VAGINAL BLEEDING: SECOND AND THIRD TRIMESTER
PROBLEM
Vaginal bleeding may occur during the second and third trimesters of pregnancy (more than 12 weeks). The bleeding may range from spotting of blood on your panties to bleeding like a menstrual period.
CAUSE
A small amount of bloody mucous discharge or spotting may occur for about 1 day following a pelvic examination or sexual intercourse. This is normal if it is not associated with cramping or contractions.
Other causes of vaginal bleeding may be related to the location of the placenta (placenta previa) or premature separation (abruption) of the placenta from your womb. Placental abruption can be associated with cocaine use, cigarette smoking, and trauma (injuries from car wrecks or physical violence).
PREVENTION
There is no known way to prevent most types of vaginal bleeding. If you have been diagnosed by ultrasound with placenta previa, you may be able to prevent bleeding by avoiding sexual intercourse and limiting your physical activity.
There is no known method of preventing placenta previa. Smoking has been associated with placental abruption and placenta previa. You should not smoke or at least you should try to cut down and stop smoking during pregnancy. When you stop smoking, it is also good for your baby’s health after delivery.
TREATMENT PLAN
A.Treatment depends on the cause of your vaginal bleeding. You may be placed on limited physical activity.
B.Stop smoking. Ask your provider for a handout on tips to stop smoking.
C.You may need to modify your activity to avoid moderate or strenuous exercise, heavy lifting (greater than 20 pounds), or standing for prolonged periods (greater than 4 hours).
D.You may need to stop work.
E.You may need to arrange help for child care, grocery shopping, and housework.
Diet: Eat fresh vegetables, fruits, and bran cereal to avoid becoming constipated. Drinking extra liquids (especially water) also helps to prevent constipation.
Medications: Continue taking your prenatal vitamins every day.
EMERGENT ISSUES/INSTRUCTIONS
Go to the emergency room/call 911 for:
A.1.Bleeding like a period.
2.A gush of fluid or blood from your vagina.
3.Sharp, knifelike pain in your abdomen that does not go away.
You Need to Notify the Office If You Have:
A.Contractions or cramps, eight in 1 hour or four in 20 minutes.
B.Bloody, mucous discharge not associated with recent sexual intercourse or a pelvic examination.
C.Bright red or dark red vaginal spotting.
D.Pelvic pressure or low backache not relieved with emptying your bladder and resting on one side.
E.Noticed decreased movement of the baby.
F.Other: ___________________________________________________________
Phone: ____________________________
PATIENT TEACHING GUIDE