During the period of bearing a child, a woman should especially carefully monitor changes in the body. The greatest concern is the first trimester, when there is a risk of miscarriage, and the last month. Discharge before childbirth is a physiological feature that indicates the preparation of the female body for the birth of a baby.

But it is important to evaluate the nature of these discharges, since the color and smell may indicate the presence of complications. You can keep your baby healthy and avoid problems during childbirth by detecting them in a timely manner.

It is important for a woman in the last month of pregnancy to know what discharge should be present before giving birth. This will help distinguish the physiologically occurring process of preparing the body from pathological conditions. Normally, abundant mucus appears first, then the plug comes out and water pours out. The fact that not everything is in order is indicated by bloody, curdled white and greenish discharge with an unpleasant odor.

Pink discharge before labor appears because the plug that previously covered the cervix may contain a small amount of blood. The mucus is slightly colored by it, but does not contain blood streaks. If the color turns red, this indicates early placental abruption or placental previa. Both are dangerous for the child, so immediate medical attention is necessary.

Brown, pink, brown discharge before childbirth is not bleeding. They are mixed with mucus, insignificant and appear, as a rule, less than a day before the birth of the child. At this time, you can begin preparing for departure to the maternity hospital: collect all the necessary things and documents, warn close relatives.

If the discharge before childbirth is white, looks like cottage cheese and has a sour smell, then most likely a fungal infection - thrush - has spread into the vagina. The disease must be treated urgently, since it significantly complicates the birth process for the mother and can harm the health of the child. Candidiasis in a woman in labor reduces the elasticity of the vagina and increases the risk of ruptures.

Green and yellow discharge before childbirth also indicates an infection (trichomoniasis, gonorrhea, chlamydia) or inflammatory processes in the pelvic organs. In any case, immediate medical attention is required.

Mucus discharge

The mucus released before childbirth can be thick, viscous, transparent or white with a slight tint. You can take a small amount of mucus with two fingers; when you separate them, its consistency (strength, viscosity) will be clearly visible.

Mucous discharge before childbirth indicates the ripening of the cervix. They are most noticeable after waking up, when a woman moves from a horizontal to a vertical position. After some time, the discharge begins to darken and turn brown - this means that there are several hours left before the birth of the baby.

Exit of the mucus plug

During pregnancy, the lumen of the cervix is ​​blocked by a mucous plug, which protects the fetus from infection. By the end of gestation, the walls become elastic and open. Under the influence of hormones, the plug softens and comes out.

It is impossible to predict exactly when this will happen: for some women two weeks before giving birth, for others a few hours.

If the mucus plug comes off all at once, it looks like the white of an egg or a jellyfish. Often this process goes unnoticed because it occurs while visiting the toilet or taking a shower.

In addition, the plug may come out gradually, over one or two days, then it will look like the usual clear or white discharge before childbirth.

After the mucus plug comes off, you should not take a bath, you should refrain from sexual intercourse, be more attentive to intimate hygiene, and change your underwear more often. During this period, the uterine cavity becomes open to infection.

Leakage of amniotic fluid

Unlike a mucus plug, the leakage of amniotic fluid cannot be ignored. They are a liquid whose volume ranges from 0.5 to 1.5 liters. Normally, it is transparent, has a slightly sweet odor or does not smell of anything. Sometimes, along with the water, particles of lubricant come out, protecting the baby’s integument in the uterine cavity. They look like small white flakes.

The process of discharge of amniotic fluid also occurs in different ways. Sometimes the liquid pours out all at once, this often happens after visiting the toilet or with a sudden change in body position. In other cases, it gradually leaks. Exactly how this will happen depends on where the bladder ruptures - near the cervix or above.

If the amniotic fluid is yellowish or greenish in color, cloudy, this may indicate that:

• the child experiences oxygen starvation;
• there is a presentation of the fetus;
• premature placental abruption began.

