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Bloody show or show is the passage of a small amount of blood or blood-tinged mucus through the vagina near the end of pregnancy.It is caused by thinning and dilation of the cervix, leading to detachment of the cervical mucus plug that seals the cervix during pregnancy and tearing of small cervical blood vessels, [1] and is one of the signs that labor may be imminent. [2]
Bleeding before childbirth is that which occurs after 24 weeks of pregnancy. [4] Bleeding may be vaginal or less commonly into the abdominal cavity. Bleeding which occurs before 24 weeks is known as early pregnancy bleeding. Causes of bleeding before and during childbirth include cervicitis, placenta previa, placental abruption and uterine rupture.
Implantation bleeding involves a small amount of bleeding that may occur 10 to 14 days after implantation of the fertilized egg. However, there is little evidence to support the existence of such bleeding. [10] Chorionic hematoma is the pooling of blood between the chorion, a membrane surrounding the embryo, and the uterine wall.
Use of aspirin before 16 weeks of pregnancy to prevent pre-eclampsia also appears effective at preventing antepartum bleeding. [ 4 ] In regard to treatment, it should be considered a medical emergency (regardless of whether there is pain ), as if it is left untreated it can lead to death of the mother or baby .
Hematometra is usually treated by surgical cervical dilation to drain the blood from the uterus. [3] Other treatments target the underlying cause of the hematometra; for example, a hysteroscopy may be required to resect adhesions that have developed following a previous surgery. [ 1 ]
Severe acute bleeding, such as caused by ectopic pregnancy and post-partum hemorrhage, leads to hypovolemia (the depletion of blood from the circulation), progressing to shock. [41] This is a medical emergency and requires hospital attendance and intravenous fluids , usually followed by blood transfusion .
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The latent phase is defined by cervical dilation of 0 to 6 cm. The active phase is defined by cervical dilation of 6 cm to 10 cm. Second stage of labor starts when the cervix is dilated to 10 cm and finishes with the birth of the baby. This stage is characterized by strong contractions and active pushing by the mother.