Heavy bleeding during pregnancy. Bleeding during pregnancy - what to do? Discharge during early and late pregnancy

– a sign that can occur regardless of the period of embryogenesis and indicates ongoing changes in a woman’s body. May occur with spontaneous miscarriage, ectopic pregnancy, Rhesus conflict, placenta previa and other conditions. This manifestation can develop against the background general well-being or be accompanied by painful sensations in the lower abdomen, lower back, or sacrum. Diagnosis of bleeding during pregnancy is based on data gynecological examination, ultrasound assessment condition of the patient and fetus. Treatment for this pathological sign is determined by its cause and is prescribed exclusively by a specialist.

Forecast and prevention of bleeding during pregnancy

Bleeding during pregnancy is usually accompanied by a favorable prognosis. Timely rendered medical care allows you to save the life of the fetus and woman. Fatal outcome is extremely rare. Prevention of bleeding during pregnancy involves early detection of benign neoplasms and their treatment before conception. To prevent the development of a pathological sign, you should register as early as possible, take all the necessary tests, and if any violations occur, immediately seek advice from an obstetrician-gynecologist. Prevention of bleeding during pregnancy also involves avoiding stress, physical activity, violent sexual contacts.

Among young ladies who have nothing to do with medicine, frightening rumors are spreading, like night horror stories, which are passed from mouth to mouth in ominous whispers, allegedly that some women can continue to walk even during pregnancy! At this point, the young ladies widen their eyes and skeptically exclaim: “It can’t be!”

And indeed, if we recall the characteristics of normal menstrual cycle, then this simply cannot happen during pregnancy! But bleeding from the genital tract, the same as during menstruation, is quite possible. And you must clearly understand that it will not bring anything good.

Bleeding in the first trimester of pregnancy

In early pregnancy, the cause of bleeding is the threat of miscarriage or miscarriage itself.

Spontaneous miscarriage. Perhaps the girl still does not know about the fact of pregnancy, especially if her periods do not have strict cyclicity and the delay is short. When bleeding occurs, she mistakes it for her period without even thinking about it. This is exactly the scenario that miscarriages took place on early stages our grandmothers and great-grandmothers in those days when there were no ultrasounds and pregnancy tests in every pharmacy. A woman’s body independently gets rid of pregnancy, which already has some damage at the initial stage. These could be some chromosomal mutations, gross malformations of the fetus, possibly improper attachment ovum to the wall of the uterus and many others. Nature very sensitively controls this process and does not allow a non-viable baby to be born or an already sick mother to bear a child. After all, pregnancy for a woman is a global test of all systems and organs. Where it is thin, it will tear and all the sores that were untreated and which in the future should have formed in your body will come out. And if a woman suffers from any disease - be it, diabetes mellitus, infectious-inflammatory process and many others, then there is a huge risk that these diseases simply will not give the fertilized egg early stages develop, that's all. It's kind of natural selection at the reproductive level.
Ectopic pregnancy. Normally, the fertilized egg should attach to the wall of the uterus. Her endometrium is like a feather bed into which it sinks future baby, sprouts with its own vessels and slowly grows and develops. If the endometrium looks not like a feather bed, but like a bench in a cold park, of course, no one will want to sit on it! And the fertilized egg looks for a better place, descending into the cervix (this is the worst option of all ectopic pregnancies, in which there is a high probability surgical removal uterus). But more often than not, the fertilized egg does not reach the uterus and remains in one of the fallopian tubes, gradually penetrating into its wall. This happens because there was an inflammatory and/or adhesive process in the tubes even before pregnancy. Her ciliated epithelium is damaged and no longer helps the egg move, and its transport function is impaired. The danger of an ectopic pregnancy should not be underestimated. The fallopian tube is not adapted to the development of a baby, its wall is thin, fragile, and when he tries to penetrate it with his vessels, sprouts and grows, it ruptures, and bleeding occurs in the abdominal cavity. If the tube does not even rupture, then it rejects the fertilized egg and external bleeding occurs (from the vagina), this scenario is called termination of an ectopic pregnancy of the type tubal abortion. These conditions are quite serious and to some extent threaten the woman’s life. It is for this purpose that you should not neglect ultrasound diagnostics if you find out that you are pregnant. Make sure that the fertilized egg is attached in the uterus.
Gynecological pathology. If a pregnant lady is sick with something, then this is definitely related to her pregnancy. Complete nonsense! Before conception, she, like anyone else, had her own bouquet of diseases that do not disappear anywhere with the appearance of a fertilized egg. There are other possible causes, but the most common cause of bleeding is:
- cervical erosion (ectopia). She may have been there before pregnancy, they just didn’t know about her. Bleeding can be contact (during sexual intercourse) or non-contact. They do not pose a particular threat, but they can add problems to a woman during childbirth, when dilation of the cervix is required, and its tissue has already been provoked.
- . Most likely, they did not know about this before pregnancy, otherwise it would not have happened. A very serious and difficult combination, the continuation of pregnancy is a big question.
Bubble drift. A rather ambiguous pathology, which, in addition to bleeding, will not give practically any other subjective symptoms. After making such a diagnosis (usually based on ultrasound data), the woman is offered to have the uterine cavity curetted (cleaning, as it is popularly called), since its further prolongation threatens to degenerate into a malignant process.
Intrauterine hematomas. Retroplacental, subchorionic, transthecal or some other ones one way or another create a threat to pregnancy. They represent a section of exfoliated tissue of an already ingrown fertilized egg with bleeding. That is, behind the placenta, for example, a cavity filled with blood is formed, and this area gradually grows, peeling off more and more of the surface of the placenta. Because of this, the unborn baby suffers, to whom he comes less and less nutrients and oxygen. The pregnancy may be interrupted and a miscarriage may occur. Either the hematoma will slowly empty, and the young lady will have spotting from the vagina, more often dark blood, even crumbly. One thing is for sure, a hematoma in the first trimester is a sign of trouble in the fetoplacental system in the second and third trimesters.
Other development scenarios, for example, in case of multiple pregnancy - twins, reduction (death) of one of the fetuses.