Blood discharge and changes in the color of amniotic fluid require an immediate call to the ambulance team. Trying to get to the maternity hospital on your own can be harmful and further complicate the situation.

When should you see a doctor?

You should see an obstetrician-gynecologist if you have discharge that differs from normal daily discharge. A specialist will be able to accurately determine their character and tell whether everything is in order. If the discharge is white, curdled, yellow or green with an unpleasant odor, then a visit to the doctor is necessary.

An infectious disease in late pregnancy is dangerous to the health of the child and negatively affects the birth process. After the plug comes out, pathogenic microflora can easily enter the uterine cavity.

An immediate call to an ambulance is necessary if bleeding develops. Copious discharge of bright scarlet blood is dangerous for the life of mother and child.

You should seek medical help if the discharge is accompanied by cramping pain in the lower abdomen. Most likely, this is a sign of the onset of labor. Moreover, this can happen even before the amniotic fluid breaks.

At the end of her term, a pregnant woman should know what discharge is normal before childbirth. Physiological changes of this kind by the end of the term consist of three stages: mucus secretion (ripening of the cervix), discharge of the plug and amniotic fluid. In all cases, you need to pay attention to the color, structure and smell of the discharge.

The birth of a child is a natural occurrence, but complications may occur during childbirth, including sudden bleeding. This condition always threatens the life of the mother and child, and therefore requires mandatory emergency medical care.

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

Causes of bleeding during childbirth

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

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

When blood loss occurs, a woman and child experience rapid heartbeat, chills, and decreased blood pressure. This phenomenon is typical for any severe bleeding. Against this background, the blood supply to the fetus drops significantly, which can lead to its death. With this development of events, a decision may be made to perform a caesarean section.

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

Sometimes bleeding occurs due to pathological placement of the placenta:

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

Cases of cervical presentation are particularly complex, but also quite rare. Moreover, all of the listed pathologies lead to premature separation of the placenta, therefore, already at the 38th week, such women are recommended to have a cesarean section.

A severe consequence of childbirth is considered to be rupture of the uterine wall. It can occur both during childbirth and during pregnancy and is accompanied by severe pain. If a caesarean section is not performed on time, the life of the mother and child cannot be saved. With timely medical care, with a high degree of probability, such a uterus will be removed due to the impossibility of healing the tear.

Risk factors for uterine bleeding are the following:

• history of surgical interventions on the uterus;
• a large number of births, abortions or miscarriages;
• inflammation of the genital organs;
• , multiple births;
• incorrect placement of the fetus in the uterus;
• pathologies of the endocrine glands;
• , preeclampsia;
• , alcohol intake, drug addiction (especially cocaine use).

In addition to these factors, the development of bleeding can be provoked by direct trauma to the abdomen, due to violence or an accident, fear, stress and rapid rupture of amniotic fluid during polyhydramnios. The woman's age also plays an important role. Women over 35 years of age experience bleeding more often during childbirth than younger women.

Why is bleeding during childbirth dangerous?

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

Bleeding itself is a secondary sign of a complication. 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 mother in labor. During such a course of labor, the child does not receive the required amount of oxygen and important elements. These children may subsequently develop certain health problems.

They are characterized by an extensive bleeding surface, with blood coming 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 expectant mother’s body is preparing for the upcoming birth, which involves a certain amount of blood loss. A pregnant woman's blood volume increases every month, which is primarily necessary to meet the needs of the growing fetus, and then compensates for losses 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 suffered extragenital diseases, while proteins that form a blood clot in the vessels during bleeding are not found in their blood, and subsequently DIC syndrome develops. The situation is aggravated by metabolic changes that are associated with the main complication: rupture of the uterine wall, premature placental abruption or improper accretion. Bleeding can be stopped only when the primary complication is detected and corrected.

Obstetric hemorrhage can begin not only in the maternity hospital, but also at home. The decisive moment for saving the life of a woman with severe bleeding is the time for hospitalization. The main treatment for such conditions is intensive therapy and surgery.

