Whether there may be spotting during contractions. Bleeding during childbirth

Date: 03.11.2019

What most often scares a young woman preparing to become a mother for the first time (or what is most often scaring her)? The answer is obvious - contractions. The anticipation of pain can cause more panic than the pain itself. And the closer the cherished date, the more obsessive this fear haunts. The surest way to get rid of fear is to stop hiding from it and hiding it from yourself, to meet it face to face, to “talk” with it. Are you afraid of contractions? So let's figure out what it is.

WHAT IS A BATTLE?

In medical terms, labor pains are involuntary regular contractions of the uterus, along with attempts related to the birth forces expelling the fetus.

Contractions indicate that childbirth has begun. (In addition to contractions, the onset of labor may be indicated by symptoms such as the outpouring of amniotic fluid and the discharge of a mucous plug that closes the lumen of the cervix; the mucous plug can come off 2-3 days before childbirth, so its discharge does not always mean that it is time to go in the hospital). Many works have been written about what, in fact, provokes the onset of childbirth. Diverging in particulars, all researchers agree on the main thing: the organisms of the mother and the child, being in close interaction, as if "agree", transmit the necessary impulses to each other.

Shortly before the start of labor, the woman's placenta and the baby's pituitary gland begin to produce specific substances (in particular prostaglandins and the hormone oxytocin), which cause contractions of the muscles of the uterus, called contractions. During pregnancy, the cervix is tightly closed. With the onset of labor pains, its opening begins: the pharynx of the uterus gradually expands to 10-12 cm in diameter (full disclosure). The birth canal is preparing to "release" the child from the mother's womb.

Intrauterine pressure increases during labor as the uterus itself contracts in volume. Ultimately, this leads to rupture of the fetal bladder and the outpouring of part of the amniotic fluid. If this coincides in time with the complete opening of the uterine pharynx, they speak of the timely outpouring of water, but if the uterine pharynx did not open enough at the time of rupture of the fetal bladder, such an outpouring is called early.

The first, preparatory period of childbirth takes, on average, 12 hours if a woman gives birth for the first time, and 2-4 hours less for those who have not given birth for the first time. At the beginning of the second stage of labor (the period of expulsion of the fetus), attempts are added to the contractions - contractions of the muscles of the abdominal wall and diaphragm. In addition to the fact that different muscle groups are involved in contractions and attempts, they have another important difference: contractions are an involuntary and uncontrollable phenomenon, neither their strength nor frequency depend on the woman in labor, while attempts to a certain extent obey her will , she can delay or strengthen them.

WHAT TO EXPECT FROM THE BATTLE?

Feelings during contractions are individual. Sometimes the first tremors are felt in the lumbar region, then spread to the abdomen, become encircling. Pulling sensations can occur in the uterus itself, and not in the lumbar region. Pain during labor (if you cannot relax or find a comfortable position) resembles the pain that often accompanies menstrual bleeding.

However, you should not be afraid of contractions in panic. You can often hear from women giving birth that the contractions were either completely painless, or the pain was quite bearable. First, during contractions, the body releases its own pain relievers. In addition, the techniques of relaxation and proper breathing learned during pregnancy help to get rid of painful sensations. And finally, there are medication methods of pain relief, but they are recommended to be used only in extreme cases, since they all, to one degree or another, affect the baby.

Real (and not false - see below) "banishing forces" come at regular intervals. At first, the intervals between contractions are about half an hour, and sometimes more, the contraction of the uterus itself lasts 5-10 seconds. Gradually, the frequency, intensity and duration of contractions increase. The most intense and prolonged (and sometimes - although not always - painful) are the last contractions preceding the attempts. When to go to the hospital? In the case of the first birth (and if it is not far from the hospital), you can wait until the interval between contractions is reduced to 5-7 minutes. If a clear interval between contractions has not yet been established, but the pain intensifies and becomes more and more prolonged, then it's still time to go to the hospital. If childbirth is repeated, then with the onset of regular contractions, it is better to immediately go to the hospital (often repeated childbirth is rapid, so it is better not to hesitate).

With the onset of contractions, mucous discharge with a slight admixture of blood may appear - this is the very mucous plug that "clogged" the entrance to the uterus. Blood (in small amounts) enters the mucus due to the smoothing and dilation of the cervix. This is a natural process that should not be intimidated, but if there is profuse bleeding, immediate examination is necessary.

TRUE OR FALSE?

It should be borne in mind that after 20 weeks of pregnancy, some (not all) women develop so-called false contractions, or Braxton Hicks contractions, and 2-3 weeks before childbirth, women begin to feel the precursor contractions. Neither one nor the other, unlike true contractions, does not lead to the opening of the cervix. There are pulling sensations in the lower abdomen or in the lower back, the uterus, as it were, turns to stone - if you put your hand to the stomach, you can clearly feel it. The same, in fact, happens during labor pains, which is why Braxton Hicks and the harbingers often confuse women giving birth for the first time. How to understand if labor is really starting and it's time to go to the hospital, or is it just false contractions?

