Third Trimester Bleeding

15 Replies
Newt - November 1

I posted this in the pregnancy complications forum. I hope it's okat to post here too. For the last two and a half weeks I have had four episodes of bleeding. Not just spotting but full blown bleeding. The bleeding, which is red, stops shortly after it starts and soaks a pad. I've gone to the hospital each time, and each time the baby has been fine. I've seen multiple Dr's and they can't say for sure what is causing it. One Dr. suggested that I might have a gradual tearing away of the placenta from the uterine wall, but not enough for concern because the baby is doing well. I am 34 weeks pregnant. This is a first pregnancy and I am 41 years old. I do not have Placenta Previa. I have no pain or cramping. Has this happened to anyone? I am really stressed over this. The Dr. has me on bed rest.

 

Tory1980 - November 2

If it is an abruption like one Doctor has suggested you need to be in the hospital as things could change rapidly (abruption usually gives some sort of pain though with a distended tender abdomen). If the placenta comes away from the wall and you don't make it to the hospital in time you could lose your little one and it is dangerous for yourself also. Bed rest won't stop it and you need to be monitored closely. Did anyone mention whether the placenta was low lying (different from previa). If so that could be why you are bleeding but red signifys new blood from somewhere and it can either be from somewhere inside the uterus or placenta or from the baby. Please don't take this the wrong way but at your age and the fact you are so far in the pregnancy I really think you should be in the hospital under a close watchful eye. Good luck and I hope you and baby are just fine!

 

Newt - November 2

Tory- I was thinking that too. What if it is an abruption and it totally tears away and I don't make it in time? I have expressed that to my Dr. She says the fact that I don't have any pain or tenderness is a sign that if it is a pulling a way - it's a minor one. But I am stil really concerned. Can I make them keep me in the hospital? I am so worried, I don't know what to do. I don't have a low lying placenta either. I am trying to trust the Dr.'s , who are high risk specialists, but I am so scared. This is my first and probably my only pregnancy. They do have me coming in twice a week now for monitoring, but is that enough? Should I insist they admit me?

 

Buffi R. - November 2

Can they tell if the bleeding is coming from the inside of your cervix or the outside? The reason I ask is because I have a condition called a "friable cervix" meaning that it's prone to bleeding. During my current pregnancy, things like intercourse (not even agressive, just normal), cervical exams, etc. can cause me to bleed very easily, and it always comes from the outside of my cervix, which my doctor said is OK. Other than the stress and extra insurance claims it causes each time (because of monitoring at the hospital), apparently it should have no affect on the baby. However, I also have a history of placental abruption, where I delivered my first at 32 weeks because of it. That same week I also developed a v____al bacterial infection that went undiagnosed for a week so the uterus had plenty of time to get irritated from the infection before I was treated. The placental abruption wasn't diagnosed until after the delivery because I had no signs of it, and they only figured it out after the placenta was delivered with a blood clot attached to it. They said it was a "marginal abruption" meaning "not very bad" so we don't know what caused my labor more - the abruption, infection, or combination of the two. I was even allowed to labor with the abruption (actually they tried to stop it for several hours until that proved unsuccessful), but I know my baby was being monitored for fetal distress and if they had detected that, they would have done an emergency c-section. But dispite all the monitoring, he did have some major problems after the birth that the doctors attributed to oxygen deprivation (which is a common side effect of abruptions), so you never know. I don't know if I answered your question at all, but that's been my experience with bleeding & placental abruptions. Hope that gives you some things to consider and questions to raise with your doctor.

 

Newt - November 2

Buffi - If you odn't mind me asking - what kind of problems did the baby have after the birth. Were the problems permanent? After I posted and received Tory's response, I talked to my Dr. about my concerns about not getting to the hospital on time. They gave me the option of being admitted. I think I am going to take that option. The potential plan is for me to go into the hospital for about a week in a half. They would do an amnio to check for lung maturity and if the baby's lungs are mature then they would see if they could deliver the baby then - probably through a c-section. Do you all think that this is a good idea or not? Also, Buffi, even though they were monitoring the baby they couldn't tell that the baby wasn't getting enough oxygen? I ask because I've had many non-stress tests and BPP tests and each time they tell me the baby is fine. Can they really tell?

