Posts Tagged ‘vaginal bleeding’

What is an ectopic pregnancy?

Friday, June 3rd, 2016

2013d030_3168An ectopic pregnancy occurs when an embryo grows in the wrong place. Ectopic means “out of place.” Approximately 1 in 50 pregnancies in the US is ectopic.

Usually, a woman’s ovaries release an egg every month, about 14 days before the first day of her period. This is called ovulation. When a couple has sexual intercourse and does not use birth control around the time of ovulation, a man’s sperm swim to meet the woman’s egg. When a sperm penetrates the egg, it’s called fertilization or conception. The fertilized egg then travels to the woman’s uterus, where it burrows into the lining of the uterus and begins to grow.

If the fertilized egg implants somewhere else other than the uterine lining, it is an ectopic pregnancy. In most ectopic pregnancies, the fertilized egg attaches to the fallopian tube. However, it can also attach to an ovary, the cervix, or somewhere in the abdominal cavity.

Unfortunately, any place outside of the uterus doesn’t have the right environment for a baby to develop. There is not enough room and if the fertilized egg continues to grow, it can cause excessive bleeding. This bleeding can be life threatening for the pregnant woman.

Risk factors

Any woman can have an ectopic pregnancy, but there are a few risk factors that increase your chances. These include:

  • A prior ectopic pregnancy
  • Smoking
  • STDs
  • Damage to a fallopian tube
  • Pelvic infections or inflammation
  • Pregnancy when using an intrauterine device (IUD) or after having a tubal ligation
  • Fertility treatments

Signs and symptoms

You will not know right away that you have an ectopic pregnancy. You may have the typical signs of pregnancy, like a missed period and nausea. Or you may have no signs of pregnancy. If you take a home pregnancy test, you will get a positive result.

But as the embryo gets bigger, you may have signs that are unusual and not typical of early pregnancy. These include:

  • Pain in the pelvic area. The pain may be mainly on one side. It can start out mild and then become sharp and stabbing.
  • Lower back pain
  • Shoulder pain
  • Bleeding from the vagina
  • Feeling faint or dizzy
  • Low blood pressure

Treatment

There are two types of treatment for an ectopic pregnancy: medicine (methotrexate) or surgery. Your provider will decide which one is best. After treatment, your provider regularly checks your hCG levels until they return to zero. This can take a few weeks. If your levels stay high, it may mean that you still have ectopic tissue in your body. If this happens, you may need additional treatment.

If you have had an ectopic pregnancy, it is important to take time to grieve for your loss. You can have a healthy pregnancy following an ectopic pregnancy but ask your provider when it is OK for you to try to conceive again.

Have questions? Email us at AskUs@marchofdimes.org.

How safe is sex during pregnancy?

Monday, February 25th, 2013

in-bed1There are lots of myths about sex and pregnancy, such as:
– Sex can be harmful or painful during pregnancy.
– Intercourse could hurt the baby.
– The baby somehow “knows” that sex is taking place.

The truth is that unless your doc or midwife advises you otherwise, sex during pregnancy is safe for the vast majority of us. And as for the baby, he or she has no idea what Mom and Dad are doing. The baby is well protected by a cushion of fluid in the womb and by the mom’s abdomen.

There are some circumstances, however, that can make sex during pregnancy unsafe. Women who have the following health complications should talk to their health provider before engaging in sex:
– A history or risk of miscarriage
– A previous preterm birth or other risk factors for preterm birth
– Unexplained vaginal bleeding, discharge or cramping
– Leaking amniotic fluid
Placenta previa (when the placenta is low and covers the cervix)
Incompetent cervix (when the cervix is weakened and opens too soon)

If your pregnancy is considered to be high risk, you may need to be more cautious than other women. Your health care provider may advise you to avoid intercourse for all or part of your pregnancy. This is an important conversation to have, so don’t be shy.

But again, for most of us, sex is safe, nothing to fear and may even become a more intimate experience. Many women find that pregnancy makes them want sex more than they did before they became pregnant. This sex drive is caused by hormonal changes. For some women, newfound voluptuousness can play a role in making them feel sexier than ever.

Other women may find that their sex drive comes in waves while pregnant. Here is a link to some common changes you may find throughout your stages of pregnancy.

What is placenta previa?

Thursday, October 11th, 2012

During pregnancy, the placenta attaches to the wall of the uterus and supplies the baby with food and oxygen through the umbilical cord. Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. (The cervix is the opening to the uterus that sits at the top of the vagina.)

Placenta previa happens in about 1 in 200 pregnancies. If you have placenta previa early in pregnancy, it usually isn’t a problem. It will be monitored, however, because it can cause serious bleeding and other complications later in pregnancy.

Normally, the placenta grows into the upper part of the uterus wall, away from the cervix. It stays there until your baby is born. During the last stage of labor, the placenta separates from the wall, and your contractions help push it into the vagina (birth canal). This is also called the afterbirth.