Braxton Hicks contractions, as opposed to true labor pains, rare and irregular ... Contractions last up to a minute, can be repeated after 4-5 hours.
False contractions painless ... Walking or taking a warm bath most often helps to completely relieve discomfort.

The role of false contractions has not yet been fully elucidated. Their appearance is associated with an increase in the excitability of the uterus, it is believed that they, shortly before childbirth, precursor contractions contribute to the softening and shortening of its neck.

WHAT TO DO WHEN BREAKING?

It is noticed that the more a pregnant woman is scared, the less she knows about what is happening to her and what she is facing, the more difficult, longer and more painful her childbirth is. Even in the very recent past, the phrase "preparation for childbirth" seemed to be complete nonsense in Russia. Fortunately, over the past decade, there have been qualitative changes in this area - many courses and schools for preparing for childbirth have been opened, where not only future mothers, but also future fathers are preparing for this important event. Enough books have been published. And most importantly, psychology has changed. Now, if not all, then most women understand that they need to prepare for childbirth, as for any difficult and important work. And the main goal of such training is to get rid of fear and pain.

What do experts usually recommend to make contractions as easy and painless as possible? As already mentioned, you will not be able to control the frequency and strength of contractions, it does not depend on you. But you can quite help yourself and your child to survive these contractions.

At first, when the contractions have just begun, it is better not to lie down, but to move: this will speed up the process of opening the uterine pharynx, which means it will shorten the time of labor.
Concentrate calmly and try to find the position of your body in which you are most comfortable. Do not hesitate if you feel like standing on all fours, lying on a large inflatable ball, or even ... dancing. Believe me, no one would ever think of condemning you for being extravagant. Circling and swinging your pelvis can help relieve tension and relieve pain.
If possible, try to sleep between contractions or at least "pretend to be asleep" (this will help to relax the body).
You can lie down for about ten minutes in a bath with warm water - of course, if you are not alone in the apartment and, if necessary, they can help you.
Lightly stroking the skin of the lower abdomen with the pads of the fingers eases the contractions at the beginning of the path. With the beginning of the fight, you need to inhale and direct the movement of the hands from the midline to the sides, while exhaling, the arms move in the opposite direction.
When contractions intensify, strong and frequent pressure with thumbs on points in the area of the anterior-superior spines of the iliac bones (these are the most protruding parts of the pelvis) helps to relieve pain. It is convenient to place your hands with your palms along the hips.
Massage of the sacral area of the spine is very useful. It is effective not only at the beginning of labor, but as long as the expelling forces are at work in your body.

As the contractions intensify, correct breathing becomes more and more important. But the most important thing is to tune in, listen to your own feelings and ... remember the child. You both have a difficult job ahead of you, but the result will be a meeting!

Tatiana Kipriyanova

I hardly recognized the first contractions. The fact is that they were very similar to "training" contractions - the so-called "Braxton-Hicks contractions", which followed me from the 7th month almost every evening. And at first I could not understand - is it still they or already the beginning of labor. Feels like - as if the belly freezes below, then "lets go". The intervals between contractions were uneven: now after 20 minutes, then after 5; but still they walked regularly (longer than two hours) - this influenced the decision to go to the hospital.

The first contractions were quite bearable - just a little bit of discomfort. There were significant gaps between them, which made it possible to relax, and I even began to doubt that I was really giving birth. Upon arrival at the maternity hospital, the examination showed an opening of the cervix of 1 cm.When the bladder was pierced (by the way, it did not hurt at all), the contractions were already more effective, the pain became quite noticeable, the intervals were about 5-10 minutes (opening 4 cm). I used to have quite painful periods, and this pain seemed to me similar to menstrual pain. Over the next hours (the child moved towards the exit), the pain became more and more intense. It was hard. I was helped a little by the massage of the lower back, which my husband did, and breathing, which I read about in the books (the medical staff also suggested how to breathe better). When the pain became simply unbearable, attempts began (by the way, I have heard more than once from others that when you feel that the limit has come and there is no more urine to endure the pain, it means that everything will be over soon). Attempts are easy to recognize - you involuntarily begin to push (I could compare this process to the urge to go to the toilet). Attempts are also painful, but the cardiography machine began to listen poorly to the baby's heart, and I had to give birth as quickly as possible. Therefore, from about the fifth attempt, I already gave birth to my boy (not without an episitomy). The whole process took us 12 hours (this was my first birth).