How to avoid bleeding during childbirth?

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

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

Any signs of concern should also be reported promptly. You should not avoid prescribed tests and ultrasound examinations; they are safe and will help you recognize the problem in time, as well as predict the development of events. For example, placenta previa is determined before the 14th week of pregnancy using ultrasound diagnostics.

The doctor notifies the pregnant woman and her relatives about the danger of possible bleeding. To prevent significant blood loss during childbirth, blood pressure is constantly monitored during pregnancy, gestosis is treated, uterine tone is relieved, physical activity and sexual activity are excluded. To monitor changes in the position of the placenta, ultrasound is performed monthly.

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

Discharge that appears shortly before labor should not frighten a woman, since its presence is a normal physiological process, indicating that the moment of delivery is already quite close.

Most often, heavy discharge before childbirth begins to be observed from the 36th week, 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 whether they pose a danger to the baby.

Brown, pink and bloody shades

The entire period of gestation, the cervix is ​​closed by a mucous plug, which is necessary to protect the fetus from harmful microorganisms from the external environment. A few days before giving birth, 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 baby to pass through the birth canal, the cervix needs to get rid of the plug. As the discharge intensifies, the cervical cartilaginous tissue softens, contractions of the uterine muscles begin, under the influence of which the plug 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, some women, during the process of the mucus plug coming out, experience pink discharge before childbirth, and sometimes yellow discharge.

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

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

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

• conducting a gynecological examination;
• having sex on days when the plug is rejected;
• discharge of the mucus plug.

Examination by a gynecologist

Throughout pregnancy, the cervix is ​​elongated, firm and closed. When the body begins to prepare for childbirth, the cervix becomes shorter, softens and begins to open. To determine how the process is going, the obstetrician-gynecologist, at approximately 38–39 weeks, conducts a mandatory examination of the woman in the 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, discharge of this kind is characterized by an insignificant amount. They usually appear within 3–4 hours after examination and do not pose any danger to further pregnancy.

Sexual intercourse

You can have sex late in pregnancy. However, it should be borne in mind that the wrong position can harm the cervix. Against this background, after 1–2 days, a brown smudge 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;
• pregnancy is multiple;
• leakage of amniotic fluid is observed;
• bloody issues;
• cervical insufficiency.

Mucus plug

Brown discharge before childbirth often occurs due to the release of a mucus plug. Its rejection can occur at completely different times, for example, several weeks before labor or a couple of days. In some cases, an immediate release of the plug is observed, followed immediately (after 2–3 hours) by the first contractions.

Discharge when the plug comes out can be of different consistency and color: mucus streaked with blood, transparent discharge, pinkish, light and brown. The latter indicate that there is little time left before labor begins.

Copious white discharge

Throughout pregnancy, the baby actively moves, changing position and poses. This happens thanks to the amniotic fluid in which it floats inside the uterus. In addition to helping the baby make movements, they also protect him from various negative external influences, such as blows or pushes in the stomach.

The release of amniotic fluid is also a natural physiological process, indicating that the baby is ready to be born. Liquid pours out after the amniotic sac ruptures; usually this process occurs instantly, but there are cases when, due to incomplete rupture, water begins to leak.

During the normal process, amniotic fluid has no color or odor. It resembles ordinary water. Sometimes there may be a sweetish aroma and some white flakes, but this is quite normal. There is no need to worry about the presence of mucus, since it appears in the waters after they pass through the vagina.

Copious white discharge that resembles flakes may appear due to 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 still early before birth, then you need to consult a doctor to eliminate the leakage.

Pathology or mucus plug

During a normal pregnancy, before birth there should be no discharge other than the discharge of the mucus plug and the discharge 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.

You can determine that the discharge refers to the rejection of the mucus plug by the following signs:

• absence of acute pain in the lower abdomen;
• no smell;
• slight presence of blood streaks;
• The discharge has a mucous consistency.

