What should be the discharge before childbirth? Bloody discharge before childbirth Why does blood flow during contractions.

It is known that and normal delivery, as well as postpartum period accompanied by bleeding. placenta ( children's place) is attached to the uterus with the help of villi and is connected to the fetus by the umbilical cord. When it is naturally rejected during childbirth, capillaries and blood vessels rupture, which leads to blood loss. If everything is in order, then the volume of lost blood does not exceed 0.5% of body weight, i.e. for example, a woman weighing 60 kg should not have more than 300 ml of blood loss. But with deviations from the normal course of pregnancy and childbirth, bleeding that is dangerous to the health and even the life of a woman can occur, in which the volume of blood loss exceeds allowable norms. Blood loss of 0.5% of body weight or more (more than 300-400 ml on average) is considered pathological, and 1% of body weight or more (1000 ml) is already massive.

All obstetric bleeding can be divided into two groups. The first combines bleeding that occurs in late pregnancy and in the first or second stage of labor. The second group includes those bleeding that develop in the third stage of labor (when the placenta departs) and after the baby is born.

Causes of bleeding in the first and second stages of labor

It should be remembered that the onset of labor can provoke bleeding, which is by no means the norm. The exception is streaks of blood in the mucous plug, which is released from the cervical canal a few days before childbirth or with the onset of labor. The waters that have departed during childbirth should be transparent, have a yellowish tint. If they are stained with blood, an emergency is needed. health care!
Why does bleeding start? The causes of blood loss can be different:

Bleeding in the third stage of labor and after them

Bleeding in the third stage of labor(when the afterbirth is separated) and already after childbirth arise due to anomalies in the attachment and separation of the afterbirth, as well as due to disruptions in the functioning of the uterine muscle and the blood coagulation system.

• Violations of the separation of the placenta. Normally, some time (20-60 minutes) after the birth of the baby, the placenta separates and membranes, constituting a child's place or placenta. In some cases, the process of separation of the placenta is disturbed, and it does not come out on its own. This happens due to the fact that the villi of the placenta penetrate too deeply into the thickness of the uterus. There are two forms of pathological attachment of the placenta: dense attachment and its increment. It is possible to understand the cause of violations only when performing manual separation of the placenta. In this case, the physician general anesthesia inserts a hand into the uterine cavity and tries to manually separate the placenta from the walls. At tight attachment it succeeds. And with an increment, such actions lead to profuse bleeding, the placenta comes off in pieces, without completely separating from the uterine wall. Only an immediate operation will help here. Unfortunately, in such cases it is necessary to remove the uterus.
• Soft tissue tears birth canal . After the placenta has separated, the doctor examines the woman in order to identify ruptures of the cervix, vagina and perineum. Given the abundant blood supply, such tears can also cause heavy bleeding during childbirth. Therefore, all suspicious places are carefully sutured immediately after childbirth under local or general anesthesia.
• Hypotonic bleeding. Bleeding that occurs in the first 2 hours after childbirth is most often due to a violation of the contractility of the uterus, i.e. her hypotonic state. Their frequency is 3-4% of total number childbirth. The cause of uterine hypotension may be various diseases pregnant woman, difficult childbirth, weakness labor activity, disturbances in the separation of the placenta, premature detachment of a normally located placenta, malformations and inflammatory diseases uterus. In this condition, most often the uterus periodically loses its tone, and the bleeding either increases or stops. If medical care is provided on time, then the body compensates for such blood loss. Therefore, in the first two hours after childbirth, the newly-made mother is constantly monitored, because in the event of bleeding, you need to act as quickly as possible. Treatment begins with the introduction of reducing medicines and replenishment of blood volume with solutions and components of donated blood. Released at the same time bladder using a catheter, an ice pack is placed on the lower abdomen, an external and internal massage uterus, etc. These mechanical methods are designed to reflexively “start” uterine contractions. If medicinal and mechanical methods of stopping bleeding are ineffective and blood loss increases, an operation is performed, possibly trying to avoid removal of the uterus.
• Late postpartum hemorrhage. It would seem that when everything is in order with a woman and 2 hours after giving birth she is transferred to the postpartum ward, then all the dangers are already behind and you can relax. However, it also happens that bleeding begins in the first few days or even weeks after the baby is born. It may be due to insufficient contraction of the uterus, inflammation, trauma to the tissues of the birth canal, and blood diseases. But more often this problem occurs due to the remains of parts of the afterbirth in the uterus, which could not be determined during the examination immediately after childbirth. If pathology is detected, curettage of the uterine cavity is carried out and anti-inflammatory drugs are prescribed.