 

Buffi R. - November 4

Well, it's kind of a long, scary story, but I'd be happy to tell you, especially if it helps in your situation. About your question on the fetal monitoring, during the delivery, I was in la-la land on Nubain (IV pain medication) and it was my first baby, so I was pretty unaware of what was going on around me. I didn't know that much about monitoring at the time, so all I can do is a__sume they were watching that well, and that they would have taken him by c-section if they detected fetal distress. With the level of abruption I had (a small one), it's very possible that he wasn't affected by it, and like I said, the infection I had might have even been the bigger culprit that put me into labor, so I don't even know if he could have been under distress. Anyway, back to the complications.....he was fairly healthy for about a week. Right after the birth, it took several minutes for him to cry, and he had low apgar scores, but I think that's normal for how early he was. Also the Nubain I was on probably made him lethargic too, God knows it konked me out. He was under an oxygen hood for the first night, then was breathing room air on his own. He had a couple bouts of jaundice that first week and had a little trouble maintaining his body temp, but again, fairly normal for his gestation. Things didn't get really serious until he was a week old when he suddenly developed a life-threatening intestinal infection called Necrotizing Enterocolitis. This is a complication of prematurity that usually affects younger gestation babies, so the doctors were surprised he developed it. Usually it's caused by a combination of three things....(1) the prematurity (causing a weak immune system), (2) oxygen loss in utero or during the birth (causing the more vital organs like the heart and brain to rob the less vital organs like the intestines of oxygen, weakening those organs) and (3) the natural bacteria that floats around in the intestines that overcome the weak intestines and flares up in a major infection. That's why it's possible his infection was caused by the placental abruption, and it does make me wonder if he had some distress that wasn't detected, but I try not to think about it. What's life-threatening about this is some babies who develop this suffer so much damage to the intestines that they can't survive. Also, blood poisoning can result (my son had this too) and that can cause all other kinds of problems. My son ended up spending the next 11 weeks in a major city NICU, three hours from our home town. He had three separate surgeries on his intestines to remove the damaged sections, had an ostomy for 6 weeks (where he pooped into a bag through his belly while parts of his intestines healed) and in total he lost 5% of his small intestine and 25% of his large. Fortunately, he doesn't have any lasting problems from this like short bowel syndrome or anything other than a scar on his belly. He poops and absorbs food just fine, so he's considered completely recovered from the infection. But then when he was 17 months old, we had a major set back when he was diagnosed with a profound hearing impairment. We don't know exactly what caused that, but the two main theories are either the antibiotic he was on for the intestinal infection, or again, it could have been a late-appearing complication of oxygen deprivation. That condition is perminant, and we went through a couple years of hell getting him fit with hearing aids, going through a cochlear implant surgery (which turned out to be a God-send), and teaching him how to speak and listen with his equipment. He's five years old now, and communicates just like any other kid. If you couldn't see his cochlear implant and hearing aid, you'd never know he was hearing impaired. So that wasn't fun either, but he's doing well with that too. Can you see why we waited four years to have a second baby?? :-) Please let me know if you have any other questions. I'm happy to share whatever info I can.

 

Newt - November 5

Buffi - Thank you so much for sharing your story. If I ask anything too personal please let me know. The reason why I have so many questions is because I'm not sure what to do. I don't know if I should have the amnio to test for lung maturity and if the lungs are mature, let the baby be delivered early - or just wait, despite my bleeding episodes, and see if the baby comes out okay without being delivered early. I know you mentioned some of the physical challenges your little one faced. Were there any issues with your baby's mental development?

