part of its attachment comes loose before labor or delivery. At the onset of labor there is often a small amount of bleeding or “show.” At the end of pregnancy the show is often found following internal exam, nations. The foregoing are some of the commoner causes of bleeding in pregnancy. There are many others that are encountered less frequently. While bleeding in pregnancy is not always serious, let us stress again that it should always be reported to the doctor.
If you called your doctor each time in pregnancy you had a twinge of abdominal pain, both you and he would spend a good deal of the nine months on the phone. On the other hand, severe and persistent abdominal pain often indicates a complication and should always be reported to your physician. When the neck of the womb opens, whether in miscarriage or labor, there are severe menstrual like cramps. Between cramps there is no discomfort. Pain that comes from the neck of the womb is felt in the midline, low in the abdomen or back, and even at times branching to the thighs.
There are many causes for abdominal pain in pregnancy. In early pregnancy many women experience a vague. poorly localized sense of lower abdominal cramp. which is of no significance. In both miscarriages and tubal pregnancies there usually will be moderate to severe pain and abnormal bleeding. When the uterus enlarges out of the pelvis (after the third month), the ligaments holding it in place begin
a cough or sudden change in motion or sudden change in the mother’s position, can cause a sharp twinge of pain low down in the groin, on one side or the other. Pregnancy does not offer any protection against serious conditions that cause abdominal pain in women who are not pregnant. A good example is appendicitis which requires prompt surgical treatment in pregnancy as at any other time. Sometimes the operation is delayed because the discomfort is thought to be one of the “aches and pains of pregnancy.
” Toward the end of pregnancy one of the more frequent serious complications giving rise to abdominal pain is premature separation of the placenta. This condition is almost always associated with bleeding, which can be heavy at times but not necessarily so. Labor pains are menstruallike cramps felt in the middle, either in front or in hack. They gradually become more severe and the interval between them gradually decreases as the labor progresses. Patients often wonder how they can distinguish between true labor pains and a false alarm. Sometimes at the beginning of labor there is slight vaginal bleeding or “show.”
This showing does not occur with false labor. Physical activity sometimes will make false labor pains disappear. Get up and pace the floor for fifteen or twenty minutes. If the pains cease, it is not the real thing. Activity will often make true labor pains more frequent and intense. Persistent and severe pain at any time in pregnancy should be re-ported to your physician.
Rupture of the Membranes
The bag of waters surrounding the baby breaks before the onset of labor in to to 15 percent of cases. Usually this happens at the end of pregnancy, and labor begins a short time later. If labor does begin, there is no danger. But if the onset of labor is long delayed, there is the possibility of an infection developing in the birth canal. An infection of this sort could be serious to both the mother and infant. Every once in a while a woman will come into the doctor’s office and blithely report that the membranes have been ruptured for several days.