Obstetric bleeding
Obstetric bleeding is a group of pathological bleeding from the uterus and other organs of the reproductive system associated with the performance of the reproductive function during pregnancy, childbirth, in the afterbirth and early postpartum periods.
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Bleeding in the first half of pregnancy:
- spontaneous miscarriage;
- bubble drift;
- ectopic pregnancy;
- concomitant pathology (polyps, erosion, cervical cancer).
Bleeding in the second half of pregnancy:
- placenta previa;
- premature detachment of the normally located placenta;
- malignant tumors of the cervix and uterine body.
Spontaneous miscarriage
- threat of miscarriage;
- miscarriage that has begun;
- miscarriage in progress (inevitable);
- incomplete miscarriage;
- complete miscarriage;
- Miscarriage (dead pregnancy).
Diagnosis :
- assessment of the general condition of the pregnant woman; examination of the cervix in mirrors, bimanual examination;
- assessment of blood loss.
Spontaneous miscarriage (abortion) - termination of pregnancy from conception to 22 weeks of pregnancy. Clinical forms of miscarriage:
I. Threat of miscarriage: History:
- Late menarche and a long period of menstruation.
- Diseases of viral etiology and infectious-allergic nature in the pre- and pubertal period in girls. Menstrual disorders.
- Medical abortions, their complications.
- Infertility, especially treated with assisted reproductive technologies.
- The presence of spontaneous termination of previous pregnancies.
- Perinatal loss in the anamnesis.
- Pathological course of previous pregnancies and births. Gynecological operations.
- Transferred TORCH-infections in the reproductive period.
- Chronic diseases in the anamnesis (including chronic tonsillitis, umbilical sepsis).
- Allergic diseases of a polyvalent nature.
- Provoking factors (injury, fall, exercise, coitus).
Complaints of a pregnant woman :
1. Pain in the lower abdomen, lower back.
2. Feeling of heaviness, pressure on the bladder, rectum, vagina, discomfort in the suprapubic area.
3. The presence of bloody discharge, but they may be absent. Discharges are scanty, dark or brown, sometimes bright on critical days, respectively, allowable menstruation.
Clinical signs :
1. Excitability of the uterus, increasing its tone. The fertilized egg completely retains contact with the uterus.
2. Decrease in basal (rectal) temperature in the first trimester to 37 ° and below.
3. The outer eye is closed, but can be opened. During gynecological examination, the size of the uterus corresponds to the delay of menstruation, the uterus responds to the examination by contraction, structural changes in the cervix are absent. In the II trimester: prolapse of the amniotic sac, discharge of amniotic fluid.
ІІ. Miscarriage that has begun: History.
Complaints of a pregnant woman:
1. Severe lower abdominal pain, low back pain.
2. Frequent urination, defecation.
3. Bloody discharge.
Clinical signs:
1. Increased uterine tone, its pain, but the size of the uterus corresponds to the term of pregnancy.
2. Decrease in basal (rectal) temperature.
3. In vaginal examination - a slight shortening of the cervix and the opening of the outer eye, the cervix may be slightly stepped with a slightly gaping outer eye. Partial detachment of the fertilized egg due to increased contractility of the myometrium.
III. Miscarriage in progress: History is the same.
Complaints of a pregnant woman:
1. Severe cramping pain in the lower abdomen.
2. Bloody discharge is significant (sometimes up to hemorrhagic shock). Leakage of amniotic fluid.
Clinical signs: 1. Opening of the cervix. 2. Fertile egg partially in the cervical canal and vagina. The cervix increases in volume, the body of the uterus shrinks.
IV. Complete miscarriage: History is the same.
Complaints of a pregnant woman:
1. Pain in the lower abdomen.
2. Bloody vaginal discharge stops.
Clinical signs:
1. The size of the uterus does not correspond to the term of pregnancy (smaller).
2. The cervical canal is closed, sometimes not completely. The fertilized egg is completely rejected, only parts of the decidual membrane may remain in the uterus, pain is reduced and bleeding stops (more common in the late second trimester of pregnancy).
Incomplete miscarriage: History is the same.
Complaints of a pregnant woman:
1. Pain in the lower abdomen of low intensity.
2. Bloody vaginal discharge of varying severity.
Clinical signs:
1. The size of the uterus does not correspond to the term of pregnancy (less).
2. The consistency of the uterus is not dense. The cervical canal is open. Part of the fertilized egg went beyond the uterus, and the uterine cavity contains its remnants, which is accompanied by varying degrees of bleeding with a decrease in pain, the size of the uterus does not correspond to pregnancy.
Treatment of miscarriage risk:
1. Hospitalization at the risk of abortion, as well as women at risk in critical periods of pregnancy (8 - 12, 16 - 22, 26 - 28, 28 - 32 weeks) and before the date of termination of previous pregnancies. Adequate bed rest.
2. A diet with a balanced content of proteins, fats and carbohydrates, with sufficient content of vitamins.
3. Non-drug methods: electroanalgesia, electrorelaxation, acupuncture, physiotherapy - magnesium electrophoresis with sinusoidal modulated current, hyperbaric oxygenation.
4. Drug treatment.
Obstetric bleeding
An obstetric hemorrhage may occur before or after delivery, but more than 80% of cases occur postpartum. Worldwide, a massive obstetric hemorrhage, resulting from the failure of normal obstetrical, surgical or systemic hemostasis, is responsible for 25% of the estimated 358,000 maternal deaths...
Obstetric bleeding is a group of pathological bleeding from the uterus and other organs of the reproductive system associated with the performance of the reproductive function during pregnancy, childbirth, in the afterbirth and early postpartum periods.