 

Buffi R. - November 5

No, he's as sharp as a tack. Extremely intelligent, almost too smart for us some days! :-) If he had any mental effects at all, I'd say it's more behavior related. He's very "busy", not clinically diagnosed as hyperactive, but sometimes I think he is. Right before his hearing impairment was diagnosed, he was officially diagnosed by an Occupational Therapist as having a condition called "Sensory Integration Dysfunction". This is a broad-spectrum term used for babies who don't quite fit the mold, and fall somewhere between full-b__wn autistic where they're highly sensitive and shield themselves from the world, and full-b__wn hyperactive where they crave sensory information. He was more on the "craving sensory information" side because he was always loud, banging things, would stuff his mouth too full of food, highly social, etc. But right before he was going to start occupational therapy (OT) to help correct the problem behaviors, his hearing impairment got diagnosed. Then we all went, "Oh....that's why he's acting that way. He can't hear, so he's compensating for that lack of sensory input." Instead of starting OT, we switched gears to speach & listening therapy, started the hearing aids, etc. and never went back to OT. His behavior did improve a lot once he started hearing more and communicating, but now that he's five, I still think he's a little more rambunctious than normal. His speach therapist told us that could just be his personality, and his teachers at school and pediatrician don't think he's out of ordinary either, but they agree he's "busy". Sometimes I think I just expect too much out of him, and wish he was calmer for my own sanity, like I want him to be a Stepford Child. :-) There's a possibility some of his behaviors could simply be from the prematurity, or it could also be left-overs from the hearing impairment, oxygen issues (he was also on a ventilator for 10 days when he first got sick, which could have caused more oxygen problems than the placental abruption did), or the fact that he was in a NICU for three months missing out on some bonding with us.....it's impossible to say. I would recommend that you let the doctors watch you and the baby as closely as possible right now, and if they start to detect fetal distress in-utero, then a c-section would be warranted. The steriod shot for lung maturity has a peak effectiveness around 48-72 hours after administering it, and you don't want to have more than one because of stress it can cause for the baby, so that's another thing to time carefully. It's a very fine line to walk, and I wish you all the best with the decisions you have ahead of you. Trust your doctors and your own instincts too, and hopefully they won't conflict. :-)

 

tish212 - November 5

ok I'm sorry to post here being I have no experience with this (but I would say better safe then sorry go to the hospital) but I wanted to address buffi....first off u r one strong woman to be able to deal with all of that and still be together...u truly r an inspiration! I'm glad ur son is doing well now...I can't imagine the fear.... I'm still pregnant with my first and having nonstop nightmares about evrything.... I just wanted to say.... I admire ur strength... and ur story also adds to my belief that God doesn't give us more then we can handle...bless u and ur family....and newt...please go to the hospital.... in my opinion it sounds like ur dr has no idea what's going on...(no offense to ur dr but u have no answer) and that would worry me.... since the dr gave u the hospital option I would take it....gl and keep us updated bless u and ur lo...

 

Buffi R. - November 5

I just read Tish's reply (by the way, thank you for the very nice comments....) and I agree, you should probably go to the hospital for additional testing and monitoring there. In all my replies, I forgot that you were trying to decide about being admitted or not. Your doctor would still probably oversee your treatment there, but maybe if things get too harried, they could even refer you to a more high-risk doctor with more experience in this area if necessary. And yes, if you are having an abruption, constant monitoring is a good idea so they don't miss something. With my current pregnancy being so high risk because of my history, I get weekly biophysical profiles (combination ultrasound & NST's) to check the baby's behavior and stress level (so far, so good), and I forget that not everyone is even monitored that often when they're still being treated from home. Please keep us posted on how you're doing...hopefully you'll have internet access at the hospital. :-) Also, Tish reminded me of a good phrase I read recently about dealing with tough situations. I actually used to get annoyed with that saying about how God doesn't give us more than we can handle, because I thought that's not a very good reward for being able to handle things well. But just a couple months ago, I saw a sign in my OB's office that says something like, "God doesn't give you what you can handle, he gives you the strength to handle what you get." I like that much better. :-) :-)

 

Newt - November 5

I spoke to my Dr. I am going to let myself be admitted on Wednesday. I do go to a high risk pregnancy office. What I am trying to decide is - if the baby's lungs are mature at 36 weeks - should I let them deliver the baby? It would mean that the baby is 4 to five weeks early. Or - option 2- since I am going to be in the hospital anyway, should I not let them induce or c-section me even if the baby's lungs are mature and just stay until the baby decides to come on his own and just keep being monitored? If the baby's lungs are mature does that mean the rest of him is fully developed? My fear is that if I the baby's lungs are mature and I don't let them deliver the baby and I start bleeding again, I might lose the baby. I don't know what to do. Please give input.