The discharge of amniotic fluid cannot be confused with anything. They are watery, flow out immediately in large quantities (from 0.5 to 1.5 ml) and are transparent. We can talk about a pathological process if there is blood in the water, 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, pregnant women develop thrush shortly before giving birth, against the backdrop of anxiety. The disease intensifies just before delivery and is accompanied by severe itching, burning, especially during urination, curd-like discharge and a sour odor.
• Leakage of amniotic fluid. The process is accompanied by constantly wet underwear. You can determine leakage using the following test: perform 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 suspiciously colored discharge may 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 excretory processes begin. After all, it is difficult to figure out on your own 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 contact a gynecologist in case of bleeding. Blood before childbirth is especially dangerous if it is in large quantities and has a bright red color. If measures are not taken in a timely manner, heavy 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 may 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 begins to open and harmful microorganisms can easily enter the uterine cavity.

You should also consult a doctor if there is discharge accompanied by malaise or cramping pain in the lower abdomen. First of all, these symptoms may indicate the onset of labor.

The birth of a baby is a joyful event that you don’t want to overshadow with anxious thoughts. But knowledge about the complications that can accompany childbirth is necessary - first of all, in order not to get confused at a critical moment and to meet them fully armed. After all, the calmer a woman behaves, and the better she understands her condition, the greater the likelihood of a successful birth outcome for both mother and child. In this article we will talk about one of the most dangerous complications - bleeding. It can develop during childbirth, in the early postpartum period, and even in the last weeks of pregnancy. The onset of bleeding poses a serious danger to the health (and sometimes to the life) of the mother and the unborn child.

Causes of bleeding

Most often, the immediate cause of bleeding is problems related to the condition of the placenta. Predisposing factors for them are:

1. Chronic inflammatory diseases of the uterine mucosa (endometritis), especially untreated or undertreated.
2. “Old” injuries of the pelvic organs and scars on the uterus (regardless of their origin).
3. A large number of abortions, miscarriages and (or) childbirth in a woman’s life, especially if they were complicated by inflammation. (If we take all cases of placenta previa as 100%, then 75% of them occur in multiparous women and only 25% in primiparous women).
4. Hormonal disorders, endocrine diseases.
5. Uterine fibroids and other diseases of the internal genital organs.
6. Severe cardiovascular diseases, some kidney and liver diseases.
7. Injuries during pregnancy.
8. The woman is over 35 years old.

So what placental problems can cause bleeding?

1. Incorrect separation of a normally located placenta
   1. Premature abruption of a normally located placenta. Placental abruption can occur in various areas. If the placenta detaches from the edge, then blood flows out of the external genital tract. In other words, in this case there is external bleeding; in such a situation, pain in the lower abdomen is insignificant or absent altogether. Placental abruption can also occur in the middle, then blood accumulates between the placenta and the wall of the uterus and a hematoma is formed; in this case, the pain syndrome is more pronounced.

   Premature abruption of a normally located placenta is accompanied by signs of blood loss: heart rate increases, blood pressure decreases, and cold sweat appears. Since this sharply reduces the amount of blood flowing to the fetus, fetal hypoxia develops, so this situation can be life-threatening for both mother and child.

   Depending on the period of labor, the condition of the woman and the fetus, childbirth can be completed through the vaginal birth canal or by caesarean section.