How to avoid bleeding?

Despite the diversity causes of bleeding, it is still possible to reduce the risk of their occurrence. First of all, of course, you need to regularly visit an obstetrician-gynecologist during pregnancy, who closely monitors the course of pregnancy and, in case of problems, will take measures to avoid complications. If something worries you on the part of the “female” organs, be sure to inform your doctor, and if you have been prescribed treatment, be sure to bring it to the end. It is very important to tell your doctor if you have had any injuries, surgeries, abortions, and venereal diseases. Such information cannot be hidden, it is necessary to prevent the development of bleeding. Do not avoid ultrasound: this study will not cause harm, and the data obtained will help prevent many complications, including bleeding.

Follow the recommendations of doctors, especially if prenatal hospitalization is necessary (for example, with placenta previa), do not dare to have a home birth - after all, in the event of bleeding (and many other complications), immediate action is needed, and help may simply not be in time! Whereas in a hospital setting, doctors will do everything possible to cope with the problem that has arisen.

First aid for blood loss

If you notice the appearance of spotting (most often this happens when visiting the toilet) - do not panic. Fear increases uterine contractions, increasing the risk of miscarriage. To assess the amount of discharge, thoroughly blot the perineal area, change a disposable pad, or put a handkerchief in your panties. Lie down with your legs up or sit with your feet up on a chair. Call an ambulance. Try not to move until the paramedics arrive. In the car, it is also better to ride lying down with your legs elevated. With heavy bleeding (when underwear and clothes are completely wet), put something cold on the lower abdomen - for example, a bottle of cold water or something from the freezer (a piece of meat, frozen vegetables, ice cubes wrapped in a plastic bag and a towel).

The discharge that appeared shortly before labor should not frighten a woman, since their presence is a normal physiological process, indicating that the moment of delivery is already quite close.

Most often, abundant discharge before childbirth begins to be observed from 36 weeks, especially in the morning. The main thing is to be able to correctly determine the nature of their occurrence in time, in order to figure out if they are dangerous for the baby.

Brown, pink and bloody shades

The entire period of gestation, the cervix is ​​\u200b\u200bclosed with a mucous plug, which is necessary to protect the fetus from the ingress of harmful microorganisms from external environment. A few days before childbirth, another cycle occurs in the body. hormonal changes, which gradually prepares the neck for opening. It is during this period that the discharge appears.

In order for the baby to pass through the birth canal, the cervix needs to get rid of the plug. As the secretions intensify, the cervical cartilage tissues soften, contractions begin uterine muscles, under the influence of which the cork is pushed out. Its release most often occurs gradually, the process can last from two weeks to several days.

All these days there is an increase in the tone of the uterus, so pregnant women often feel mild pain in the lower abdomen. In addition, some women experience pink discharge before childbirth, and sometimes yellow, during the process of the release of the mucous plug.

Also, a few days before delivery, bleeding may appear. Their presence requires immediate medical attention, as the discharge of fluid with blood before childbirth indicates the occurrence of complications.

In addition, women in labor often experience brown discharge. They can also develop due to the presence of pathology, therefore medical assistance in this case is mandatory, especially if there is an unpleasant smell.

However, this kind of discharge is also capable of appearing for such reasons as:

• conducting a gynecological examination;
• having sex on the days when the cork is rejected;
• expulsion of the mucous plug.

Examination at the gynecologist

Throughout pregnancy, the cervix is ​​elongated, dense and closed. When the body begins to prepare for childbirth, the cervix becomes shorter, softened and begins to open. To determine how the process is going, the obstetrician-gynecologist, at about 38–39 weeks, conducts a mandatory examination of the woman on the chair.

During such an examination, a softened and half-open uterus can easily be injured, as a result of which brown or reddish discharge appears. Unlike a pathological complication, discharges of this kind are characterized by a small amount. They usually appear within 3-4 hours after the examination and do not pose any danger to further gestation.

sexual intercourse

You can have sex in the later stages of gestation. However, it should be borne in mind that an incorrectly chosen position can harm the cervix. Against this background, after 1-2 days, a brown daub may occur.

sexual intercourse on recent weeks before childbirth is not recommended if:

• there is a threat of premature contractions;
• there is placenta previa;
• the pregnancy is multiple;
• there is leakage amniotic fluid;
• bloody issues;
• cervical insufficiency.

Mucus plug

Brown discharge before childbirth often occurs against the background of the discharge of the mucous plug. Its rejection can occur absolutely in different dates, for example, a few weeks before labor or a couple of days. In some cases, there is an instant exit of the cork, after which the first contractions begin immediately (after 2–3 hours).