 

Newt - November 5

Also, I forgot to mention that rigt now they have me coming in twice a week for the NST and BPP.

 

Buffi R. - November 5

That's the magic question......should you let them deliver you early or not. This whole pregnancy I've been worried I'd have to make the same decision some day. Last time no one knew what was going on until after I delivered, and my body made the decision for me by going into labor overdrive. This time since we've been watching for repeat abruptions, I knew I might have to decide that some day too. Considering how you'll be 36 weeks by then, if I had to say one way or the other, I would say to let them deliver you. That's a lot further along than I was (32 weeks) and four weeks makes a huge difference in development of the whole baby. Our pediatrician said if we even carry this baby to 35 weeks we'll have a much different birth experience (for the better) than we had before. From what I've learned about placental abruptions since I had mine (and believe me, I've read a lot) they can be very hard to diagnose sometimes. Only about 20% of all abruptions can be seen on an ultrasound, so you can't always rule them out that way. Also, you've already had pretty excessive bleeding, but even no bleeding can sometimes happen with an abruption. In my case, all my bleeding was internal and after my son was delivered, a big gush of blood came out after him. Apparently it was trapped between my uterus and belly, pooling there. Some other signs of abruption I never had were excessive thirst, soreness of the belly, and a contraction that doesn't go away (meaning it doesn't peak and then go back down, it just peaks and stays there). Maybe in my case, my abruption was so mild that it was normal I didn't have these symptoms, but obviously something happened at some point to put me into such a strong labor that no amount of anti-labor drugs would stop it. (infection? abruption? both? we'll never know) But even if your abruption is mild like mine was, it could easily get worse quickly (maybe that's what happened to me too), and if it were me, I wouldn't want to risk having the baby be in distress even for five minutes. Especially at 36 weeks if the lungs are mature, which most likely means the rest of the baby is mature too. I have a friend who delivered unexpectedly at 36 weeks with no chance to get a steriod shot or anything like that. She delivered by c-section and he came home with her after her 4-day recovery. He's been the picture of health from the beginning. I can't remember if you said if you already had a steriod shot or not, but depending on when you plan the delivery, you might be able to at least get 24 hours in after the shot, or even better 48 hours. I got the shot all of five hours before my son was born, and it had no time to work, but in your case you could definitely time this better. If you even need the shot (a__suming the amnio shows that the lungs aren't mature yet), waiting a couple more days to give the shot time to work would probably be fine, I just wouldn't recommend waiting another four weeks to deliver or waiting until you go into labor on your own. Depending on what puts you into labor naturally (like if the abruption gets worse), that could be really bad for you and the baby. If it were me, I'd get admitted like you said, then start testing for lung development and plan a delivery date sooner than later. If you were only like 30 or 32 weeks along, I'd say to wait much longer.

 

tish212 - November 5

I would let them deliver....the reason I say that is because about 30 to 40 years ago...they figured 36 weeks was the length of pregnancy...not 40 weeks... if ur lo's lungs show mature then that shows that ur baby will be capable of breathing on its own....with the bleeding I would feel safer having the baby outside...just incase....its ur choice but if I were in ur positon I would.

 

tish212 - November 5

also...buffi I know its like cliché to say it...but I lie by that...cuz times do get tough.... and that helps me realize I will see the light at the end...but I love that saying too....thank for sharing it! and ur very welcome....

 

tish212 - November 5

ok try again "I live by that saying" not lie by it lol stupid keyboard....

 

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