Vaginal bleeding. Blood from the vagina

Bleeding from the genitals can occur in both men and women, but the causes of these processes are different. Minor bleeding does not threaten the life and health of the patient, but should be the reason for a visit to the doctor. If the blood loss is significant, then emergency assistance is needed to stabilize the situation, replace blood loss, eliminate the cause of bleeding and further treatment.

Normal vaginal and uterine bleeding

In some cases, bleeding from the genitals is considered normal, physiological, and is not a cause for concern. Such bleeding includes:

Pathological bleeding from the genitals

Pathological uterine bleeding occurs as a result of improper functioning of the body. In this case, bleeding from the genital organs is caused not only by malfunctions of the reproductive system, but also by other organs. For example, uterine bleeding can be triggered by infectious diseases, blood diseases, liver problems, and high blood pressure.

Other bleeding is caused by reasons directly related to disturbances in the functioning of the genital organs. Such bleeding can primarily be caused by diseases of the uterus - endometritis, fibroids, endometriosis, benign and non-benign tumors, cervicitis, adenomyosis.

Bleeding with endometritis. Endometritis is called inflammation of the inner layer of the uterus, which occurs due to infection. Streptococci, staphylococci, gonococci, E. coli and other bacteria directly lead to the disease. They can enter as a result of abortions, gynecological manipulations, non-compliance with personal hygiene rules, and promiscuous sex life. The main symptom of endometritis is bleeding between menstrual cycles. In this case, along with the blood, signs characteristic of endometritis may come out. mucopurulent discharge. With the acute onset of the disease, the patient may feel pain in the lower abdomen and fever, but chronic, sluggish endometritis does not produce such symptoms.

The disease is diagnosed based on the patient’s complaints and a previous history of the disease. During a gynecological examination, the uterus is swollen and painful. To identify the cause of endometritis, diagnostic curettage and sent for histological analysis. Additionally carry out ultrasound diagnostics and hysteroscopy.

Bleeding due to uterine fibroids arise due to a decrease in uterine tone, a violation of its contractile abilities and the appearance of additional venous plexuses. They can appear both in the middle of the cycle and during menstruation, lengthening it by a couple of days. The blood released due to fibroids is dark in color, thick, and does not contain any impurities of pus. When myomatous nodes grow under the mucous membrane of the uterus, mucous with an unpleasant odor is added to the bloody discharge.

The diagnosis is established based on concomitant factors (lack of childbirth, long-term contraception, irregular sex life, previous inflammatory diseases of the uterus, etc.) and gynecological examination. During the examination, doctors note that the uterus has a lumpy structure, is denser to the touch, and is slightly increased in size. Upon palpation, myomatous nodes can be seen. Additionally, an ultrasound examination is performed to determine the type of fibroid, the degree of its growth into the uterine layers, and the presence of associated complications, both for the uterus and for other organs.

Bleeding with endometriosis. Research in different countries show that about eighty percent of patients suffer from bleeding with endometriosis. Endometriosis of the uterus occurs due to improper hormonal regulation of the natural process of endometrial shedding when pregnancy does not occur. An increase in estrogen levels and prolonged ovulation contribute to the proliferation of the endometrium, and sometimes hematogenous migration of endometrial cells into the fallopian tubes, muscle layer uterus

The classic symptom of endometriosis is prolonged menstruation and bleeding in the middle of the cycle. The severity of bleeding is individual in each case, but all cases are characterized by the duration of this process. As a rule, there is no pain during bleeding.

If bleeding due to endometriosis is too long, this can cause iron deficiency anemia, which causes signs of weakness, drowsiness, general malaise, and decreased performance.

Bleeding from uterine tumors are not specific sign this disease, therefore diagnosing tumors only on the basis of this sign is not correct. However, with cancerous formations in the uterus, symptoms of tumor germination and its disintegration appear later. Bleeding is accompanied by pain in the lower abdomen, pain after sexual intercourse, weight loss, and various types of vaginal discharge.

The bleeding itself from tumors varies in strength and duration. Blood can be present as streaks in mucous secretions, or it can be released for a long time and in large volumes. Diagnosis of the disease is carried out by a thorough examination of the genital organs and taking a biopsy.

Bleeding with cervicitis occurs due to both trauma to the inflamed cervix during sexual intercourse, and spontaneously during exacerbation of the inflammatory process. Most often, women notice such bleeding after intercourse; they are small in volume, contain mucus, or themselves appear as bloody streaks in the mucus. The discharge also contains pus coming out of the cervical canal. The disease is diagnosed based on the patient’s complaints and a gynecological examination, which clearly shows the inflammatory process in the cervix. Additionally, a colposcopy is performed and a smear from the cervical canal is taken.

Bleeding with adenomyosis caused by a disruption of the normal formation of tissues in the body. In particular, with adenomyosis, the endometrium begins to grow into the myometrium, which causes bleeding. Typically, bleeding occurs in the middle of the cycle, the volume of blood released is insignificant. Patients complain about painful sensations lower abdomen, pelvic pain, feeling of internal pressure. Diagnosis is made based on ultrasound examination and careful history taking.

The nature of bloody discharge as a sign of disease

Although bloody issues and so a clear symptom of dysfunction of the genital organs in a woman, they can be different in nature. Depending on the nature of the discharge, we can assume what disease caused the bleeding.

