In this article we will tell you about a very important topic - hematomas in early pregnancy. They appear, as you know, quite often and bring a lot of anxiety. We will talk with an obstetrician-gynecologist, a reproductive specialist at GMS IVF.
After the long-awaited pregnancy, we want to believe that now all the problems are behind us, and our baby is already with us! But a very difficult period of pregnancy begins, which is also full of pitfalls and stress that a woman has to face. One of the worst situations for a pregnant woman is the appearance of bloody discharge from the genital tract. In this case, abandoning all her affairs, the woman rushes to the doctor in horror to make sure that the baby is alive and in the uterine cavity. And after an ultrasound examination he often hears the verdict “Retrochorial hematoma.” What kind of pathology is this, why does it appear, how dangerous is it - this is what my story is about today.
A retrochorial hematoma is a collection of blood in the space between the wall of the uterus and the membrane of the fertilized egg (the chorion, which becomes the placenta after 16 weeks of pregnancy).
Most often this occurs due to the threat of termination of pregnancy, when, for example, in response to an increase in the tone of the uterus, the fertilized egg partially exfoliates from its wall, slight bleeding begins, but the blood stops and remains in the cavity of the exfoliated area. Also, a hematoma can occur due to the germination of the walls of the uterine vessels by the villi of chorionic tissue.
Is this normal?
Dark brown discharge is mainly caused by normal processes in the female body and means that the fetal egg has been attached. This phenomenon is called implantation bleeding. But if conception has occurred, then the daub may well indicate that violations have occurred. If you know for sure that you are pregnant and encounter spotting during the period when you usually had your period, this may mean:
- risk of miscarriage;
- ectopic pregnancy;
- fetal freezing;
- hormone failure;
- infections and inflammations;
- diseases of the cervix.
As a conclusion, if you have brown discharge, you need to consult a doctor in a timely manner and, of course, do a test. If the result is positive, you will know that conception has taken place, then you will need to do an ultrasound.
Examinations in the second trimester of pregnancy
In the second trimester of pregnancy, you should also undergo some tests to exclude fetal pathology and start treatment in time if necessary. Features of the second trimester of pregnancy determine the list of necessary studies and consultations.
At 14–20 weeks, a screening test for chromosomal pathologies is required. Based on their results, the risk of having a child with the following diseases is assessed:
- Down syndrome;
- Edwards syndrome;
- trisomy, etc.
An ultrasound examination is also mandatory. It allows you to assess the harmonious development of the fetus. Additionally, the doctor evaluates the heart rate of the unborn baby, its position, and the length of the umbilical cord.
General and biochemical blood tests are also performed. The first allows you to assess the mother's hemoglobin level, since anemia during pregnancy is not uncommon. When conducting biochemistry, the following indicators are especially important:
- alpha fetoprotein (AFP);
- hCG;
- free estriol.
An obstetrician-gynecologist will definitely tell you what to do in the second trimester of pregnancy if there are abnormalities in the tests.
Why does spotting appear?
During pregnancy, brown discharge occurs due to a lack of progesterone coupled with muscle hypertonicity. It is important to take action in time, then the daub will stop. If we talk about implantation bleeding as a phenomenon, then it is often one of the early symptoms of pregnancy. Even in the absence of a delay, such discharge will indicate a likely past conception. First, the egg unites with the sperm and a fetal egg is formed, then it penetrates the uterine mucosa and, finally, during this, small vessels are damaged, which causes the coagulation of drops of blood and the appearance of brown discharge. Therefore, if the daub meant pregnancy, then it will go away on its own in a few days. In other cases, as mentioned above, you should definitely visit a gynecologist.
Vitamins and minerals in the second trimester of pregnancy
What you need to know about the second trimester of pregnancy? During this period, the fetus actively grows and develops, its body begins to function independently. Micronutrients in food are no longer enough for two organisms. Therefore, women during this period are strongly recommended to take vitamin and mineral complexes. They help provide the child with the substances necessary for growth and development, and the mother to maintain her health. After all, if there is a shortage of any useful substances, they will be “extracted” from the pregnant woman’s body and given to the baby.