The discharge during the discharge of the cork can be of different consistency and different colors: mucus streaked with blood, transparent discharge, pinkish, light and brown. The latter indicate that there is little time left before the onset of childbirth.

Profuse white discharge

Throughout pregnancy, the child actively moves, changing position and posture. This happens due to the amniotic fluid in which it floats inside the uterus. In addition to helping the baby to move, they also protect him from various negative external influences such as punching or thrusting in the stomach.

The discharge of amniotic fluid is also natural physiological process indicating that the child is ready to be born. The liquid is poured out after the amniotic sac has ruptured, usually this process occurs instantly, but there are times when, due to incomplete rupture, water begins to leak.

During the normal process, the amniotic fluid has neither color nor odor. It resembles ordinary water. Sometimes there may be a sweetish aroma and an admixture of white flakes, but this is quite normal. There is no need to worry about the presence of mucus, as it appears in the waters after passing them through the vagina.

Abundant white discharge, resembling flakes, may appear due to leaking amniotic fluid. They are necessary to protect the child, so you should not worry. But if this kind of discharge appeared when it was too early before the birth, then you need to consult a doctor to eliminate leakage.

Pathology or mucous plug

In the normal course of pregnancy before childbirth, there should be no discharge other than the discharge of the mucous plug and the outflow of amniotic fluid. Both of these processes are not pathological if the gestation period has come to an end, and they began from the 38th week. Otherwise, we can talk about premature birth.

It is possible to determine that the discharge refers to the rejection of the mucous plug by the following signs:

• absence acute pain lower abdomen;
• no smell;
• slight presence of blood streaks;
• the discharge has a mucus-like consistency.

The outpouring of amniotic fluid cannot be confused with anything. They are watery, flow immediately into in large numbers(from 0.5 to 1.5 ml) and transparent. We can talk about a pathological process if blood is present in the waters, there is a greenish tint and an unpleasant odor. In this case, the woman in labor needs immediate hospitalization.

Also, the presence of pathology is indicated by this kind of discharge:

• Curd. Often in pregnant women, shortly before childbirth, against the background of experiences, thrush appears. The disease intensifies just before delivery and is accompanied by severe itching, burning sensation, especially during urination, curd secretions and sour smell.
• Leakage of amniotic fluid. The process is accompanied by constantly wet underwear. Leakage can be determined by this test: perform hygiene of the genital perineum, wipe yourself dry, lie down on a clean, dry and white sheet. If after 15–20 minutes several wet spots appear, then amniotic fluid is leaking.
• Bloody, greenish and other discharges. Any suspicious color of the discharge may be a sign of the onset of complications, as well as pathological changes in birth canal or mother.

When to See a Doctor

You should visit a doctor immediately after the excretory processes have begun. After all, it is difficult to figure out on your own whether they are normal or pathological, it is better to entrust this matter to a specialist in order to protect yourself from unnecessary worries.

In addition, it is necessary to immediately consult a gynecologist when blood secretions. Especially dangerous blood before childbirth is in large quantities and has a bright red color. If timely action is not taken, it may begin profuse bleeding which is dangerous not only for the life of the baby, but also for the mother.

The reason for visiting the clinic is also the appearance of discharge with bad smell. This may be a sign of an infectious process in genitourinary system, which is very dangerous for the baby, especially at the end of pregnancy, when the cervix began to open and harmful microorganisms can easily enter the uterine cavity.

Also, you should consult a doctor for discharge accompanied by malaise or pain in the lower abdomen, which have a cramping character. First of all, these symptoms may indicate the onset of labor.

Among women reproductive age glands of the cervix and vagina produce a mucous secretion that performs protective functions. At the end of pregnancy, the nature of the discharge changes as the hormonal balance changes: the production of progesterone decreases, and estrogen and oxytocin increase. Mucous discharge may become thicker, lose transparency, acquire a yellowish or milky color, and small fragments of blood may be found in them. Often spotting before childbirth scares expectant mothers: is this phenomenon an indispensable evidence of a serious pathology?

Bleeding as a danger signal

The undoubted danger is the presence of blood in the secretions:

• In the first trimester of pregnancy. At this time, the appearance of discharge, colored brown or red, is a sign of a threatened miscarriage. With timely started adequate treatment, the fetus can be saved.
• In the second and beginning of the third semester of pregnancy. At a period of less than 36 weeks, blood in the discharge may be a symptom of placenta previa (when it is located in the lower part of the uterus, and blocks the birth path of the child). Due to damage to the uteroplacental vessels with an anguish or premature discharge of the placenta, bleeding occurs, sometimes very profuse. This pathology is dangerous for both the mother and the fetus, and requires urgent medical intervention.
• If the discharge before childbirth contains scarlet blood in large numbers or large blood clots. From a medical point of view, this condition is classified as an emergency. In this case, you should immediately call an ambulance and go to the hospital. Before the arrival of a medical carriage, it is advisable for a pregnant woman to move less so as not to provoke increased bleeding.

