Hemorrhage (bleeding) of pregnancy

Pelvis | Gynecology | Hemorrhage (bleeding) of pregnancy (Disease)


Obstetrical hemorrhage refers to heavy bleeding during pregnancy, labor, or the puerperium. Bleeding may be vaginal and external, or, less commonly but more dangerously, internal, into the abdominal cavity. Typically bleeding is related to the pregnancy itself, but some forms of bleeding are caused by other events.

Causes and Risk factors

Hemorrhage during pregnancy may be caused by many things, including injury to the uterus, bleeding from retention of the placenta, clotting disorders, uterine rupture, ectopic pregnancy, toxemia of pregnancy (preeclampsia / eclampsia), placenta previa, miscarriage, molar pregnancy, or placental abruption. It may be life threatening for the mother and unborn baby.

Obstetrical hemorrhage is a major cause of maternal mortality. The most common bleeding event is the loss of a pregnancy, a miscarriage, medically also called an abortion. Bleeding from an early miscarriage may be similar to that of a heavy menstruation, but later on, a pregnancy loss may be accompanied by excessive or prolonged bleeding. An ectopic pregnancy may lead to bleeding, internally, that could be fatal if untreated.

Diagnosis and Treatment

The primary consideration is the presence of a placenta previa, a condition that usually needs to be resolved by delivering the baby via cesarean section. Also a placental abruption can lead to obstetrical hemorrhage, some times concealed.

The goal of therapy is to stop the cause of bleeding, ensure the mother and baby remain healthy, and if necessary replace the lost blood. Treatment include blood transfusions, intravenous fluids, and fetal and maternal monitoring. ...