Anna Goncharova

The contractions were like a very violent and painful period. At first they were very weak and I didn't even feel discomfort. It looked like a very mild (not painful) spasm inside the abdomen. Painful contractions became only four hours later. And it most resembled painful menstruation. But it only hurt for about an hour. It was possible to endure, but with difficulty. My husband helped a lot. Even in the most intense moment, the pain was not constant. Everything went on with a frequency of 5 minutes. At first, the pain grew rapidly, reached its maximum, and then disappeared just as quickly. Each fight took about two minutes. For about three minutes there was no pain at all! The worst thing for me was at the moment of the beginning of a new fight - when it didn't hurt yet, but you understand that everything started from the beginning. Unpleasant, but bearable. And only one hour. As soon as I was allowed to push, the pain stopped. I didn't have any more pains, which are sometimes written about (in the lower back, or somewhere else).

By the time the contractions began, I was already in the hospital, so I immediately went to the doctor, and the doctor confirmed that labor had begun. The doctor and midwife said when to start pushing. It didn't hurt at all, and it didn't hurt at all to give birth. Although they made an incision, I did not notice it at all.

In general, I remember childbirth very well, but the pain is forgotten very quickly. I remember more with pleasure - and, first of all, all sorts of funny moments. The feeling of horror and "never again" was not there at all. Maybe because there was a good maternity hospital and I gave birth with my husband!

Elizaveta Samoletova

Unfortunately, I was psychologically completely unprepared for childbirth. Therefore, already being in the delivery room (I was in the maternity hospital on preservation), I felt that my stomach ached very badly, and was frightened. Of course, "theoretically" I knew that I was going to have contractions, but I had little idea of what it was. Of course, there was no question of counting the intervals between contractions (this was suggested by the midwife, who was sitting next to the table and writing something). It seemed to me that I was dying, and in a weakening voice I asked for a cesarean section. The midwife laughed cheerfully for some reason. I ask: "What are you laughing at?" And she told me: "According to my calculations, every second woman in childbirth asks to do her caesarean."

I suffered for about an hour. I was very offended that the people who were around (nurses, midwives, department heads and even some trainees who showed me as an example of an "old primiparous woman with a slightly narrowed pelvis") took my suffering for granted and like nothing sometimes they tried to talk to me about some boring everyday topics (they asked where I work, where did I get such a strange surname and how I would call my unborn child). And when my stomach started to hurt especially badly, the midwife came up and mockingly (as it seemed to me then) told me how I should breathe.

When the attempts began, it became easier and even, I would say, more interesting, because the "result of labor" was about to appear. He appeared. It contained 3 kg 600 g.

Then I apologized to the doctors, but they laughed again and said that almost everyone behaves like me. And I decided that I would prepare for the next birth for a long time and seriously.

PREGNANCY IS THE BEST GIFT OF NATURE.

Pregnancy, childbirth, motherhood - this is the greatest happiness that happens to a woman! There is nothing to be afraid of! Everything goes the way you set yourself up, with what thoughts you approach everything. Pregnancy will be easy even with severe toxicosis, edema and a huge stomach, if you take it all as natural. In no case should you feel sorry for yourself. One must love, pamper, protect oneself. In no case should you complain about the tummy, that it interferes, it's hard with it. One should praise him, rejoice at him, look at him with affection in the mirror. During pregnancy, diseases that did not bother them before can make themselves felt: diseases of the cardiovascular system, respiratory and excretory. Observations show that the most severe complications occur in the second half of pregnancy. This makes it necessary to establish a special regime for women from the very beginning of pregnancy. Any strong mental excitement or physical stress can adversely affect a woman's health. This should be taken into account by her husband, all her relatives and colleagues. Normally, pregnancy proceeds without bleeding from the genital tract. Any bleeding during pregnancy and childbirth is a complication and poses a threat to the fetus and the mother. Every woman who is admitted to the clinic with complaints of spotting should be carefully examined. The main task for the doctor is to determine the source of bleeding (pathology of the placenta or local changes).

REASONS OF BLEEDING DURING LABOR.

LOCAL: cervicitis, ectopia of the mucous membrane of the cervix, cervical cancer, trauma and infections of the genital tract;

PLACENTA PATHOLOGY: premature detachment of a normally located placenta (this is a detachment of a normally located placenta before the birth of the fetus), placenta previa and vascular presentation, pathological attachment of the placenta.

PREMATURE PLACENTAL REMOVAL(30%) is usually diagnosed on the basis of the clinical presentation, which includes: bleeding from the genital tract, abdominal pain, tension and soreness of the uterus. A mild form of pathology can be diagnosed only by examining the placenta after its birth or by ultrasound, which reveals the normal location of the placenta and retroplacental hematoma. Ultrasound is of particular importance in the conservative treatment of premature placental abruption. The prognosis largely depends on the timely diagnosis of these complications.

