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More than half of women affected by placenta praevia (51.6%) have bleeding before delivery. [9] This bleeding often starts mildly and may increase as the area of placental separation increases. Placenta praevia should be suspected if there is bleeding after 24 weeks of gestation. Bleeding after delivery occurs in about 22% of those affected. [2]
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]
During the third trimester of pregnancy, thinning of the lower uterine segment or contractions caused by cervical dilation can increase the amount of stress placed on the placental attachment to the uterine wall. In patients with placenta praevia, these stresses can cause detachment of the placenta from the uterine wall causing haemorrhaging.
Along with placenta previa and uterine rupture it is one of the most common causes of vaginal bleeding in the later part of pregnancy. [6] Placental abruption is the reason for about 15% of infant deaths around the time of birth. [2] The condition was described at least as early as 1664. [7]
Alcohol: Use during pregnancy can cause fetal alcohol syndrome and fetal alcohol spectrum disorder. [67] Tobacco use: During pregnancy, causes twice the risk of premature rupture of membranes, placental abruption and placenta previa. [68] Also, it increases the odds of the baby being born prematurely by 30%. [69]
Obstetric causes of first trimester bleeding include the following: Early pregnancy loss is a term often used interchangeably with spontaneous abortion and miscarriage and refers to pregnancy loss during the first trimester. [7] It is the most common cause of early pregnancy bleeding and is associated only with heavy (versus light) bleeding. [8]
Postpartum bleeding, abdominal pain, mass in the vagina, low blood pressure [1] Types: First, second, third, fourth degree [1] Risk factors: Pulling on the umbilical cord or pushing on the top of the uterus before the placenta has detached, uterine atony, placenta previa, connective tissue disorders [1] Diagnostic method
Other causes of vaginal bleeding in late pregnancy include placental abruption, placenta previa, vasa previa, uterine rupture, and non-obstetric causes. [10] While bloody show is not considered as vaginal bleeding requiring medical intervention, other more serious types of bleeding may visibly present as minor bleeding. [10] As such, if any of ...