Thus, we can formulate the main risk factors for the development of bleeding in the first half of pregnancy:

Infectious-inflammatory factor.
Anatomical problems (malformations of the uterus - saddle-shaped, with a septum, bicornuate, etc., as well as impaired peristalsis of the fallopian tubes and, as a result, tubal pregnancy).
Immunological disorders.
Violation of the processes of formation of the fertilized egg (chromosomal, gene damage).
Thrombophilias (congenital or acquired syndromes of blood coagulation disorders).

Treatment of bleeding in the first half of pregnancy

In order to exclude the possibility of developing all these complications, it is necessary to carry out full examination and prenatal preparation. The main groups of drugs used to treat threatened miscarriage:

Antispasmodics (Drotaverine intramuscularly or Papaverine in rectal suppositories).
Hemostatic drugs (Tranexam tablets or injections).
Magnesium preparations (Magne B6, Magne B6 forte, 2–4 tablets per day for 3 months).
Hormonal support (Duphaston).
Systemic enzyme therapy is possible (Wobenzym 5 tablets 3 times a day)

Bleeding in the second half of pregnancy

In the second half of pregnancy, placenta previa can provoke bleeding.

Placenta previa

Placenta previa is a pathology in which the placenta is located too low and covers the internal os (the place where the uterus passes into the cervical canal). Presentation may be:

complete when the placenta completely covers the area internal pharynx(the worst option);
incomplete presentation – partial overlap;
low location of the placenta (placentation), when its lower edge is located below 5 cm from the internal os.

Symptomatically, this can manifest itself as follows: bleeding from the genital tract with scarlet blood, occurring against the background of complete well-being, without any visible reasons, without pain. Often such women end up in the hospital by ambulance because they woke up at night literally in a pool of blood. Such bleeding may recur. But if the diagnosis of low placentation is made in the second trimester according to ultrasound, do not immediately despair, the placenta can migrate up to 32 weeks.

In case of heavy bleeding and full-term pregnancy, emergency delivery by Caesarean section is indicated. Conservative therapy up to 24 weeks can still be performed on an outpatient basis, in antenatal clinic, and after this period mandatory inpatient treatment is necessary. Main groups of drugs:

Hemostatic therapy (Tranexam, IM 1 g/day).
Tocolytic therapy (Indomethacin, Nifedipine).
Prevention of immaturity of the fetal pulmonary system from 26 to 34 weeks of pregnancy (hormonal therapy).
Possible antibacterial therapy according to indications.