   2. Difficulty in independent and timely separation of the placenta in the third stage of labor (tight attachment or accretion of the placenta - all or partly). Normally, after the baby is born, the placenta separates and is delivered. When the placenta separates, a large wound surface forms in the uterus, from which blood begins to ooze. This physiological (normal) bleeding stops very quickly due to contraction of the walls of the uterus and compression of the vessels located in them, from which, in fact, the blood flowed. If the process of placenta rejection is disrupted, then bleeding begins from the surface of the mucous membrane, which has already been freed from the placenta, and tightly attached fragments of the placenta do not allow the uterus to contract and compress the vessels. If a tight attachment of the placenta is suspected, a manual examination of the uterine cavity is performed. This is an operation that is performed under general anesthesia. If the placenta cannot be separated manually, it is said to be placenta accreta. In this case, an emergency hysterectomy is performed.
2. Incorrect placement of the placenta:
   1. when they partially or completely block the internal os of the cervix.
   2. Low location of the placenta when its edge is located closer than 5-6 cm from the internal os of the cervix.
   3. Cervical placenta previa- a rather rare location of the placenta, when, due to the slightly open internal os of the cervix, it can partially attach to the mucous membrane of the cervix.

With the onset of labor (if not earlier, even during pregnancy), the incorrect location of the placenta definitely develops into its premature detachment. This occurs due to more intense stretching of the lower (compared to the upper and middle segments) parts of the uterus as pregnancy progresses and their rapid contraction during dilatation of the cervix during childbirth. Complete and cervical placenta previa are more complex and severe complications. The lower parts of the uterus are less adapted by nature to fully provide the baby with everything necessary. The developing fetus suffers more from a lack of primarily oxygen and, naturally, nutrients. When the placenta is completely or cervically attached, bleeding can begin spontaneously in the second trimester of pregnancy and be extremely intense. It should be especially emphasized that with complete placenta previa there is no need to talk about independent childbirth at all, since the placenta tightly blocks the “exit”, i.e. cervix.

In this case, a planned caesarean section is performed at 38 weeks of pregnancy. If bleeding occurs, then it is carried out. In case of marginal placenta previa, full labor activity, light bleeding and good condition of the mother and the newborn child, it is possible to carry out delivery through the natural birth canal. However, the decision on the form of delivery always remains with the doctor. In rare forms of placenta previa, when it affects areas of the cervix, preference is given to cesarean section; Moreover, this situation may even result in the removal of the uterus, since this location of the placenta is PURELY combined with its ingrowth into the wall of the cervix.

Bleeding is accompanied by another, more rare complication - uterine rupture. This extremely serious condition can occur both during pregnancy and directly during childbirth.

Obstetricians specifically determine for themselves the time characteristics of the rupture (threatening, beginning and completed rupture) and its depth, i.e. how severe is the damage to the uterine wall (it can be a crack, an incomplete rupture, or the most dangerous - complete, when a through defect is formed in the uterine wall with penetration into the abdominal cavity). All these conditions are accompanied by varying degrees of severe bleeding and severe pain that does not stop between contractions. The contractions themselves become convulsive or, conversely, weaken; The shape of the abdomen changes, signs of child hypoxia increase, and the fetal heartbeat changes. At the moment of complete rupture of the uterus, the pain sharply intensifies, becoming “dagger-like,” but the contractions stop completely. A false impression of decreased bleeding may appear, since the blood no longer flows out as much as it enters the abdominal cavity through the rupture. The abdominal deformity remains, the child can no longer be felt in the uterus, but next to it, and there is no heartbeat. This is a critical condition: only immediate surgery and resuscitation measures can save the mother and baby (if he is still alive). The operation usually ends with the removal of the uterus, since the torn, thinned, blood-soaked walls of the uterus are almost impossible to sew up.

The risk group for the probable occurrence of uterine rupture includes:

1. Pregnant women with an existing scar on the uterus (regardless of its origin: trauma, cesarean section, removed, etc.). It should be noted that modern cesarean section techniques are aimed at minimizing the risk of the above-described complications during repeated pregnancies. For this, a special technique is used to cut the body of the uterus (transverse, in the lower segment), which creates good conditions for subsequent wound healing and minimal blood loss in the event of a possible rupture during childbirth.
2. Multiparous women with complicated previous births.
3. Women who have had multiple abortions.
4. Women with complications after an abortion.
5. Patients with chronic endometritis.
6. Women in labor with a narrow pelvis.
7. Pregnant women with a large fetus.
8. Pregnant women with abnormal position of the fetus in the uterus
9. Women in labor with discoordinated labor (a condition when, instead of a simultaneous contraction during a contraction, each fragment of the uterus contracts in its own way).