Obstetric bleeding is a group of pathological bleeding from the uterus and other organs of the reproductive system associated with the performance of the reproductive function during pregnancy, childbirth, in the afterbirth and early postpartum periods.
Obstetric bleeding
An obstetric hemorrhage may occur before or after delivery, but more than 80% of cases occur postpartum. Worldwide, a massive obstetric hemorrhage, resulting from the failure of normal obstetrical, surgical or systemic hemostasis, is responsible for 25% of the estimated 358,000 maternal deaths...
Obstetric bleeding is a group of pathological bleeding from the uterus and other organs of the reproductive system associated with the performance of the reproductive function during pregnancy, childbirth, in the afterbirth and early postpartum periods.
Bleeding in the first half of pregnancy:
- spontaneous miscarriage;
- bubble drift;
- ectopic pregnancy;
- concomitant pathology (polyps, erosion, cervical cancer).
Bleeding in the second half of pregnancy:
- placenta previa;
- premature detachment of the normally located placenta;
- malignant tumors of the cervix and uterine body.
Spontaneous miscarriage
- threat of miscarriage;
- miscarriage that has begun;
- miscarriage in progress (inevitable);
- incomplete miscarriage;
- complete miscarriage;
- Miscarriage (dead pregnancy).
Diagnosis :
- assessment of the general condition of the pregnant woman; examination of the cervix in mirrors, bimanual examination;
- assessment of blood loss.
Spontaneous miscarriage (abortion) - termination of pregnancy from conception to 22 weeks of pregnancy. Clinical forms of miscarriage:
I. Threat of miscarriage: History:
- Late menarche and a long period of menstruation.
- Diseases of viral etiology and infectious-allergic nature in the pre- and pubertal period in girls. Menstrual disorders.
- Medical abortions, their complications.
- Infertility, especially treated with assisted reproductive technologies.
- The presence of spontaneous termination of previous pregnancies.
- Perinatal loss in the anamnesis.
- Pathological course of previous pregnancies and births. Gynecological operations.
- Transferred TORCH-infections in the reproductive period.
- Chronic diseases in the anamnesis (including chronic tonsillitis, umbilical sepsis).
- Allergic diseases of a polyvalent nature.
- Provoking factors (injury, fall, exercise, coitus).
Complaints of a pregnant woman :
1. Pain in the lower abdomen, lower back.
2. Feeling of heaviness, pressure on the bladder, rectum, vagina, discomfort in the suprapubic area.
3. The presence of bloody discharge, but they may be absent. Discharges are scanty, dark or brown, sometimes bright on critical days, respectively, allowable menstruation.
Clinical signs :
1. Excitability of the uterus, increasing its tone. The fertilized egg completely retains contact with the uterus.
2. Decrease in basal (rectal) temperature in the first trimester to 37 ° and below.
3. The outer eye is closed, but can be opened. During gynecological examination, the size of the uterus corresponds to the delay of menstruation, the uterus responds to the examination by contraction, structural changes in the cervix are absent. In the II trimester: prolapse of the amniotic sac, discharge of amniotic fluid.
ІІ. Miscarriage that has begun: History.
Complaints of a pregnant woman:
1. Severe lower abdominal pain, low back pain.
2. Frequent urination, defecation.
3. Bloody discharge.
Clinical signs:
1. Increased uterine tone, its pain, but the size of the uterus corresponds to the term of pregnancy.
2. Decrease in basal (rectal) temperature.
3. In vaginal examination - a slight shortening of the cervix and the opening of the outer eye, the cervix may be slightly stepped with a slightly gaping outer eye. Partial detachment of the fertilized egg due to increased contractility of the myometrium.
III. Miscarriage in progress: History is the same.
Complaints of a pregnant woman:
1. Severe cramping pain in the lower abdomen.
2. Bloody discharge is significant (sometimes up to hemorrhagic shock). Leakage of amniotic fluid.
Clinical signs: 1. Opening of the cervix. 2. Fertile egg partially in the cervical canal and vagina. The cervix increases in volume, the body of the uterus shrinks.
IV. Complete miscarriage: History is the same.
Complaints of a pregnant woman:
1. Pain in the lower abdomen.
2. Bloody vaginal discharge stops.
Clinical signs:
1. The size of the uterus does not correspond to the term of pregnancy (smaller).
2. The cervical canal is closed, sometimes not completely. The fertilized egg is completely rejected, only parts of the decidual membrane may remain in the uterus, pain is reduced and bleeding stops (more common in the late second trimester of pregnancy).
Incomplete miscarriage: History is the same.
Complaints of a pregnant woman:
1. Pain in the lower abdomen of low intensity.
2. Bloody vaginal discharge of varying severity.
Clinical signs:
1. The size of the uterus does not correspond to the term of pregnancy (less).
2. The consistency of the uterus is not dense. The cervical canal is open. Part of the fertilized egg went beyond the uterus, and the uterine cavity contains its remnants, which is accompanied by varying degrees of bleeding with a decrease in pain, the size of the uterus does not correspond to pregnancy.
Treatment of miscarriage risk:
1. Hospitalization at the risk of abortion, as well as women at risk in critical periods of pregnancy (8 - 12, 16 - 22, 26 - 28, 28 - 32 weeks) and before the date of termination of previous pregnancies. Adequate bed rest.
2. A diet with a balanced content of proteins, fats and carbohydrates, with sufficient content of vitamins.
3. Non-drug methods: electroanalgesia, electrorelaxation, acupuncture, physiotherapy - magnesium electrophoresis with sinusoidal modulated current, hyperbaric oxygenation.
4. Drug treatment.
Obstetric bleeding
Obstetric bleeding is a group of pathological bleeding from the uterus and other organs of the reproductive system associated with the performance of the reproductive function during pregnancy, childbirth, in the afterbirth and early postpartum periods.
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