Etiology and risk factors for premature placental abruption.

1. A large number of births in the anamnesis; 2. Overstretching of the wall of the uterus (polyhydramnios, multiple pregnancies); 3. Preeclampsia and arterial hypertension; 4. Age (the risk increases with age); 5. Direct trauma to the abdomen (road accident, physical violence); 6. Smoking; 7. Drug addiction, especially cocaine; 8. Drinking alcohol; 9. Myoma of the uterus, especially the location of the node in the area of the placental site; 10. Rapid discharge of amniotic fluid with polyhydramnios; 11. Nervous - mental factors (fear, stress).

a. Bleeding from the genital tract is observed in 80% of cases; b. Pain is a common symptom that occurs due to stretching of the serous membrane of the uterus. Appears suddenly, localized in the lower abdomen and in the lower back, constant; v. Soreness and tension of the uterus is more common in more severe cases; d. With the formation of a retroplacental hematoma, the uterus increases. This can be detected by re-measuring the circumference of the abdomen and the height of the fundus of the uterus; e. Signs of intrauterine fetal hypoxia are often observed; e. Premature placental abruption can cause premature birth.

Terms and methods of delivery with premature placental abruption.

1. With mild premature placental abruption, if the condition of the pregnant woman is stable, spontaneous childbirth is allowed. In other cases, emergency delivery is required. 2. If premature placental abruption occurred during childbirth, the condition of the woman in labor and the fetus is satisfactory, the BCC is replenished and childbirth is proceeding normally, there is no need to accelerate their course. 3. For rhodostimulation and decrease in the flow of thromboplastin into the blood, an amniotomy is performed. 4. Vaginal delivery is preferred. 5. Caesarean section is performed with intrauterine fetal hypoxia and the absence of conditions for rapid delivery through the vaginal birth canal, with severe detachment with a threat to the life of the mother, with immaturity of the cervix.

Complications of premature placental abruption.

1. Hemorrhagic shock. 2. DIC - syndrome. 3. Kuveler's uterus with extensive hemorrhage in the uterine wall. 4. Ischemic necrosis of internal organs, acute renal failure. 5. Due to hypoxia - congenital anomalies in the fetus. Prognosis: Premature detachment is referred to as severe obstetric complications. Perinatal mortality reaches 30%.

PLACENTA OFFER(20%) - a pathology in which the placenta is partially or completely located in the lower segment of the uterus (in the area of the internal uterine pharynx, i.e. on the way of the born fetus) Distinguish: complete placenta previa, partial placenta previa, marginal and low-lying (i.e. 2cm above the internal pharynx).

Etiology and risk factors for placenta previa.

The etiology of placenta previa is unknown. Risk factors are divided into uterine and fruit. Uterine factors include atrophic and dystrophic processes in the endometrium, accompanied by a violation of the conditions of implantation. Sometimes the occurrence of placenta previa is due to the characteristics of the ovum itself. Due to the later appearance of the proteolytic activity of the trophoblast, the ovum descends into the lower parts of the uterus, where nidation occurs. Thus, the chorionic villus grows in the area of the internal pharynx. Reasons: 1. Chronic endometritis; 2. Pathological changes in the endometrium after surgery (abortion, diagnostic curettage of the uterus, cesarean section, conservative myomectomy, uterine perforation); 3. Myoma of the uterus; 4. Abnormalities in the development of the uterus; 5. Infantilism; 6. A large number of births in the anamnesis; 7. Smoking; 8. Purulent - septic complications in the postpartum period; 9. Diseases of the cardiovascular system, kidneys, diabetes mellitus.

Diagnosis of placenta previa is based on clinical findings. Complaints about the appearance of scarlet bloody discharge from the genital tract, weakness, dizziness are characteristic. They note the high standing of the presenting part of the fetus, its unstable position, often oblique or transverse position. Breech presentation is often accompanied by a clinical threat of termination of pregnancy, fetal malnutrition. In 95% of cases, placenta previa can be diagnosed using ultrasound. Vaginal examination is carried out only with a prepared operating room.

Terms and methods of delivery with placenta previa.

With severe bleeding that threatens the life of the mother, regardless of the gestational age, an emergency delivery by cesarean section is performed. In the absence of severe bleeding and at a gestational age of 36 weeks or more, after confirmation of the maturity of the fetal lungs, delivery is carried out in a planned manner. With a partial placenta previa and a mature cervix, birth through the vaginal birth canal is possible. If the lungs of the fetus are immature or the gestational age is less than 36 weeks and there is no bleeding, conservative treatment is carried out. Restriction of physical activity, abstinence from sexual activity and douching, maintenance of hemoglobin is necessary.