A good choice would be the Pregnon Mama complex, which takes into account the needs for vitamins and minerals during pregnancy. In addition, it contains 200 mg of omega-3. The peculiarity of the complex is easily digestible forms of nutrients. For example, iron is contained in liposomal form, which is absorbed several times better than other types of iron and is therefore more effective in preventing anemia. Folic acid is found in the form of methylfolate.
Spotting for threatened miscarriage
With an incomplete miscarriage, brown discharge also occurs, but in this case it becomes bloody and includes clots. You will also feel cramps in the lower abdomen and pain.
In the case of a frozen pregnancy, menstruation is delayed and bleeding occurs, accompanied by abdominal pain. It is enough to donate blood for hCG and do an ultrasound to confirm or refute the death of the fetus in the womb. Here are the reasons why threats of miscarriage may arise:
- there is not enough progesterone in the body;
- there are diseases of the endocrine system;
- there are problems with the pituitary gland;
- the body is exposed to stress;
- excess physical activity;
- bad habits (smoking, alcohol and drugs).
If you do not consult a doctor in time if there is a threat of miscarriage, you will lose your baby and also risk having to have a curettage.
What should you avoid in mid-pregnancy?
In the second trimester of pregnancy, the characteristics of a woman’s condition suggest some restrictions and more careful behavior in everyday matters.
- Do not take medications without a doctor's prescription.
- Do not wear tight, constricting clothing.
- Never lift more than 3 kg.
- If you are involved in strength or team sports, you will have to give up training. You can move on to more gentle and relaxing activities, such as swimming, Pilates, etc.
It is in the second trimester that a woman gets used to her new role, “gets to know” the baby when he moves, and becomes attached to him. This is a period of bright feelings and genuine emotions. Do everything in your power to ensure that your future baby develops correctly and is born healthy!
THIS IS NOT AN ADVERTISING. THE MATERIAL WAS PREPARED WITH THE PARTICIPATION OF EXPERTS.
Brown discharge during ectopic pregnancy
The implantation of the embryo occurs from the third to the seventh day after the rupture of the follicle. If it is attached already on the first or second day, there is a possibility of an ectopic pregnancy, which cannot be carried to term. And then urgent medical attention is needed, otherwise you may lose the opportunity to have children in the future, and there is a risk of death. These signs can help identify an ectopic pregnancy:
- pain in the abdominal area;
- weakly positive test result;
- Ultrasound does not demonstrate the presence of a fetal egg in the uterus;
- HCG in the blood is increased;
- bleeding from the vagina occurs;
- blood pressure is below normal;
- my head is spinning.
In particularly severe cases, you may even lose consciousness due to severe blood loss.
Endometriosis
Brown or bloody discharge are also the main symptoms of endometriosis of the cervix or uterine body. This does not necessarily cause pain. Endometriosis of the cervix is nodular, small cystic formations or growths in the form of red or purplish-blue stripes. Dark bloody and brown discharge may appear from individual lesions. Endometriosis of the uterine body is the growth of endometrial cells in the myometrium (the muscular layer of the uterus). Pathological discharge decreases in size after menstruation, and its color becomes lighter.
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Uterine erosion and spotting
If a pregnant woman has cervical erosion, a woman may occasionally experience slight vaginal discharge. The reason is that the eroded area is irritated and damaged during the growth of the uterus and stretching of the cervical canal. In this case, it is also recommended to be observed by a specialist.
In case of erosion, spotting may occur even in the absence of pregnancy. For example, it is often caused by mechanical trauma during sexual intercourse or during examination by a doctor. And if it appears due to inflammation of the endometrium, you will find brown discharge before the start of your period.
Treatment for retrochorial hematoma
It is recommended to treat retrochorial hematoma, mainly because only there it is possible to ensure truly complete physical rest and the absence of any stress. No promises to “lie down all the time” at home can be realized - there will always be a bunch of urgent household chores that you want to do - from cleaning to laundry. In addition, the hospital can provide emergency assistance at any time - intravenous administration of hemostatic agents, for example. If it is not possible to go to a hospital, then you should consider the option of a day visit to the clinic or staying with us for a couple of days.