If a woman knows that she belongs to one of these categories, she should warn her doctor at the antenatal clinic and the obstetricians at the maternity hospital about this.

Why is bleeding dangerous?

Why do obstetric hemorrhages remain so dangerous today, despite all the achievements of modern medicine, the development of resuscitation techniques and a fairly large arsenal of means to replenish blood loss?

Firstly, bleeding is always a secondary complication of an existing obstetric problem. In addition, it very quickly becomes massive, that is, in a relatively short period of time the woman loses a large volume of blood. This, in turn, is explained by the intensity of uterine blood flow, which is necessary for normal fetal development, the vastness of the bleeding surface. What can be more successfully turned off by hand when the valve is broken: a single stream of water from a tap or a fan shower? Approximately the same can be said about bleeding, for example, from a damaged artery in the arm and bleeding during childbirth. After all, this is precisely the situation in which doctors find themselves trying to save a woman in labor, when blood is gushing from a large number of small damaged vessels of the uterus.

Of course, the body of a pregnant woman “is preparing for a normal small loss of blood during childbirth. The volume of blood increases (although this primarily meets the needs of the developing fetus, which needs more and more nutrition every day). The coagulation system is put on alert." the blood system, and when bleeding occurs, all its forces, without exception, “rush into battle.” At the same time, the increased coagulation ability of the blood develops into complete exhaustion - coagulopathy; there are no elements (special proteins) left in the blood that can form a blood clot and “close the hole.” The so-called DIC syndrome develops. All this is aggravated by severe metabolic disorders due to the main obstetric complication (uterine rupture, premature or tight attachment, etc.), and until this primary complication is corrected, it is unlikely to cope with the bleeding. A woman’s strength is often exhausted due to pain and physical stress.

Features of labor management

If bleeding occurs during childbirth, work is carried out in several directions simultaneously. The anesthesiologist begins infusion of special blood replacement solutions and blood products through large veins. Thanks to this, substances and proteins responsible for blood clotting enter the bloodstream. To improve blood clotting, fresh frozen plasma is started to be infused, then, depending on the volume of blood loss, red blood cells are poured into another vein, sometimes these blood products are injected in parallel into different vessels. The patient is also given hemostatic drugs and painkillers. Obstetricians determine the cause of bleeding and the type of surgery to be performed.

To maintain normal oxygen supply to tissues, inhalation of humidified oxygen through a mask is used.

The patient is connected to a monitor that constantly monitors her blood pressure, heart rate, blood oxygen saturation (saturation) and continuously takes an ECG. Simultaneously with the above measures, the patient is quickly put under anesthesia for further surgical treatment and the woman is transferred to artificial ventilation with a breathing apparatus. Practice has proven that blood transfusions in patients under anesthesia are safer than in conscious patients.

Of course, transfusion of blood and solutions will be successful only when the initial complication that caused the bleeding is eliminated. Therefore, the task of obstetricians is to identify this complication and determine a plan for treatment procedures, be it manual examination of the uterus, emergency caesarean section, removal of the uterus, etc.

After the bleeding has stopped, the woman is transferred to the intensive care ward of the maternity hospital or to a specialized intensive care unit of the hospital under the constant supervision of medical personnel.

Remember that bleeding in pregnant women can occur not only during childbirth in a hospital, but also at home. When obstetric hemorrhage occurs, time becomes decisive, and in the case of childbirth outside the hospital, it, alas, works against us. Therefore, when planning a trip somewhere in the last weeks of pregnancy or, calculate in advance how long it will take you to end up in the hospital. Remember that with obstetric hemorrhage a condition occurs very quickly when, despite intensive therapy and external clamping of the abdominal aorta (and this is very difficult to do in pregnant women), the ambulance team and even the medical helicopter team may not be able to transport the patient to hospital is alive, since the main method of treatment against the background of intensive care remains surgery.