Complications of placenta previa. 1. Hemorrhagic shock; 2. Massive bleeding during pregnancy, during delivery and in the postpartum period; 3. Placental insufficiency; 4. Accretion of the placenta, especially in the area of the scar on the uterus, which can lead to blood loss and extirpation of the uterus.

Forecast: maternal mortality with placenta previa is close to zero. Perinatal mortality does not exceed 10%. The main reason for the death of children is prematurity. With placenta previa, there is a high risk of birth defects.

OFFER OF VESSELS- This is a condition when a segment of umbilical cord vessels running inside the embryonic membranes is located above the internal pharynx. Vascular rupture causes bleeding from the genital tract and intrauterine hypoxia. A test is made for denaturation with alkalis - 2-3 drops of an alkali solution are added to 1 ml of blood. Fetal erythrocytes are more resistant to hemolysis, so the mixture retains its red color. The erythrocytes of the pregnant woman are hemolyzed, and the mixture turns brown.

Complications with vascular presentation.

Bleeding occurs from the vessels of the fetus, therefore, fetal mortality exceeds 75%, mainly due to blood loss. Treatment: emergency caesarean section if the fetus is viable.

Pathological attachment of the placenta or accretion of the placenta- This is a pathological attachment of chorionic villi to the wall of the uterus, their ingrowth into the myometrium or penetration through the thickness of the myometrium. Risk factors for pathological attachment of the placenta in placenta accreta.

1. Surgery on the uterus in history; 2. Placenta previa; 3. Smoking; 4. A large number of births in the anamnesis; 5. Inflammatory processes in the uterus; 6. Pathology of the endocrine glands Treatment: curettage of the uterine cavity or hysterectomy.

Bleeding from the cervix. 1. Conduct a cytological examination of a smear from the cervix; 2. To stop bleeding, electrocautery or tamponade is used; 3. The discharge from the cervical canal is examined for bacteria and viruses.

POLYPS OF THE UTERINE NECK. 1. Bleeding usually stops on its own; 2. The cause of bleeding is the injury of the polyp; 3. If the bleeding does not stop, the polyp is removed and sent for histology.

BLOODY DISCHARGE FROM THE GENITAL TRACT IN THE FIRST PERIOD OF LABOR usually caused by cervical dilatation and are blood-stained mucus.

INJURY OF THE EXTERNAL GENITAL ORGANS OR VAGINA- the history usually has an indication of injury.

PREVENTION AND INFORMATION FOR PATIENTS.

Primary prevention begins in the antenatal clinic with the identification and treatment of extragenital diseases, menstrual irregularities, inflammation of the reproductive system, prevention of unplanned pregnancy and identification of risk groups for bleeding. Mandatory ultrasound examination at 9, 16-24, 32-36 weeks of pregnancy. The localization of the placenta is determined during each study, starting from the 9th week of pregnancy. The diagnosis of previa is established after the end of the placentation process at the time of 14 weeks of gestation. It is necessary to warn the pregnant woman and her relatives about the danger of bleeding. It is necessary to constantly monitor blood pressure, treat preeclampsia, relieve uterine tone, correct hemostasis, exclude physical activity, sex life, ultrasound control every month to trace the migration of the placenta. When bloody discharge appears, hospitalization is recommended.

Prenatal discharge is not always a bad sign. Most often, this is a natural and explainable phenomenon, so you shouldn't rush to the hospital right away and worry. Each stage of pregnancy has its own type: from mucous membranes to amniotic fluid. Most often, normal discharge prompts the expectant mother that very soon the long-awaited baby will be born. But few people know which ones are normal and which ones signal health problems.

According to statistics, such discharge appears before childbirth:

familiar mucous membranes;
amniotic fluid;
discharge after passing the cork;
cheesy white discharge before childbirth;
yellow, purulent with an unpleasant odor;
bloody (eg, pinkish or brown discharge before childbirth).

During pregnancy, discharge of various colors and nature may appear.

Some of them are signs of pathological processes in the body, others are a completely natural phenomenon, which indicates the preparation of a woman for the birth process.

Normal discharge

All normal discharge from women in labor should be clear or white, but odorless, in a small amount, with a thick texture. In medicine, they are called mucus.

The mucous plug accompanies pregnancy until the beginning of delivery, since its function is to protect the fetus from infections from the outside. Gradually, it becomes unnecessary and unnecessary, so it comes out. We can say with full confidence that abundant mucous discharge before childbirth indicates that no more than a week is left before the baby is born.

Important! After the mucus has gone, the expectant mother needs to be very careful: do not take a bath, do not lead an intimate life, carefully monitor hygiene so as not to introduce harmful microbes into the uterus.

