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Ultrasound showing a subchorionic hemorrhage [1] Chorionic hematoma is the pooling of blood ( hematoma ) 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 .
Bleeding in excess of this norm in a nonpregnant woman constitutes gynecologic hemorrhage. In addition, early pregnancy bleeding has sometimes been included as gynecologic hemorrhage, namely bleeding from a miscarriage or an ectopic pregnancy, while it actually represents obstetrical bleeding. However, from a practical view, early pregnancy ...
Of women with heavy menstrual bleeding, up to 20% will have a bleeding disorder. [24] Heavy menstrual bleeding since menarche is a common symptom for women with bleeding disorders, and in retrospective studies, bleeding disorders have been found in up to 62% of adolescents with heavy menstrual bleeding. [25]
Tranexamic acid treatments, which reduce bleeding by inhibiting the clot-dissolving enzymes, appear to be more effective than anti-inflammatory treatment like NSAIDs, but are less effective than LNG-IUS. [25] Tranexamic acid tablets may reduce loss by up to 50%. [26] This may be combined with hormonal medication previously mentioned. [27]
About 30% of women have bleeding in the first trimester (0 to 14 weeks gestational age). [1] [5] Bleeding in the second trimester (12 to 24 weeks gestational age) is less common. [6] About 15% of those who realize they are pregnant have a miscarriage. [1] Ectopic pregnancy occurs in under 2% of pregnancies. [1]
The bleeding may be due to placental abruption, uterine rupture, placenta accrete, undiagnosed placenta previa, or vasa previa. [3] Cesarean section is indicated. Post-partum hemorrhage is defined by the loss of at least 1,000 mL of blood accompanied with symptoms of hypovolemia within 24 hours after delivery.
Atrophic vaginitis develops in 10-50% of postmenopausal women. Of those who are postmenopausal and have developed atrophic vaginitis, 50-70% develop symptoms. [ 1 ] [ 23 ] Around 30% of women with atrophic vaginitis discuss their symptoms with their primary healthcare provider.
Tranexamic acid, a clot stabilizing medication, may also be used to reduce bleeding and blood transfusions in low-risk patients, [31] however evidence as of 2015 was not strong. [2] A 2017 trial found that it decreased the risk of death from bleeding from 1.9% to 1.5% in women with postpartum bleeding. [3]