Physiological causes of bleeding

IN prenatal period the presence of spotting is not considered a pathology, and in most cases it is a sign that childbirth will begin very soon. However, everything is individual here. Women who actively discuss the topic of childbirth on the forums write that after they noticed blood in the secretions, some had contractions after a few hours, while others after a week or two.

Bloody issues often observed after the discharge of the birth plug or at the beginning of the opening of the cervix - due to the inevitable rupture of small capillaries. Obstetricians note a frequent relationship between the color of the discharge and the time remaining before childbirth: the darker the color of the discharge, the sooner the woman will begin to give birth.

Other causes of spotting before childbirth that do not pose a danger to either the mother or the baby can be gynecological examination or careless sexual contact. In both cases, the appearance of traces of blood in the secretions is caused by mechanical irritation the cervix, which in the prenatal period becomes loose, softened, and easily injured. Blood smears in the secretions may not appear immediately, but several hours after visiting the gynecologist or a couple of days after having sex.

Should be remembered

It is considered normal when the amount of blood in prenatal secretions small. These may be scanty, smearing marks or blotches of small brown, brown, pinkish or red clots, or the mucus may have a uniform, faint pale pink or brownish color.

However, if you find even those listed in the safe list of spotting before childbirth, play it safe and contact your doctor. If necessary, he will refer you to an ultrasound or prescribe other unscheduled examinations.

During the period of bearing a child, a woman should especially carefully monitor changes in the body. The greatest concern is the first trimester, when there is a risk of miscarriage, and the last month. Allocations before childbirth - physiological feature, indicating the preparation female body to the arrival of the baby.

But it is important to assess the nature of these secretions, since the color and smell may indicate the presence of complications. It is possible to preserve the health of the baby and avoid problems during childbirth with the help of their timely detection.

woman on last month pregnancy, it is important to know what discharge should be before childbirth. This will help to distinguish the physiologically ongoing process of preparing the body from pathological conditions. Normally, abundant mucus appears first, then a cork comes out and water pours out. The fact that not everything is in order is evidenced by bloody, cheesy white and greenish discharge with an unpleasant odor.

Pink discharge before childbirth appears because the outgoing plug, which previously covers the cervix, may contain a small amount of blood. The mucus is slightly stained with it, but does not contain blood streaks. If the color turns red, this indicates an early detachment of the placenta or its presentation. Both are dangerous for the child, so immediate medical attention is needed.

Brown, pink, brown discharge before childbirth is not bleeding. They are mixed with mucus, insignificant and appear, as a rule, less than a day before the birth of the child. At this time, you can start preparing for departure to the hospital: collect all the necessary things and documents, warn close relatives.

If the discharge before childbirth is white, similar to cottage cheese and has a sour smell, then, most likely, it has spread into the vagina fungal infection- milkmaid. The disease must be treated urgently, since it greatly complicates the process of childbirth for the mother and can harm the health of the child. Candidiasis in a woman in labor reduces the elasticity of the vagina and increases the risk of ruptures.

Greens and yellow discharge before childbirth also indicate infection (about trichomoniasis, gonorrhea, chlamydia) or inflammatory processes in the pelvic organs. In any case, immediate medical attention is required.

Mucus secretions

The mucus released before childbirth is thick, viscous, transparent or white with a slight tint. You can take a small amount of mucus with two fingers, when they are separated, its consistency (ductility, viscosity) will be clearly visible.

Mucous discharge before childbirth indicates the maturation of the cervix. They are most noticeable after waking up, when a woman is moving from horizontal position to vertical. After some time, the discharge begins to darken, become brown - this means that there are several hours left before the birth of the child.

Mucus plug exit

During pregnancy, the cervix is ​​blocked by a mucous plug that protects the fetus from infection. By the end of gestation, the walls become elastic and open. Under the action of hormones, the cork softens and comes out.

It is impossible to predict at what time this will happen: for some women, two weeks before giving birth, for others, a few hours.

If the mucous plug comes off all at once, outwardly it resembles an egg white or a jellyfish. Often this process goes unnoticed because it occurs while going to the toilet or taking a shower.

In addition, the cork can come out gradually, within one or two days, then it looks like the usual transparent or white discharge before childbirth.