Water is poured out during contractions or immediately in front of them. It is also a normal physiological process that directly signals the onset of labor. Water can drain like this:

all at once, that is, the woman acutely feels how a transparent stream has flowed out of her;
gradual "smudges" during the day.

Mucous plug

The liquid should be odorless, colorless, but may contain some white mucus. If the waters are green - this is a bad sign, an immediate appeal to a specialist is required.

Pathological discharge

Other secretions, which are not mentioned above, are considered pathological in medicine, that is, they indicate abnormal physiological processes in the body that can threaten the health of a pregnant woman or her child.

What should you pay special attention to?

spotting, including brown discharge before childbirth;
watery brown with an unpleasant odor;
gray with the smell of rotten fish;
watery green;
light curdled consistency (while the pregnant woman experiences constant itching in the perineum);
yellow mucus;
green slime.

Important! Pink discharge before childbirth does not always refer to bloody, if there are several drops of blood in the discharge, this is a variant of the norm, when capillaries burst in the reproductive organ when the mucous plug leaves. If there is a lot of blood in the discharge, this is a very bad sign that requires hospitalization. But first things first.

Brown discharge appears in two cases:

microtrauma of the uterus;
placental abruption.

The most dangerous are spotting or having an unpleasant odor.

The first option is practically not dangerous, it may be associated with a trip to a gynecologist, where a woman was examined on a gynecological chair. In addition, mucus becomes brown if a woman is sexually active in the last months of pregnancy.

Bleeding occurs for one reason - placental abruption. This case threatens the life of both the woman in labor and her unborn child. If a woman noticed blood from the vagina, she should immediately call an ambulance or get to the hospital on her own as soon as possible.

The opaque color of the leaking waters, as well as their unpleasant odor, signals that the fetus begins hypoxia, that is, a lack of oxygen. If there is no smell, then there is a possibility that the baby in the womb has emptied.

The main symptom of thrush is itching and light discharge, similar to curd. This disease needs to be treated urgently so that there is no risk of infection of the fetus, because candidiasis passes through the birth canal.

Another infectious disease is bacterial vaginosis, the color of the mucus is gray, and the smell is very unpleasant.

All yellow discharge is a symptom of sexually transmitted infections. A woman should urgently consult a doctor so that he can schedule an examination, diagnose and begin timely treatment. Otherwise, it is also possible to infect the baby through the birth canal.

Discharge with thrush is similar to cottage cheese.

Reasons for the appearance

Brown discharge before childbirth at 38 weeks of gestation after a full examination by a gynecologist of a woman in labor is not dangerous and is associated with the fact that the cervix is already fully ripe, softened and ready for delivery. Droplets of blood appear in the discharge a couple of hours after ingestion.

The discharge of the mucous plug, which was already mentioned above, a woman may feel, or may not even notice. The mucus may also be a little pink, this has nothing to do with the threat of termination of pregnancy.

If the color of the discharge is orange, this is a signal from the body that the expectant mother is abusing vitamin-mineral complexes and there are an abundance of such things in the body. Vitamin intake should be reduced or eliminated altogether.

By the color of the discharge, one can judge the health of a woman.

Any normal physiological discharge has practically no color (transparent or light - cream, white), odor. In all other cases, an infection is possible, which is easily transmitted to the child during childbirth from the mother. Therefore, it is so important to visit a doctor on time and cure the ailment before childbirth.

What discharge indicate the onset of labor?

It is the discharge that is the first harbingers of childbirth, which appear even before the contractions. What secretions before childbirth signal the onset of labor activity?

A clot of mucus or a partial, profuse discharge of a mucous plug. In this case, childbirth can begin in a couple of hours, and in a few days, but no later than a week later. The cork comes off when the cervix is completely ready for the baby's birth.
Watery discharge, transparent and odorless, slightly mixed with non-colored mucus. This happens just before or even during contractions. Sometimes the bladder does not burst on its own, then the doctor in the maternity ward pierces it, when it becomes clear that the contractions are regular and non-training. If the water is leaking, and there have been no contractions for a long time, it is still necessary to go to the hospital urgently, otherwise the baby will begin to lack oxygen. If this happens, then the liquid is released in a green or yellow tint.

A drooping belly is a sign of imminent labor.

We can say with confidence that labor begins:

drooping of the tummy;
feeling like pressure builds up in the lower abdomen, as if something presses on the intestines with great force;
stopping weight gain;
changes in mood;
the appearance of frequent and painful cramps;
bowel movement.

Does not indicate the onset of labor:

irregular spasms;
if you change your posture or start walking, the spasms stop;
movement of the fetus during spasm (this is reported to the doctor).

Important! By the 38th week, the woman should have bags for the maternity hospital ready. If a woman doubts whether labor has begun or not, it’s better to get to the hospital, it’s better than giving birth later at home or on the way to the hospital.