Bed rest is recommended, and in order to restore the outflow of blood, it is advised to lie down with a cushion, for example made from a rolled blanket, under the pelvic area. To prevent congestion in the intestines, it is recommended to follow a diet: exclude legumes, spicy foods; products that strengthen stool or enhance intestinal motility (chocolate, coarse fiber). The intestines overflowing with gases put pressure on the pregnant uterus and increase the tone of the uterus, which increases the threat of miscarriage and increases the size of the hematoma. Also, to reduce the risk of increased uterine tone, you need to limit the consumption of strong tea and coffee.
Drug therapy consists of using drugs that improve blood clotting, due to which bleeding stops and the hematoma stops growing (tranexam, dicynon, vikasol). To relieve hypertonicity of the uterus, due to which the hematoma can grow, antispasmodics (no-spa, metacin, suppositories with papaverine) are used. In order to normalize hormonal regulation in the body, metabolic vitamin therapy is used. Progesterone preparations are used. In this case, the scheme and route of administration are selected individually by the doctor; these can be either drugs for intramuscular administration (oil solution of progesterone), or suppositories (Utrozhestan, Iprozhin), tablets (Duphaston) or gel (Crinone). It should be noted that when bloody discharge appears from the genital tract, utrozhestan continues to be administered intravaginally. Its effectiveness is not reduced!
Treatment usually lasts from 2 to 4 weeks, and, if indicated, is repeated at critical times (12–14, 20–24, 28–32, 36–38 weeks). Resorption of the hematoma usually occurs from 2 to 4-5 weeks.
Brown discharge not due to pregnancy
Spotting may not always indicate fertilization. So you shouldn’t make hasty conclusions, because one of the reasons could be:
- inflammatory process;
- hormone surges;
- polyps;
- cervical erosion;
- violation of oral contraceptives.
Finally, irregularities in the menstrual cycle and the appearance of brown discharge are normal for the first few periods in life. If there are no other symptoms, then this is completely normal. Brown spotting often occurs due to endometriosis and hyperplasia, inflammatory processes (for example, adnexitis and endometritis), and polyposis. Doctors associate the occurrence of polyps with exposure to the human papilloma virus. With this disease, women have long and heavy periods, and the growths themselves are located in the uterus or cervical canal.
There are also causes of brown spotting, such as sexually transmitted diseases and damage to the genital organs. You can suspect a sexually transmitted disease based on symptoms such as itching, burning and unpleasant odors from the genitals.
Pathological discharge
Unfortunately, this is where the manifestations of normal discharge end, and the rest are already considered pathological. Some of them can deprive a woman of the joy of motherhood and the opportunity to become pregnant in the future. Let's take a closer look at them.
Erosion
With cervical erosion, a pregnant woman may experience brownish discharge of varying intensity, not accompanied by an unusual odor or pain. They are especially intensified after intimacy or a gynecological examination. If during pregnancy the doctor first diagnoses erosion, then he takes smears in order to exclude cervical dysplasia (changes in the number of layers and the structure of the forming cells in its epithelium).
Cervical erosion is an ulcer of its mucous membrane.
During pregnancy, erosion cannot be treated: it is cauterized after the woman stops breastfeeding. Erosion must be eliminated, as it can cause cancer to develop in a woman’s body.
During pregnancy, erosion cannot be treated: it is cauterized after completion of lactation
The procedure for cauterizing cervical erosion is quick and virtually painless.
Incorrect attachment of the fertilized egg
Sometimes the fertilized egg attaches too close to the cervix. It moves through the fallopian tubes using special villi that throw the egg like a ball. Next, the embryo is fixed in the upper part of the uterine cavity with the help of trophoblast. Due to disruptions in a woman’s hormonal system, the fertilized egg may attach closer to the uterine os. The fetus will grow, and the trophoblast will grow and be responsible for the development of the placenta. Due to its incorrect location, a woman may experience aching pain in the lower abdomen, and she may experience brownish discharge.
Due to the incorrect location of the placenta, the expectant mother may experience brown discharge
Simply put, in this way the expectant mother will develop placenta previa. This condition requires constant monitoring by specialists, as it may put the expectant mother at risk of miscarriage.