During labor, your baby passes through the cervix into the birth canal. If you have placenta previa, when the cervix begins to efface (thin out) and dilate (open up) for labor, blood vessels connecting the placenta to the uterus may tear. This can cause severe bleeding during labor and birth, putting you and your baby in danger.

The most common symptom of placenta previa is painless bleeding from the vagina during the second half of pregnancy. Call your health care provider right away if you have vaginal bleeding anytime during your pregnancy. If the bleeding is severe, go to the hospital.

An ultrasound usually can find placenta previa and pinpoint the placenta’s location. In some cases, your provider may use a transvaginal ultrasound instead.

Even if you don’t have vaginal bleeding, a routine, second trimester ultrasound may show that you have placenta previa. Don’t be too worried if this happens. Placenta previa found in the second trimester fixes itself in most cases.

Treatment depends on how far along you are in your pregnancy, the seriousness of your bleeding and the health of you and your baby. To learn more, read our article on placenta previa.

Ectopic pregnancy

Tuesday, September 1st, 2009

crampsIn an ectopic or “out of place” pregnancy, a fertilized egg implants outside of the uterus, usually in the fallopian tube, and begins to grow. When this happens, the birth of a baby is not possible and the woman’s health is threatened.  It can be pretty scary, so familiarize yourself with symptoms.

With an ectopic pregnancy, about 1 week after a missed menstrual period a woman may experience slight, irregular vaginal bleeding that may be brownish in color. Some women mistake this bleeding for a normal menstrual period. The bleeding may be followed by pain in the lower abdomen, often felt mainly on one side.  If you experience this, call your doc right away or go to the emergency room.  Without treatment, these symptoms may be followed in several days or weeks by severe pelvic pain, shoulder pain (due to blood from a ruptured ectopic pregnancy pressing on the diaphragm), faintness, dizziness, nausea or vomiting.

An ectopic pregnancy can be difficult to diagnose, so several tests need to be performed. If the provider finds an ectopic pregnancy, the embryo (which cannot survive) must be removed so that it does not cause the fallopian tube to rupture, resulting in life-threatening internal bleeding. Most ectopic pregnancies are diagnosed in the first 8 weeks of pregnancy, usually before the tube has ruptured.

There are two treatments for ectopic pregnancy: medication (using a drug called methotrexate which stops growth of the pregnancy and saves the fallopian tube. The woman’s body gradually absorbs the pregnancy); and surgery (the provider usually makes a tiny incision in the fallopian tube and removes the embryo, trying to preserve the tube, although sometimes it must be removed). After either of these treatments, the provider monitors the woman for several weeks with blood tests for hCG until levels of the hormone return to zero.

The most significant risk factor for ectopic pregnancy is sexually transmitted infections (STIs), such as chlamydia. For most women, the cause of an ectopic pregnancy is unknown.

Many women who have had an ectopic pregnancy can have healthy pregnancies in the future. Studies suggest that about 50 to 80 percent of women who have had an ectopic pregnancy are able to have a normal pregnancy. Women who have had an ectopic pregnancy have about a 10 percent chance of it happening again, so they need to be monitored carefully when they next attempt to conceive.

No cheating on bed rest

Thursday, August 20th, 2009

bed-rest“I’m putting you on bed rest” can mean a lot of different things.  Some women are put on bed rest at home, some are in the hospital.  Some are on partial bedrest, meaning they can get up and fix a sandwich for lunch, take a shower, etc. and stay off their feet the rest of the time.  Others are on strict bed rest and must remain horizontal, perhaps hooked to monitors, at all times.  You’ve got to know exactly what your doc means.

A lot depends on why you’re on bed rest.  Although there is no clear consensus on the benefits of it, many doctors prescribe bed rest to address a complication.   If your blood pressure is elevated, bed rest may help reduce the pressure. It may increase blood flow to the placenta or reduce strain with certain placental complications.  Bed rest may help reduce vaginal bleeding, take pressure off an incompetent or effacing cervix, lower the chance of preterm labor and the possibility of delivering too early. Bed rest can mean a lot of different things, so if your provider mentions it to you, ask a lot of questions so that you fully understand what is meant.  (Can I use the toilet, take a shower or bath? Can I sit up, go into the kitchen? Is sex off limits? What exercises are OK and what’s not?)

The object of bed rest is to allow pregnancy to continue in as healthy a way and for as long as possible.  But it can turn into a real drag pretty quickly.  If you’re going stir crazy and tempted to cheat, don’t.  Instead, work on crossword puzzles, Sudoku, photo albums, baby announcements, read, listen to books on tape, watch movies, write emails or blog posts… Take up a new hobby like scrapbooking or knitting. Plan a girls night in, watch a flick and do your nails. Allow your family and friends to help you.  Work up weekly menus and shopping lists for them.  Most of them will be happy to help keep you and your baby healthy.  It’s not forever, and it is for the best possible outcome.