After the discharge of the mucous plug, you can not take a bath, you need to refrain from sexual intercourse, be more attentive to intimate hygiene, change your underwear more often. The uterine cavity during this period becomes open to infection.

Outflow of amniotic fluid

Unlike the mucous plug, the discharge of amniotic fluid cannot be overlooked. They are a liquid, the volume of which is from 0.5 to 1.5 liters. Normally, it is transparent, has a slightly sweet smell or doesn't smell. Sometimes, along with the waters, particles of a lubricant come out that protect the integument of the child in the uterine cavity. They look like white small flakes.

The process of discharge of amniotic fluid also occurs in different ways. Sometimes the liquid pours out all at once, this often happens after going to the toilet or with a sharp change in body position. In other cases, it gradually leaks. How exactly this will happen depends on the location of the bladder rupture - near the cervix or above.

If the amniotic fluid is yellowish or greenish color, cloudy, this may indicate that:

• the child experiences oxygen starvation;
• there is a presentation of the fetus;
• placental abruption began.

Blood discharge, discoloration amniotic fluid require an immediate call for an ambulance. Trying to get to the hospital on your own can be harmful and complicate the situation even more.

When should you see a doctor?

You should go to an obstetrician-gynecologist if you have a discharge that differs from the usual daily one. The specialist will be able to accurately determine their nature and say if everything is in order. If the discharge is white, curdled, yellow or green with an unpleasant odor, then a visit to the doctor is a must.

An infectious disease in late pregnancy is dangerous for the health of the child and adversely affects the process of childbirth. After the cork is released, the pathogenic microflora can easily enter the uterine cavity.

An immediate call to the ambulance team is necessary when bleeding develops. Copious excretion bright scarlet blood is dangerous for the life of mother and child.

You should seek the help of doctors if the discharge is accompanied by cramping pain in the lower abdomen. Most likely, this is a sign of the onset of labor. And this can happen even before the discharge of amniotic fluid.

By the end of the term, a pregnant woman should know which discharge before childbirth is the norm. Physiological changes of such a plan by the end of the term consist of three stages: mucus secretion (maturation of the cervix), discharge of the cork and amniotic fluid. In all cases, you need to pay attention to the color, structure and smell of the discharge.

Blood before childbirth is considered the norm in two cases - if the process of childbirth begins with accompanying contractions or if the cork has come off. In these two cases, expectant mothers should not worry. You need to calmly collect things, documents and go to the hospital.

If bleeding begins before childbirth, it manifests itself in large quantities and has a scarlet color, you should immediately call an ambulance, ask relatives to prepare things and, without making sudden movements, wait for an ambulance. And, already being in the hospital, ask for help from a midwife or doctor.

Discharge before childbirth with blood - as a sign of a long-awaited start

Discharge before childbirth with blood can mean the onset of labor. The uterus is ready for childbirth, there is a timely discharge of the mucous plug. lower abdomen future mom will feel a little heaviness and a little pain, and then you can observe translucent mucus or pink. Pink color indicates the presence of blood droplets, sometimes streaks or round spots are visible.

Blood clots before childbirth indicate to women that their baby is preparing to be born. Expectant mothers do not need to worry if this happens on time. For some women, the mucus plug comes off at 38 weeks, and they can expect to give birth for about 2-3 days. And sometimes the cork leaves immediately before childbirth at 40-41 weeks. Women in labor themselves may not see this plug.

And it happens that after an examination by a gynecologist, slight discharge with blood appears. They are normal if the gestation period is closer to childbirth, this also indicates the preparation of the cervix.

What kind of bleeding before childbirth can be dangerous

Dangerous may be heavy bleeding before childbirth, which occurred prematurely due to placental abruption or multiple pregnancy. In these cases, you should C-section. Placental abruption is not normal early term and mostly arises either from the wrong way of life of the mother or pathologies.

Abundant bleeding is dangerously large blood loss in the mother and hypoxia in the fetus. To avoid problems and preserve your health and the health of your unborn child, you need to take care of yourself. News correct image life, nor smoke or drink alcohol, and even more so do not take drugs. Include more in your diet healthy vegetables, fruits and meat, spend more time outdoors and take care of your nerves. Thus, a woman will take care of her unborn baby.

Thus, we can conclude that the appearance of blood before childbirth is not a reason to panic. It is worth paying attention to the period and amount of allocations. On the late term, blood can appear even after examination by a gynecologist. And if the blood went before childbirth, and the woman is at 38-40 weeks of pregnancy, the discharge means the beginning of childbirth and gives a reason to go to the hospital with things.