Premature abruption of a normally located placenta

Premature abruption of a normally located placenta is an untimely separation of the placenta. Detachment is the same retroplacental hematoma, only large sizes and threatening the life of not only the child, but also the mother. With significant detachment, hemorrhagic shock occurs, a condition that threatens the woman’s life. There are very specific criteria for classifying detachment:

mild degree, when the total area of the detached placenta does not exceed 1/6 of the total area of the placenta, i.e. its volume is insignificant. In this case, the bleeding will be external, from the genital tract, no more than 800–1000 ml in total. In 80%, the condition of the fetus is not affected.
moderate degree, when the total area of the detached placenta is from 1/6 to 1/3 of the total area of the placental tissue. In this case, bleeding will be not only external, but also internal. Therefore, if a woman sees a small amount of scarlet blood on the pad, then, most likely, the remaining blood simply remained inside the hematoma and is slowly exfoliating the placenta from the inside, saturating the walls of the uterus. The area of non-functional, non-functioning placenta becomes gradually larger and larger, which means that less and less comes to the child. less blood enriched with oxygen. The probability of a child's death is up to 80%. The woman’s condition worsens, she becomes pale, covered in cold, sticky sweat, and possibly dizziness and confusion.
severe degree, when the area of detachment is already 2/3 or more. Blood loss increases to 1.5 liters, due to internal losses. The uterus is gradually completely saturated with blood. The probability of a child's death is close to 100%. Most often, the woman is already unconscious, level blood pressure falls, hemorrhagic shock occurs. This is an extremely difficult condition, in which it is very important that relatives (!), namely they will make the necessary decisions, understand that the fight is not for the life of the child, not for the possibility of future conception, realization in the future reproductive function(if the uterus is massively saturated with blood, it is removed in most cases), but for the life of the woman herself!

Why does such a formidable complication arise? There is no smoke without fire; most likely, the pregnancy itself was not as successful as it seemed at first glance. Factors leading to premature detachment normally located placenta:

Preeclampsia, or preeclampsia according to the new classification. This is perhaps the most main reason, leading to placental abruption, since already from a short time structural changes occur in the walls of blood vessels.
Inflammatory diseases in the uterine cavity, including after previous surgical interventions (abortion, curettage).
Malformations of the uterus.
Attachment of the placenta to.
Blood diseases (thrombophilia, congenital and acquired).
Incompatibility of the blood of mother and fetus based on blood group or Rh factor.
Immunological disorders in the mother's body.
Post-term pregnancy, i.e. gestation period more than 42 weeks.
Large fetus, multiple pregnancy (twins, triplets), polyhydramnios, everything that excessively overstretches the walls of the uterus from the inside.
Trauma, be it a woman falling, a blow to the stomach.

Thus, there are quite a lot of risk factors, but this does not mean that if a pregnant woman has any of them, she will definitely experience abruption. There is nothing absolute in medicine; everything is very, very individual. Someone may have a disaster even in the midst of complete well-being, but someone goes through all 9 months with a bunch of predisposing factors and gives birth quite safely.

It is not difficult to imagine the reaction of any girl or woman who discovers such an unpleasant symptom as bleeding during pregnancy. Blood discharge during pregnancy is quite common occurrence. This is not an easy period. But it is quite difficult to overcome the feeling of fear for an unborn tiny creature. At early pregnancy complications occur more frequently. In order not to get lost in guesswork, you need to urgently apply for medical assistance. This can prevent severe bleeding.

Many people wonder whether they should visit a doctor if they notice spotting at the beginning of pregnancy. The answer is clear - the sooner the better. During the entire first trimester, a woman is at special risk. It is urgent to take care to preserve the fragile life of the baby. Therefore, the presence of blood during pregnancy clearly indicates the presence of a problem in the body.

Any red discharge during pregnancy should not be ignored. Bloody discharge in the first weeks is quite acceptable. But if it's bleeding and it doesn't stop, this symptom extremely dangerous. There is a direct risk of miscarriage, sudden death of the fertilized egg.

To prevent fetal loss, it is advisable to visit your gynecologist as soon as possible. During pregnancy, bleeding is not always dangerous, but the opposite can also happen. Early in pregnancy, blood sometimes indicates the risk of losing the baby. Timely examination will help to find the cause of the pathological phenomenon at an early stage of pregnancy. There may not be a second chance. Type of blood during pregnancy early stages- an alarm signal.

If the Rh factor is negative, then even with pink discharge, not to mention bleeding in pregnant women, it is necessary to visit a specialist quickly, literally within 24 hours. It's always better to be safe than sorry important point and prevent bleeding during pregnancy.

