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Obstetrical bleeding is bleeding in pregnancy that occurs before, during, or after childbirth. [4] 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.
It is estimated that less than 1ml of fetal blood is lost to the maternal circulation during normal labour in around 96% of normal deliveries. [ 1 ] [ 2 ] The loss of this small amount of blood may however be a sensitising event and stimulate antibody production to the foetal red blood cells, an example of which is Rhesus disease of the newborn.
Uterine atony is the failure of the uterus to contract adequately following delivery. Contraction of the uterine muscles during labor compresses the blood vessels and slows flow, which helps prevent hemorrhage and facilitates coagulation.
[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.
There are several posited ways that have been positioned to cause amniotic fluid embolism. The first of which involves the thought that a combination or one of the following that include a difficult labor, a placenta that is abnormal and trauma to the abdomen through a caesarean section or other surgical tools dissipates the barrier that exists from the maternal fluid to the fetal fluid.
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]
Another prominent sign of labour is the rupture of membranes, commonly known as "water breaking". During pregnancy, a baby is surrounded and cushioned by a fluid-filled sac. Usually the sac ruptures at the beginning of or during labour. It may cause a gush of fluid or leak in an intermittent or constant flow of small amounts from a woman's vagina.
Lochia discharge typically continues for four to eight weeks after childbirth, [2] a time known as the postpartum period or puerperium. A 2016 review ties this "lochial period" to worldwide customs of postpartum confinement , a time for the new mother and baby to bond.