Question

Complications of Pregnancy Bleeding disorders What are the signs and symptoms of bleeding disorder during pregnancy

Answer 1

Complications of Pregnancy

Bleeding Disorders during Pregnancy:

Bleeding disorders during Pregnancy is also considered as Antepartum Haemorrhage.

Antepartum Haemorrhage : Bleeding from or in to the genital tract after 28 weeks of pregnancy but before the birth of the baby is considered as Antepartum Haemorrhage.

Causes of Antepartum Haemorrhage

• Placental causes : Placental praevia, Abruptio placenta (70% incidence)
• Extra placental causes : cervical polyps, cervical carcinoma, varicose veins and local trauma.(5% incidence )

Placenta Praevia : Partial or complete implantation of placenta in the lower uterine segment instead of the upper segment is considered as placenta praevia.

Types :

Type I low lying : Almost the placenta is in upper segment, only some part will be in the lower segment

Type II Marginal : Placenta reaches the margin of the internal OS, but will not cover it.

Type III Incomplete or partial : Placenta covers partial part of the internal OS

Type IV Complete or Total : Placenta completely covers the internal OS

Signs and Symptoms :

The only symptom is vaginal bleeding

Signs : Uterus feels relaxed, size of the uterus is proportionate to the size of gestation , Floating head of the Fetus engagement does not take place, Malpresentation, Bright red blood in the vagina.

Abruptio Placenta : Bleeding takes place through the premature separation of the placenta.

Types :

Revealed : Following the separation of the placenta the blood escapes through the membranes in to the cervical canal and blood is visible out side.

Concealed : Following separation the blood cannot be escaped out side the cervix because of the disturbances in the presenting part and thus bleeding takes placed internally.

Mixed : Some part of the blood is visible out side and some will be concealed inside.

Signs and Symptoms :

Revealed : Abdominal discomfort, painful vaginal bleeding, visible blood loss, uterine tenderness, Feral hear sounds are present, Feral parts are palpable, size of the uterus is proportionate to the gestational age , urine output is normal.

Concealed/ Mixed: Acute abdominal pain followed by slight vaginal bleeding, Dark coloured blood with serious discharges, Size of the uterus is disproportionate and globular, uterus is tense, tender and rigid, Feral parts cannot be palpated, Feral heart sounds are usually absent, urine output is diminished.