Implantation bleeding, implantation bleeding or period

Pregnancy Bleeding

Pregnancy bleeding tips for articles women issues read more pregnancy bleeding true tips. Vaginal bleeding in early pregnancy miscarriage or not? Blood loss in the first months of pregnancy is usually harmless and can have various causes. In half of the number of times the blood loss during early pregnancy there is a miscarriage. Here the pregnancy tissue from the uterus driven, coupled with labor-like pain and blood loss. Other causes may be an abnormality of the cervix or (rarely) an ectopic pregnancy (see Ectopic pregnancy).

What does vaginal bleeding in early pregnancy?

Blood loss in the first months of pregnancy may have several causes.
Often, the bleeding will stop and innocent. In half of the blood loss in the first months of pregnancy there is a miscarriage. This is usually accompanied by menstrual-like pain or like contractions.

Causes of vaginal bleeding in early pregnancy, including miscarriage

An example of a common, innocent cause of bleeding early in pregnancy is the invasion (implantation) of the fertilized ovum into the uterus. Also, abnormalities of the cervix as a polyp or inflammation (eg Chlamydia, see SOA) lead to blood loss without affecting the pregnancy. This type of bleeding often occurs after intercourse or after (hard) stool and is easily treated. A rare cause of ectopic pregnancy (see Ectopic pregnancy).

In half of the blood loss in the first months of pregnancy there is a miscarriage, an abortion. The cause of miscarriage is almost always an abnormality in the chromosomes that occur coincidentally with the fertilization of the egg. This leads to a disturbance in the construction of the pregnancy so the pregnancy can develop and disposal.

What is a miscarriage?

A miscarriage is the loss of an early pregnancy. Miscarriage is also called an abortion. There are different types of miscarriages can be distinguished, usually depending on the stage of pregnancy when the miscarriage occurred or depending on the progress of the miscarriage. In normal pregnancy, amniotic sac containing an embryo created (see Figure

At a very early miscarriage (blighted ovum) is early in the pregnancy, the growth stopped and there is no developed embryos. On the (internal) ultrasound is only one amniotic sac visible.

Vaginal bleeding during the first months of pregnancy: miscarriage or not?

At a slightly later miscarriage (missed abortion), growth, and proceed in an embryo visible through an internal ultrasound. The embryo has no heart action and is usually smaller than the gestational age indicates. These types of miscarriage may go unnoticed, sometimes accompanied by low (dark) blood loss or low abdominal pain. Does the uterus expel the pregnancy tissue and opens the cervix itself, produces crampy pain and blood loss. The chance that the pregnancy results is very large. Is the pregnancy tissue from the uterus driven entirely disappears the pain and bleeding and the cervix closes again. Sometimes there is still tissue in the cavity of the uterus and the miscarriage (yet) complete.

What is the risk of miscarriage with bleeding in early pregnancy?

A miscarriage is a common and natural phenomenon: at least one in ten pregnancies, a miscarriage occurs. In the Netherlands, every year 20,000 women miscarry. The chance of miscarriage increases with age. For women under thirty-five years, the risk of miscarriage in pregnancy about 1 in 10. Between the thirty-five and forty years ending on a 5 to 6 pregnancies in miscarriage. Between forty and forty-five in year 1
3, over forty-five years half of the pregnancies (see Figure 2).
Once a miscarriage usually means no increased risk in a subsequent pregnancy in a new miscarriage. In a number of miscarriages in a row gets the chance of miscarriage is higher (see also recurrent miscarriage).

Possible symptoms of a miscarriage

Vaginal bleeding and mild menstrual like pain can be the first sign of a miscarriage. Pregnancy symptoms like breast tenderness and morning sickness sometimes take off in front of a miscarriage. With a blighted ovum or missed abortion, you usually few symptoms. If the pregnancy tissue is expelled by contractions of the uterine contractions you like pain and bright red bleeding. A miscarriage can not be stopped or prevented. The pain and blood loss are gradually increased to a miscarriage and when the uterus is completely empty, again. Is the pain or heavy blood loss or hold for too long, please contact your physician.

Study of bleeding in early pregnancy

Physical examination
The doctor or midwife viewed with a spreader (speculum) of the cervix (see First visit to the gynecologist). Any internal investigation following the size of the uterus and to assess whether the cervix to open.

Ultrasound
This research can be internally through the vagina, or externally through the abdomen, occur. The
uterus and the pregnancy should be visible and to assess whether the
pregnancy (still) intact (see pregnancy ultrasound). Ultrasound does not change the outcome of pregnancy.