Why bleeding may occur

The causes of bleeding during pregnancy are individual and have different character. In addition to the dangers, there are a number of bloody discharges during pregnancy; they do not pose a serious threat. If you experience spotting in the middle of your cycle, you should also visit a doctor.

Bleeding sometimes occurs in the first half of pregnancy, in some cases during later. Everything is individual. It depends general condition the woman’s health, the course of the pregnancy process, possible complications.

It is important to monitor any unusual sensations in the body. If you bleed during pregnancy, there is a reason. Moreover, you should not ignore it if spotting appears in the first weeks. Spasms and pain indicate the seriousness of the situation, especially when bleeding appears in the first weeks.

Other reasons

Experts note a number of the most common reasons why blood may bleed during pregnancy; spotting appears in the early stages. Don't be afraid. An experienced doctor will diagnose and decide what can be done. Bleeding in the first half of an interesting situation is closely related to certain factors.

Problems related to the placenta. Her incorrect location capable of causing vaginal bleeding no signs of pain. If the placenta is too low, sooner or later a complication will arise in the form of blood loss. Low presentation placenta occurs in only 1-2% of women. In most cases, this phenomenon occurs after 20-21 weeks. For an accurate diagnosis, an ultrasound is performed.
Placental abruption is a very serious and dangerous diagnosis, especially if it is bleeding during pregnancy. The placenta may detach completely or partially. Accompanied by severe blood loss and pain. Immediate medical attention is required due to the increased threat to both mother and baby.
An ectopic pregnancy occurs when the fertilized egg develops outside the uterine cavity. Accompanied by strong and acute pain lower abdomen. It is urgent to get rid of the embryo. Otherwise, there is a risk of rupture of the fallopian tube. This is dangerous due to internal bleeding.

Cervical pregnancy

You should pay attention to spotting in early pregnancy. This pathological phenomenon is a type of ectopic growth of a fertilized egg. The fertilized egg does not reach the uterine cavity, but enters the cervix. There it consolidates and begins to develop.

The enlargement of the fertilized egg is the cause of heavy bleeding. This poses a risk of developing all kinds of complications and significant blood loss. IN in this case During early pregnancy, bleeding may occur non-stop. Need to call urgently ambulance.

A pathology such as bleeding in the early stages occurs for some reason. It could be intrauterine device as a contraceptive, IVF, uterine curettage, etc. It is advisable to immediately visit a gynecologist for any suspicious symptoms. If a diagnosis is made, the doctor will select suitable look therapy.

Additional factors

Bloody discharge during pregnancy can trigger lovemaking. It is recommended to limit sex life to prevent bleeding during pregnancy different terms. Often after intimate caresses, a woman discovers pinkish discharge on the pad. In the later stages, there is no need to worry, this fact indicates that the uterus becomes softer and the blood supply to the vagina increases. It is worth telling your doctor about this.

According to statistics, in the first 12 weeks, a small percentage of women experience spontaneous miscarriage. Abnormal fetal development is the verdict of experts.

At 15-16 weeks, you can calm down and it’s already possible to safely carry your baby to term. For this reason, most women in interesting position prefer to remain silent until a certain period.

Often during a miscarriage there are no cramps, heavy bleeding. HCG level(a special hormone) stops increasing. Pathology can only be recognized by ultrasound. The doctor prescribes cleaning, as the absence of a heartbeat in the fetus is determined.

Menstruation while pregnant

What else could bleeding in the first month of pregnancy indicate? Is it possible to have periods while pregnant? It sounds absurd, but it sometimes happens because of work hormonal system. Low levels of hormones are unable to stop the usual menstrual cycle.

Typically, the placenta helps process hormones by the third month. This is sufficient in rare cases, but popular belief the fetus is washed. Your period comes on time as expected. Moreover, this is accompanied by the usual symptoms: nagging pain in the lumbar region, pulling in the lower abdomen.

It is very rare, but some women experience this phenomenon throughout the entire period of pregnancy. Labor begins on time and healthy babies are born.

Menstruation in pregnant women is not normal occurrence. It's all about disrupted hormonal levels. Women with this pathology are required to be under the supervision of doctors.

Signs of implantation bleeding

Even small drops of blood during early pregnancy should not be ignored. The reasons for its origin are very different. Could this be a sign of fertilization? The zygote (fertilized egg) is securely attached to the surface of the uterus. This process leads to the appearance of bloody streaks or blood, which lasts no more than two days. This usually falls on the date of the expected menstruation.

