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Fetal-maternal haemorrhage is the loss of fetal blood cells into the maternal circulation. It takes place in normal pregnancies as well as when there are obstetric or trauma related complications to pregnancy.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Chorionic hematoma is the pooling of blood between the chorion, a membrane surrounding the embryo, and the uterine wall. [2] It occurs in about 3.1% of all pregnancies , [ 2 ] it is the most common sonographic abnormality and the most common cause of first trimester bleeding .
Some other common factors that can cause cephalohematoma are when using forceps or vacuum-assisted delivery methods, vaginal delivery of large infants, primigravida (the first pregnancy conceived by a pregnant person), when the infant is in a non-ideal position during delivery, and having a prolonged second stage of labor.
Early recognition of this injury is crucial for survival. Infants who have experienced a difficult operative delivery or are suspected to have a SGH require ongoing monitoring including frequent vital signs (minimally every hour), and serial measurements of hematocrits and their occipital frontal circumference, which increases 1 cm with each 40 mL of blood deposited into the subgaleal space.
Caput succedaneum is a benign neonatal condition involving a serosanguinous (containing blood and serum), subcutaneous, extra-periosteal fluid collection with poorly defined margins caused by the pressure on the presenting part of the fetal scalp by the vaginal walls and uterus as the infant passes through a narrowed cervix during delivery.
If the bleeding is severe, immediate delivery is an option as long as the fetus is old enough to survive, or fetal blood volume restoration may be considered. [9] Another possible complication is cord hematoma, which doesn’t have any characteristic symptoms but can be indicated by sudden bradycardia.
[1] [2] Such bleeding could be visible or external, namely bleeding from the vagina, or it could be internal into the pelvic cavity or form a hematoma. Normal menstruation is not considered a gynecologic hemorrhage, as it is not excessive. Hemorrhage associated with a pregnant state or during delivery is an obstetrical hemorrhage.