Detachment of the fertilized egg
Due to a lack of progesterone, the fertilized egg may detach from the uterine wall. Due to the detachment of the embryo, bleeding microtraumas of the vessels will appear. In this regard, a woman may experience the following symptoms:
- discharge from scarlet to dark brown;
- nagging pain in the lower abdomen.
This condition can be dangerous for the baby and foreshadow the threat of miscarriage, so the expectant mother needs to take measures to eliminate it as soon as possible.
When the fertilized egg is detached, a woman experiences discharge ranging from scarlet to dark brown in color.
If the ovum is detached, the doctor will refer the woman to the hospital, where the cause of the pathology will be identified. If it is associated with hormonal imbalance, the doctor will prescribe hormone-containing medications.
Fetal freezing
When this pathology occurs, the following signs appear:
- scanty brown discharge;
- loss of signs of pregnancy (toxicosis, drowsiness, etc.).
It is impossible to save a child after the pregnancy has died. Therefore, the doctor performs curettage of the fetus with its subsequent study, which makes it possible to establish the cause of death and eliminate it for the normal development of the subsequent pregnancy.
When the fetus freezes, scanty brown discharge appears
My friend had fetal failure. At first she developed a reddish-brown spotting that became more and more intense. She ended up going to the hospital where she had an ultrasound. The doctor said that the baby was not developing in accordance with the gestational age, but suggested that we wait and do an ultrasound again. My friend went to sleep in the ward, and at night she woke up from bleeding - the child could not be saved, but everything was fine with her friend. The doctors cleaned her up.
Ectopic pregnancy
Sometimes it happens that the fertilized egg attaches to the fallopian tube or cervix. This condition is accompanied by the following symptoms:
- dark brown vaginal discharge;
- intense pain from the implantation of the fertilized egg.
Due to the occurrence of such a pathology, a woman may no longer become pregnant or even die. But if the problem can be diagnosed in time, then doctors are able to remove the embryo while preserving the fallopian tube. In advanced cases, the pipe ruptures, as the growing egg presses on it. This condition is accompanied by internal bleeding and requires urgent surgical intervention.
With an ectopic pregnancy, dark brown vaginal discharge appears
Hydatidiform mole
This pathology is a product of conception that does not imply the correct development of the embryo. When a problem occurs, the chorionic villi grow into bubbles filled with fluid. This pathology of pregnant women is quite rare. It belongs to the so-called trophoblastic tumors, which are most often non-cancerous. Their growth outside the uterus exists, but this pathology can be eliminated. The problem is characterized by the following symptoms:
- brownish, bloody discharge, which eventually turns into bleeding;
- vomiting;
- rarely: tremor (shaking) of the limbs, increased temperature.
The problem is eliminated by curettage or removal of the uterus. To exclude relapse, chemotherapy and radiation therapy are used.
Gynecological diseases
Sometimes during pregnancy a woman learns about health problems. They may be as follows:
- benign formations (fibroids, fibroids). With them, during the period of supposed critical days, a woman experiences brown discharge of varying intensity (depending on the course of the disease). With constant medical supervision, it is possible to carry a healthy baby even with a complex form of neoplasms: the smaller they are and the further away from the uterus, the more favorable the prognosis;
- polyps of the cervical canal, often causing brown vaginal discharge. If the polyp is uncomplicated, then the baby is not in danger: usually this neoplasm is present in the woman’s body until the moment of birth and is released along with the placenta. But a constantly bleeding polyp worries the expectant mother, so the doctor may recommend its removal. If the neoplasm has formed against the background of chronic cervicitis, then there is, albeit a small, risk of infection of the baby. In this case, the doctor will prescribe medication. But a polyp with suspected malignancy (transformation into a malignant tumor) is dangerous, and when it appears after a biopsy, the doctor sometimes prescribes an operation to terminate the pregnancy;
- endometriosis, in which a woman may notice abundant brownish mucous discharge with bloody inclusions. As uterine tone increases, the amount of discharge increases. With this problem, there is a high risk of miscarriage, so the woman should be under the supervision of doctors and take the medications they recommend. However, endometriosis does not affect the development of the child in any way. Because of it, the cervix loses its elasticity, so often at the end of pregnancy, instead of a natural birth, a woman is prescribed a caesarean section.