Is it possible to avoid bleeding?

The risk of bleeding can be significantly reduced with regular monitoring by a doctor at the antenatal clinic. If you have had injuries to the pelvic organs, tell your doctor about it; if anything worries you about the “female” organs, be sure to notify your doctor; if you are sick, be cured to the end. You should not avoid ultrasound: it will not cause harm, but will help the doctor identify the problem in time. Try to fight unwanted pregnancies not with abortions, but with more “peaceful” means: this will save you from big troubles in the future. And don’t decide to have a home birth.

Dmitry Ivanchin,
anesthesiologist-resuscitator,
senior doctor of the surgical department
Emergency Medical Center
Moscow Health Committee

05.08.2007 19:53:02, Natasha

I gave birth at 23 years old, the pregnancy was without complications, everything was fine, the birth took place in 6 hours. 20 m., boy 4560, without breaks. And then the bleeding started, there was a manual examination, I lost 800 ml. I am diagnosed with varicose veins of the lower cone. and pelvic organs. In the end, everything was fine, the uterus contracted well, the very next day it was 11 weeks, although hemoglobin was 73, but nothing. I have a question: what is the probability that there will be no bleeding during the second birth, how to avoid it?

08/26/2006 13:28:12, Maria

I'm 10 weeks pregnant. A couple of days ago, spotting of a dark brown color (brown) began, two days later the color changed to scarlet, I am in conservancy, the doctors say that there is a real threat of miscarriage. Why? After all, there is no pain in the lower abdomen or other discomfort! All tests show that the body is healthy and it has enough! An ultrasound showed hypertonicity of the uterine wall, although the fetus is healthy and feels normal. Tell me how serious this is, what to count on, and what could it even be?

06/23/2005 10:38:52, Oksana

Question to the author. Dmitry, please answer here or, even better, to my mailbox [email protected]
First pregnancy at 29 years old (mild), the condition is without pathologies, I do not belong to a risk group. Full-term birth at the Center for Births and Rehabilitation in August 2002. Bleeding, manual separation of part of the child's place under general anesthesia. For six months I had health problems, weakness, stitches did not heal, in general, a nightmare. How likely is it that the second pregnancy will end in such a birth? Would it be better, given your age - 32 years and a problematic first birth, to plan a cesarean section in the future to avoid complications? I really don't want to take risks. And I’m scared to give birth, but I want a second child.

There was bleeding and manual separation. Pavda was not in any intensive care unit; on the second day the baby was brought in (mother and child ward). One thing is not clear. How to plan for a second child? Will there be similar complications a second time? Judging by the article, most likely they will. But then what about the talk that the second birth is easier than the first?

Why scare people? It’s really very scary.

Discharge during the prenatal period is not always a bad sign. Most often, this is a natural and understandable phenomenon, so there is no need to rush to the hospital immediately and worry. Each stage of pregnancy has its own type: from mucous to amniotic fluid. Most often, normal discharge tells the expectant mother that the long-awaited baby will be born very soon. But few people know which ones are normal and which ones signal health problems.

According to statistics, the following discharge appears before childbirth:

• habitual mucous membranes;
• amniotic fluid;
• discharge after the plug comes out;
• curdled white discharge before childbirth;
• yellow, purulent with an unpleasant odor;
• bloody (for example, pinkish or brown discharge before childbirth).

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

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

Normal discharge

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

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

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

During contractions or immediately before them, water pours out. This 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 a transparent stream flowing out of her;
• gradual “smudges” during the day.

Mucus plug

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

Pathological discharge

Other discharges that 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, cheesy consistency (while the pregnant woman experiences constant itching in the perineum);
• yellow mucus;
• green slime.