When is hospitalization required?

If a woman has a pathological case, then the ambulance team should be called without delay. Critical situations include:

If you have severe back and lower back pain, you should immediately consult a doctor

If a woman in labor notices at 8-9 months yellow or cheesy discharge on her panties before childbirth, you should not call an ambulance, as well as treat yourself (especially with traditional medicine that cause an allergic reaction in the fetus), it is enough to visit a doctor in the near future ... If this is not done, a possible infection will complicate childbirth and will be transmitted to the child either after the mucous plug has passed, or during delivery.

Discharge before childbirth always prompts a woman what processes are taking place in the body at a particular time. Is the pathology developing or do you need to collect bags in the hospital? Do you need to call an ambulance to save the life of yourself and the child, or you can just make an appointment with a doctor in the near future, who will prescribe treatment if necessary, tell in more detail what is happening in the body.

The most dangerous are precisely the bloody and green watery ones, as they directly indicate the problem that occurs at this moment. Only transparent or light odorless are considered normal, they are harbingers of childbirth.

Having a baby is a natural phenomenon, but during childbirth, complications are possible, including sudden bleeding. This condition always threatens the life of the mother and child, and therefore requires compulsory emergency medical care.

The main task of the doctor at the first stage is to determine the source of bleeding. Surgery is often the only way to stop blood loss.

Causes of bleeding during childbirth

The main cause of bleeding during childbirth is pathology of the placenta and predisposing diseases.

Disturbances in the work of the placenta can be different. Most often, its premature detachment occurs in a normal location. The placenta can exfoliate in different places, but if this process began from the edge, then external bleeding is inevitable. In this case, the pain is practically not felt. With a detachment of the middle part, a hematoma forms and severe pain occurs.

With blood loss, a woman and a child have a rapid heartbeat, chills and a decrease in blood pressure. This phenomenon is typical for any heavy bleeding. Against this background, the blood supply to the fetus significantly decreases, which is fraught with its death. With this development of events, a decision can be made about a caesarean section.

Sometimes the cause of uterine bleeding is the pathological accretion of the placenta to the walls of the uterus. The chorionic villi penetrate into the myometrium so deeply that at the last stage of labor, the placenta is not able to independently separate from the walls of the uterus, which cannot contract. In this case, a medical intervention is performed under general anesthesia. If the bleeding cannot be stopped, then the woman's life is in serious danger. For doctors, this condition is a direct indication for the removal of the uterus.

Sometimes bleeding occurs due to abnormal placement of the placenta:

cervical presentation, in which the placenta grows to the cervix;
, which partially or completely blocks the entrance to the pharynx of the uterus;
too close placement of the placenta to the cervical pharynx.

Cases of cervical presentation are especially complex, but also quite rare. Moreover, all of the above pathologies lead to premature exfoliation of the placenta, therefore, already at the 38th week, a cesarean section is recommended for such women.

A serious consequence of childbirth is considered to be a rupture of the uterine wall. It can occur both during childbirth and during the period of gestation and is accompanied by severe pain. If the caesarean section is not carried out in time, then the life of the mother and child cannot be saved. With timely medical care, such a uterus is most likely removed due to the impossibility of fusion of the rupture.

Risk factors for the occurrence of uterine bleeding are the following:

a history of surgical interventions on the uterus;
a large number of births, abortions or miscarriages;
inflammation of the genitals;
, multiple pregnancy;
improper placement of the fetus in the uterus;
pathology of the endocrine glands;
, preeclampsia;
, alcohol intake, drug addiction (especially cocaine use).

In addition to these factors, direct trauma to the abdomen, due to violence or road traffic accidents, fear, stress, and rapid rupture of amniotic fluid during polyhydramnios can provoke the development of bleeding. A woman's age also plays an important role. In women over 35, bleeding during childbirth occurs more often than in younger women.

Why is bleeding during childbirth dangerous?

Despite the progress in the field of modern medicine, as in ancient times, obstetric bleeding during childbirth is considered the same dangerous phenomenon.

Bleeding itself is a secondary sign of a complication that has arisen. Blood loss in a short time can turn into massive bleeding, in which a woman loses significant volumes of blood. This condition threatens the life of the woman in labor. A child with a similar course of childbirth does not receive the required amount of oxygen and important elements. Subsequently, these children may develop certain health problems.

They are characterized by an extensive bleeding surface, while blood comes out of many small and large damaged vessels of the uterus. It can be very difficult for doctors to cope with such a problem.

Physiologically, the body of the expectant mother is prepared for the upcoming birth, which involves a certain amount of blood loss. The blood volume of a pregnant woman increases every month, which is primarily necessary to meet the needs of the growing fetus, and then compensates for the loss during childbirth.