Any diseases associated with changes in hormone levels can lead to miscarriage or fetal death. That’s why it’s so important to see a doctor if you have any strange discharge.
Sexual infections
When registering, the expectant mother undergoes examinations for the presence of sexually transmitted infections. However, during pregnancy she continues to have an intimate life, so she is not immune from these diseases. Infections can be identified by the following signs:
- dark yellow or green vaginal discharge;
- itching;
- burning;
- putrid smell.
With this problem, you need to consult a doctor who will select medications according to the type of infection.
Many pathogenic bacteria can cause genetic abnormalities in the fetus or its death. Therefore, if the above symptoms appear, you should immediately consult a doctor.
Miscarriage
Typically, this pathology begins with detachment of the fertilized egg, due to which a woman may observe brownish or bloody discharge in her underwear. If at this moment she rushes to the doctor, then perhaps the pregnancy can be saved. Gradually, the discharge intensifies, which entails the loss of the child. Pain in the lower abdomen should also alert you - if it occurs, coupled with characteristic discharge, you should urgently see a doctor. If he can no longer help, then the uterine cavity is cleaned.
A friend of mine somehow got nervous at work - this was her second time experiencing a miscarriage. A girl who is in the eighth week of pregnancy began to have spotting, brownish-red, low-intensity discharge. The doctor quickly examined her and prescribed Magnesia (injections) and put her in storage. I don’t remember how much time my friend spent in the maternity hospital under the supervision of doctors, but now her child is already 7 years old.
What to do if you have brown discharge instead of your period?
If you are faced with spotting and it does not go away in two or three days, and is also not a sign of the first menstruation or the upcoming menopause, then this is a reason to contact a gynecologist. First, the doctor will interview you, then examine you and, most likely, refer you for an ultrasound or other examinations. The most reliable option is microbiological tests, namely a smear. It is taken from the vagina and cervix to understand what caused the spotting. In severe cases of the disease, women are referred for laparoscopy to make an accurate diagnosis. Here's what experts recommend:
- use white pads or underwear during pregnancy to see discharge in time;
- refuse tight artificial underwear;
- try not to disturb the vaginal microflora when washing and not to cause infections;
- Save the drainage pad to ask your doctor for advice.
And remember that only a gynecologist will say for sure whether spotting is a sign of pregnancy or is caused by other reasons.
What other changes in the nature of discharge should you pay attention to?
Immediately before, during and immediately after pregnancy, women sometimes experience the following changes in the nature of their discharge:
- Discharge during ovulation.
The amount of discharge (leukorrhea) depends on the day of the menstrual cycle. The amount of discharge increases immediately before ovulation (the most favorable time for conception), and it usually has a liquid consistency. Immediately after ovulation, the discharge becomes thicker and less noticeable, and its volume decreases. These fluctuations are usually noticed by women who purposefully plan a pregnancy and monitor ovulation periods.
- Mucus plug.
A mucus plug, as the name suggests, is made up of mucus that accumulates in the cervix, blocking the entrance to the uterine cavity. Its purpose is to protect the fetus from infection. Just before contractions begin, the cervix dilates and the plug comes out of the vagina. The color of this mucus is usually clear or slightly pinkish with traces of blood, and its consistency is usually thicker than normal pregnancy discharge.
- Amniotic fluid.
A few hours before the onset of contractions, the amniotic sac breaks and the water breaks. This does not always happen on the same scale as in the movies: for some, the water recedes in a small trickle, for others the volume of water may be more significant, and still others do not notice anything at all.
- Lochia.
Immediately after natural childbirth or cesarean section and separation of the placenta, new discharge appears - lochia. This is mucus with blood that is released for several days after birth. At first it is a thick red discharge, which gradually fades and becomes yellowish or white. After a cesarean section, the volume of lochia is slightly less than after a natural birth. Lochia usually lasts four to six weeks after birth.
During pregnancy, the body undergoes many amazing changes. To find out what's next for you and your baby, download our special pregnancy guide.