Important! Pink discharge before childbirth is not always considered bloody; if there are a few drops of blood in the discharge, this is a variant of the norm when capillaries in the reproductive organ burst when the mucus plug is released. 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 discharges that are bloody or have an unpleasant odor.

The first option is practically not dangerous; it may be associated with a trip to the gynecologist, where the woman was examined in a gynecological chair. In addition, the mucus turns 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 mother and her unborn child. If a woman notices blood from the vagina, she should immediately call an ambulance or get to the hospital herself as soon as possible.

The opaque color of leaking water, as well as its unpleasant odor, indicates that the fetus is experiencing hypoxia, that is, a lack of oxygen. If there is no smell, then there is a possibility that the baby has emptied in the womb.

The main sign of thrush is itching and light discharge, similar to cottage cheese. 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.

Any yellow discharge is a symptom of sexually transmitted infections. A woman should urgently consult a doctor so that he can prescribe an examination, make a diagnosis and begin timely treatment. Otherwise, the child may also become infected through the birth canal.

Thrush discharge looks like cottage cheese

Reasons for appearance

Brown discharge before childbirth at the 38th week of pregnancy after a full examination by a gynecologist of the woman in labor is not dangerous and is due to the fact that the cervix has already fully matured, softened and become ready for delivery. Droplets of blood appear in the discharge a couple of hours after ingestion.

A woman may feel the release of the mucus plug, which was already mentioned above, or may not notice it at all. The mucus may also be a little pink, this has nothing to do with the risk of miscarriage.

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 is an excess of such things in the body. Vitamin intake should be reduced or eliminated altogether.

The color of the discharge can indicate a woman's health

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

What discharge indicates the onset of labor?

It is the discharge that is the first harbinger of labor, which appears even before contractions. What discharge before labor signals the onset of labor?

1. A clot of mucus or partial profuse discharge of a mucus plug. In this case, labor can begin in a couple of hours, or in a few days, but not later than in a week. The passage of the plug occurs when the cervix is ​​completely ready for the birth of the baby.
2. Watery discharge, clear and odorless, slightly mixed with non-colored mucus. This happens just before contractions begin or even during them. Sometimes the bubble does not burst on its own, then it is punctured by a doctor in the maternity ward, when it becomes clear that the contractions are regular and not training. If the water is leaking, and there have been no contractions for a long time, you need to urgently go to the maternity hospital, otherwise the baby will begin to lack oxygen. If this happens, the liquid will be green or yellow in color.

A drooping belly is a sign of imminent labor

We can say with confidence that labor begins:

• drooping tummy;
• a feeling of increasing pressure in the lower abdomen, as if something were pressing on the intestines with great force;
• stopping weight gain;
• changes in mood;
• the appearance of frequent and painful spasms;
• bowel movement.

Does not indicate the onset of labor:

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

Important! By the 38th week, a woman should have her bags ready for the maternity hospital. If a woman doubts whether labor has begun or not, it is better to still get to the hospital; this is better than later giving birth at home or on the way to the maternity 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 experience severe pain in the back and lower back, consult a doctor immediately

If a woman in labor notices yellow or curdled discharge on her panties before giving birth at 8-9 months, you should not call an ambulance, nor should you treat yourself (especially with traditional medicine, which causes an allergic reaction in the fetus), it is enough to visit a doctor as soon as possible . If this is not done, a possible infection will complicate childbirth and be transmitted to the baby either after the mucus plug comes out or during delivery.

Discharge before childbirth always tells a woman what processes are occurring in the body at a specific period of time. Is pathology developing or do you need to pack your bags for the maternity hospital? Do you need to call an ambulance to save the life of yourself and your child, or can you simply make an appointment with a doctor in the near future, who will prescribe treatment if necessary and tell you in more detail what is happening in the body.

The most dangerous are the bloody and green watery ones, since they directly indicate a problem that is occurring at that moment. Only transparent or light odorless ones are considered normal; they are harbingers of labor.