Possible causes in the II-III trimester:
- An incompetent cervix (premature opening of the cervix, which can lead to premature birth);
- Miscarriage (before the 20th week) or intrauterine death of the fetus;
- Features of placenta previa;
- Placental abruption;
- Premature birth (especially if bleeding is accompanied by spasms, dull back pain, or pelvic pressure);
- Pathological conditions of the cervix, such as an infectious process, inflammation or neoplasms on the cervix;
- Ruptured uterus.
Diagnosis of bleeding in the II and III trimesters of pregnancy
History and physical examination
The anamnesis includes a large number of childbirth, abortions, post-abortion and postpartum septic diseases, uterine fibroids, deformation of the uterine cavity, advanced age of primiparous, pregnancy as a result of ovulation stimulation, in vitro fertilization.
An examination of the cervix with vaginal speculum and a vaginal examination should be performed. When viewed in the mirrors, bleeding with scarlet blood from the cervical canal is found. During a vaginal examination, behind the internal pharynx, placental tissue and rough membranes are determined. If ultrasound data is available, vaginal examination should not be performed.
Treatment for bleeding during pregnancy also depends on the cause of the symptom. If there are no pathological changes or the manifestation is provoked by damage to the polyp, medical attention is not required. In rare cases, the doctor recommends its removal. Expectant tactics are also used in the case of cervical erosion. Its moxibustion is carried out after childbirth. Bleeding during pregnancy against the background of the threat of miscarriage and placenta previa requires immediate hospitalization in an obstetric hospital, followed by the appointment of drug treatment. To reduce the uterine tone, sedatives and tocolytics are used. At the same time, pregnancy management requires close supervision by a specialist.