Bloody discharge in the first weeks of pregnancy may look different. They come in a pinkish tint or bright scarlet color like a cut. At the same time, not too abundant, rather smearing. The process of attachment of the zygote occurs on average 6-12 days after ovulation and fertilization have occurred.

A special calendar should be kept to monitor menstruation. Normal menstruation begins with weak discharge, the amount of which gradually increases. Every woman knows her individual characteristics. Implantation bleeding has completely different characteristics and causes. It does not increase, does not last long, and quickly stops.

Dangerous or not

Bleeding due to the attachment of the zygote occurs quite often. Many women experience unusual discharge and bleeding in early pregnancy. This is mistaken for the start of menstruation. Therefore, the woman remains completely unaware of her interesting situation.

A reliable sign of pregnancy is implantation bleeding. This is the presence of bleeding during pregnancy. It is during this short period of thorough fixation of the egg that the blastocyst turns into an embryo.

Symptoms of cessation of development of the fertilized egg

Frozen pregnancy occurs in any woman and has no age restrictions. This means a complete absence of signs of fetal life, which means its death. It is possible to prevent such a terrible phenomenon if you strictly follow medical recommendations. Bleeding in pregnant women in the early stages may indicate some abnormalities.

This anomaly can occur at any stage of pregnancy, although it is more common among women over 40 years of age. One should not lose sight of such a sign as the onset of bleeding at the beginning of pregnancy. Usually there are no special manifestations. Sometimes there is scanty bleeding, and the lower abdomen hurts.

Genetic abnormalities in embryo development are a common cause of this pathological phenomenon. The problem can be diagnosed using the necessary blood tests and ultrasound examination. It is up to the attending physician to decide whether to perform curettage or wait until a miscarriage occurs. The sight of blood early in pregnancy is not necessarily dangerous. It all depends possible reasons, through whose fault this happens.

Blood during early pregnancy can tell a lot. Various ailments genitourinary system before conception can play a cruel joke in the future. A woman in the process of carrying a baby can get a consequence called hydatidiform mole. Old-time women suffering from ovarian dysfunction and malfunction are also at risk of developing the disease. hormonal levels.

The chorion is an important part of the embryonic layer. When drift occurs, the chorion begins to grow greatly. The embryo stops its development, and the villi turn into vesicles. Incomplete hydatidiform mole is a sign of abnormal fertilization: two sperm penetrate the egg at once. This can cause spotting during pregnancy.

For this reason, bleeding occurs in early pregnancy. This phenomenon represents serious concern due to its ability to transform into a malignant neoplasm. It is possible to recognize a hydatidiform mole when medical examination. If there is no bleeding, then the symptoms do not manifest themselves. You should visit your doctor regularly to watch for symptoms of mole.

Features of blood loss during pregnancy

Bleeding during early pregnancy is common. Discharge in the first trimester of pregnancy is often unusual and has different characteristics. It's no secret that during pregnancy a woman experiences unusual, new sensations. Bleeding during pregnancy can be alarming. They have some features:

spotting during pregnancy appears suddenly;
bleeding during pregnancy can be quite massive;
bleeding in the early stages often poses a danger to the fetus;
blood loss is debilitating female body, deprives of protective forces;
due to bleeding in the early stages, blood volume decreases, which has a bad effect on the functioning of the heart;
there is a risk of disseminated intravascular coagulation.

What to do if blood appears at the beginning of pregnancy? The main thing is not to panic. It is first necessary to establish the cause of bleeding in early pregnancy.

It is impossible to do this on your own. An immediate visit to a gynecologist will speed up the improvement in your well-being. Correct diagnosis is the first step to recovery.

The very first, outwardly noticeable sign of pregnancy is the cessation of menstruation. Normally, regular bleeding does not recur during the entire gestation period. Any spotting that occurs after pregnancy has been established requires attention.

Physiology of amenorrhea during pregnancy

After fertilization, significant hormonal changes occur. The activity of sex hormone synthesis shifts towards the production of progesterone. First, in the first trimester, it is produced corpus luteum pregnancy in the ovary. Then the placenta takes over this function.

An increase in progesterone levels prevents the ovarian follicles from producing new eggs and inhibits the proliferation of the endometrium. Due to this, menstruation stops, and the fertilized egg gets the opportunity to securely gain a foothold in the uterine cavity and continue its development.