Also, during the gestation period, the blood coagulation system is on alert, and then its activity can turn into complete exhaustion, or coagulopathy. This phenomenon is observed in women who have undergone extragenital diseases, while proteins that form a blood clot in the vessels during bleeding are not found in their blood, and subsequently, disseminated intravascular coagulation syndrome develops. The situation is aggravated by changes in metabolism, which are associated with the main complication: rupture of the uterine wall, premature detachment of the placenta or its incorrect accretion. Bleeding can be stopped only when the primary complication is detected and corrected.

Obstetric bleeding can begin not only in the hospital, but also at home. The decisive moment for saving a woman's life with heavy bleeding is the time for hospitalization. The main treatment for such conditions is intensive care and surgery.

How to avoid bleeding during childbirth?

It is impossible to fully predict how the birth will go, but you can reduce the likelihood of blood loss by regularly visiting an antenatal clinic. The local gynecologist should be aware of a history of pelvic injuries.

Even at the stage, it is necessary to cure extragenital diseases, inflammatory processes of the genital organs and menstrual irregularities. When interviewing and registering, as well as during pregnancy, the doctor determines the risk group for uterine bleeding.

All signs of concern should also be reported promptly. Prescribed tests and ultrasound examinations should not be avoided, they are safe and will help to recognize the problem in time, as well as predict the course of events. For example, placenta previa is determined before the 14th week of pregnancy using ultrasound diagnostics.

The doctor informs the pregnant woman and her relatives about the danger of possible bleeding. To prevent significant blood loss during childbirth, at the stage of pregnancy, blood pressure is constantly monitored, gestosis is treated, the tone of the uterus is removed, physical activity and sex life are excluded. To track the change in the position of the placenta, an ultrasound scan is performed monthly.

All pregnant women should be aware of the dangers of “home birth”. Even the most successful pregnancy can end in bleeding. In this case, the time for salvation is calculated in minutes.

The discharge that appears shortly before labor should not scare 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 week 36, 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 pose a danger to the baby.

Brown, pink and bloody shades

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

In order for the child to pass through the birth canal, the cervix needs to get rid of the plug. As the secretions increase, the cervical cartilage tissue softens, contractions of the uterine muscles begin, 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, in some women, when the mucous plug comes out, pink discharge is observed before childbirth, and sometimes yellow.

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

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

However, this kind of discharge can appear for such reasons as:

carrying out a gynecological examination;
having sex on days when the plug is rejected;
discharge of the mucous plug.

Examination by a gynecologist

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

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

Intercourse

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

Sexual intercourse in the last weeks before childbirth is not recommended if:

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

Mucous plug

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

Discharge when the cork comes off 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 labor.

Profuse white discharge

Throughout pregnancy, the child actively moves, changing position and posture. This is 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 punches or pushes in the stomach.

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

In a normal process, the amniotic fluid is colorless and odorless. It resembles ordinary water. Sometimes there may be a sweetish aroma and an admixture of white flakes, but this is quite normal. Do not worry about the presence of mucus, as it appears in the waters after they pass through the vagina.

A profuse, white, flake-like discharge may appear from leaking amniotic fluid. They are necessary to protect the child, so there is no need to worry. But if this kind of discharge appears when it is too early to give birth, then you need to consult a doctor to eliminate leakage.

Pathology or mucous plug

In the normal course of pregnancy, there should be no discharge before childbirth, except for the discharge of the mucous plug and the outpouring of amniotic fluid. Both of these processes are not pathological, if the gestation period has come to an end, and they began at 38 weeks. 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:

lack of acute pain in the lower abdomen;
no smell;
slight presence of blood streaks;
discharge has a slimy consistency.

The outpouring of amniotic fluid cannot be confused with anything. They are watery, immediately flow out in large quantities (from 0.5 to 1.5 ml) and transparent. We can talk about a pathological process if there is blood 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 ailment intensifies just before delivery and is accompanied by severe itching, burning, especially during urination, curd discharge and a sour smell.
Leakage of amniotic fluid. The process is accompanied by constantly wet underwear. You can determine the leakage by this test: hygiene of the genital perineum, wipe 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 discharge. Any suspicious color discharge can be a sign of the onset of complications, as well as pathological changes in the birth canal or uterus.

When to see a doctor

You should visit a doctor immediately after the excretory processes have begun. After all, it is difficult to independently figure out 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 in case of bleeding. Blood is especially dangerous before childbirth in large quantities and has a bright red color. If measures are not taken in a timely manner, then profuse bleeding may begin, 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 an unpleasant odor. This can be a sign of an infectious process in the 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 need to consult a doctor with discharge, accompanied by malaise or pain in the lower abdomen, having a cramping character. First of all, this symptomatology may indicate the onset of labor.