Examination of the tissue
The pregnancy tissue is macroscopically with the naked eye, viewing and actually fits a pregnancy. Sometimes microscopic examination, but this study says nothing about the cause of the miscarriage. Both are just to confirm that a miscarriage has occurred. Also, the sex of the fruit can not be determined.

Blood tests
In more than blood loss, blood can be checked for anemia (Hb: hemoglobin). Sometimes the blood group and Rhesus factor examined. A first miscarriage is no reason for research. After two miscarriages, research in blood
You and your partner to place the chromosomes and after several miscarriages may have to the coagulation of the blood or antibodies in the blood (antibodies) (see also habitual abortion (recurrent miscarriage)).

What if a miscarriage diagnosed?

You can not do anything to prevent the miscarriage occurs. There is no treatment possible. You can choose to wait for the spontaneous course or arrange for the removal of pregnancy tissue through a curettage.

Wait
Usually, a miscarriage after the first bleeding within a few days going, sometimes it takes longer, even a few weeks. Gradually cramping pain in the uterus and increases the blood loss increases. The pain goes away almost immediately after a miscarriage that normally. The blood loss decreases rapidly and is similar to the last day of menstruation.

Advantages of waiting:
You may prefer to wait because a spontaneous miscarriage gives a more natural course. The grief can be experienced at home and possible complications of curettage should be avoided.

Disadvantages of waiting:
If you decide to await spontaneous miscarriage, it is wise to consider how long you want to wait and this with the doctor. Wait is medically harmless and does not affect a new pregnancy. However, it can be emotionally difficult. Also, by large blood loss or pain, or an incomplete miscarriage curettage later required. Pregnancy symptoms may persist as long as pregnancy tissue in the uterus is present.

Curettage
When a curettage removes the gynecologist with a thin tube (vacuĆ¼mcurettage) or scraper (curette) through the vagina and the cervix, the pregnancy tissue from the uterus. This can occur under general anesthesia or under local anesthesia, depending on the hospital. Discuss this with your gynecologist. Optionally, the miscarriage be generates by means of tablets.

Benefits of curettage:
Less uncertainty than to wait and less disruption of normal life.

Disadvantages of curettage: A curettage is a medical procedure. A rare complication is Asherman’s syndrome: this caused adhesions inside the uterus. This may adversely affect fertility and should, through an operation (see Therapeutic hysteroscopy) are removed at a later stage. Occasionally, a perforation: the tube or curette passes through the wall of the uterus. Usually this has no effect, but sometimes it is wise one extra night in hospital stay. Often you get than antibiotics. Another complication is an incomplete curettage, with a remainder of the miscarriage remains. This part may still come out spontaneously but this may need to undergo curettage half.

Anti-D immunoglobulin

If rhesus negative blood group you have anti-D immunoglobulin given you (anti-D) (see Blood).

After the miscarriage

Physical recovery
The physical recovery after a spontaneous miscarriage or curettage is usually smooth. For one to six weeks, take some bleeding and brownish discharge have. It is wise to community (society) to wait until the bleeding is over. Conceiving itself is not complicated by miscarriage and medically there is no need to wait to try again to get pregnant. The next menstrual period occurs after about four to six weeks.

If you after a spontaneous miscarriage or curettage medical attention? It is wise in the following circumstances the doctor or midwife to warn:

– With severe blood loss (long and more than a normal menstrual period). Especially with complaints of seeing stars or faint you should seek medical advice.

– If symptoms persist. If you have cramping pain and / or heavy bleeding may continue to indicate an incomplete miscarriage. There is still a remainder of the pregnancy in the uterus is present. A (new), curettage may be needed.

– If fever. A temperature of 38 / C or higher may indicate inflammation in the
uterus, which may be treated with antibiotics

– With concerns.

Emotional Recovery
After a miscarriage can be a difficult time. Sadness, guilt, disbelief, anger and a feeling of emptiness are common emotions. It is difficult to say how much time is needed. Guilt is rarely justified. It is wise to talk about your feelings with your partner, family, friends or doctors.

A subsequent pregnancy

A subsequent pregnancy proceeds in most cases well even in women who have gone through a miscarriage. If you want to become pregnant anyway, it is wise healthy life (see Precepts). A miscarriage is inevitable, but it can provide reassurance for a subsequent pregnancy to agree that a doctor (internal) ultrasound allows.


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