Obstetric blood loss

If a pregnant woman begins to bleed from the external genitalia, we're talking about about obstetric hemorrhage. Whatever is causing them.

A normal pregnancy almost always goes without blood until birth.

The classification of conditions when blood is detected during pregnancy is based on the main criterion - the period of occurrence. Highlight:

Bleeding in the early stages.
Bleeding in late pregnancy.
During childbirth.
In the early postpartum period.
In the late postpartum period.

Let's take a closer look at bleeding in the early and late stages of pregnancy. They will differ from each other in reasons, volume and danger to the fetus. In some cases, they may pose an immediate threat to the mother's life.

First half

On initial stages, especially in the first trimester, interaction maternal body and the fruit is just getting better. Plus, the embryo has to go through several critical periods, which often lead to pregnancy failure.

Therefore, among the causes of spotting in the first trimester, miscarriage is the leading cause. The following is a list of factors that provoke blood loss:

Ectopic pregnancy.
Trophoblastic disease (hydatidiform mole).
Cervical pregnancy.
Bleeding from varicose veins of the external genitalia.
Benign (polyps) and malignant neoplasms of the cervix.

As you can see, some reasons are directly related to the pathology of gestation, others are of a slightly different nature.

Spontaneous abortion

In approximately 25% of all conceptions, the embryo does not survive the differentiation stage. This is the stage of formation of all organs and systems of the fetus. During this critical period Errors often occur, resulting in loss of embryo viability.

Sometimes all this happens during the time between periods. Then a miscarriage can be confused with regula, which come with a slight delay and look more abundant than usual. Clots may pass.

The miscarriage may be incomplete and then dead tissue and blood clots will remain in the uterine cavity. If even a small fragment does not come out, then the uterus is not able to return to its previous volume. Bleeding can be profuse (profuse) and poses a direct threat to a woman’s life.

Ectopic pregnancy

Occurs if the attachment of the fertilized egg occurs outside the uterine cavity (most often in one of the fallopian tubes). In most cases, such a pregnancy is terminated on its own.

In this case, a reflex detachment of the inner layer of the uterus (decidua) occurs. Light bleeding is observed, which may not correspond to actual blood loss.

During an interrupted tubal pregnancy, a significant amount of blood flows into the abdominal cavity, and not through the genital tract.

If slight spotting similar to menstruation appears in the first 12 weeks, this may indicate a tubal miscarriage. To find out the cause, you must immediately consult a doctor and undergo an ultrasound.

Hydatidiform mole

To put it simply, this disease is manifested by pathology of the placenta, which increases significantly, but becomes more loose. In this case, bleeding during pregnancy is accompanied by an abortion clinic. Clots are released from the external genital tract. The blood is dark. There may be chorionic villi that look like vesicles.

Trophoblastic disease requires qualified medical intervention. The embryo, if there was one, dies at the very start of the disease.

Cervical pregnancy

One of the options for ectopic attachment of the fertilized egg. The cervix does not have the necessary elasticity and cannot stretch. Its mucous membrane is very thin, the submucosal layer is rich in vessels with arterial blood.

If it is not diagnosed in time, it can cause a very serious condition. Blood flows profusely, scarlet.

In the very early stages, bleeding can be painless: the vessels of the cervix are destroyed under the influence of the growth of chorionic villi, and not overstretching.

Varicose veins of the vulva

One of the few cases when bleeding during pregnancy does not pose a direct threat to the fetus. Changed veins and nodes can bleed. The abundance is average, the blood is dark, venous. Clots may be detected.

Sexual intercourse can cause such a complication. The risk increases towards the end of the first trimester and reaches its maximum by the third. Spontaneous onset uncharacteristic.

Neoplasms

Cervical polyps may bleed due to their friability. The slightest impact on their surface causes capillary bleeding. Visually this is identified as smearing.

The presence of a malignant tumor may have a similar clinical picture, therefore scanty, brown discharge should be a reason for diagnosis.

Second half

If in the first 12 weeks bleeding during pregnancy is primarily dangerous for the fetus, then in later periods the risks for the mother increase significantly. In the second and third trimesters, blood loss is most often caused by two pathologies:

Placenta previa (complete or incomplete).
Premature abruption of the normally located placenta (PONRP).

These conditions are the most common cause of maternal death.