Abundant bright red discharge without any admixture of pus indicates high blood pressure, endometriosis;
Thick, dark-colored bloody discharge indicates uterine fibroids, polyps, and neoplasms in the uterine cavity;
Minor bleeding mixed with pus suggests cervicitis, endometritis;
Minor discharge without any admixture of pus may indicate adenomyosis, initial stage tumor germination.

It is important to remember that the above is a pure clinic of diseases, which is quite rare. Most often, other symptoms may be added to the discharge, confusing the doctor, so when assessing the discharge in a patient, you should not rely on classic manifestations, but always take into account what complications and accompanying illnesses can blur the clinic of true pathology. Sometimes this is difficult even for doctors, not to mention patients, so women do not need to become hysterical and suspect that they have late-stage cancer when dark discharge. Perhaps in this case there was a rupture of the venous vessels during the growth of fibroids, which is not a malignant neoplasm and can be successfully treated with hormonal drugs; it may not require surgical intervention provided that tumor growth is stopped.

Causes of bleeding during pregnancy

The onset of pregnancy significantly changes the functioning of a woman’s body. Now it has new functions, but also new threats - sudden bleeding. Discharge of blood from the genital organs during pregnancy most often occurs in the first or third trimester, which is associated with the greatest changes in a woman’s body - preparation for bearing a child and preparation for childbirth. Bleeding at any of these stages can pose a threat to pregnancy.

In the first trimester of pregnancy bleeding can be caused by:

threat of miscarriage if before pregnancy the woman had genital tract infections, chronic and acute inflammatory diseases of the uterus. Such bleeding can also occur due to taking certain medications, too much physical activity, or injury to the lower abdomen;
complete miscarriage, when the embryo is no longer capable of further development and separated from the uterine cavity;
incomplete miscarriage, when the embryo has died, but, nevertheless, is still in the uterine cavity. Its further expulsion is inevitable, therefore such a pregnancy is not preserved, but the uterine cavity is curetted;
a frozen pregnancy, as a result of which the fetus does not develop, but the mother’s body is still able to provide for its vital functions. After the fruit freezes, female body receives a signal about it as a foreign body, and after some time it is spontaneously expelled from the uterine cavity. In some cases, doctors may insist on using abortion medications or curettage of the uterine cavity;
ectopic pregnancy - the attachment of the fetus not in the uterine cavity leads to further problems, for example, rupture of the fallopian tubes may occur and severe bleeding from the genitals may occur. In this case, both the fallopian tube and the fertilized egg are removed; provided the second tube is healthy, pregnancy is possible in the future;
hydatidiform mole. Hydatidiform mole is the fertilization of a defective egg, as a result of which an embryo as such is not formed. However, chorionic villi grow in the form of bubbles, and the woman’s body reacts to this with symptoms of pregnancy - vomiting, nausea, and malaise. With hydatidiform mole profuse bleeding may occur at any time.

If bleeding in the early stages is more dangerous for the fetus than for the woman, then later periods endanger both the life of the fetus and the life of the mother. They may occur in the following cases:

Placenta previa causes painless bleeding in seventy percent of women with this diagnosis, and twenty percent of expectant mothers feel cramping pain in the lower abdomen. In another ten percent, the blood does not come out freely, but pours into the uterine cavity between its wall and the placenta;
placental abruption is a very rare occurrence, but the most severe for the fetus and mother. In this case, dark red blood comes out with clots, the uterus is in good shape, and the lower abdomen hurts as if it were contractions. In this case, the question of emergency surgery caesarean section;
An even more rare situation is bleeding from the umbilical cord or vessels located in the fetal membrane. A clear indicator of this pathology is an increase and then a slowdown in the fetal heartbeat, which indicates blood loss. In each case, the doctor makes an individual decision to continue the pregnancy.

Bleeding after childbirth

During the postpartum period, bleeding from the genitals is normal. They continue abundantly for another two hours after the baby is born, and then gradually decrease and take the form of menstruation. The duration of such bleeding varies, but no more than a month after the birth of the child. The discharge at first is bright red in color, and after ten days the blood is only mixed with the mucous discharge. After some time, clear mucus will be released from the vagina, and then the discharge will stop.

Pathological bleeding may occur if:

after childbirth, there are remains of the placenta in the uterine cavity (division anomalies, additional lobule);
there are disturbances in uterine contraction as a result of the birth of a large fetus, polyhydramnios, overweight women in labor, long labor;
injuries were diagnosed when the child passed through birth canal(uterine ruptures, vaginal ruptures);
the blood clotting process is disrupted.

After giving birth, for two hours, the woman is in the postpartum ward, where doctors monitor her. When the bleeding stops, the young mother and baby are transferred to a regular ward until discharge from the hospital. However, in difficult cases, bleeding can occur even with an apparently favorable end of labor. The reasons for such late bleeding are as follows:

placental polyp (remnants of the placenta that have not been removed);
development of endometritis;
pathologies in the blood clotting chain;
disturbances in uterine contractions.

If there is a sudden onset of bleeding and a rapid increase in the volume of blood released, it is necessary to urgently call ambulance and take the woman to a medical facility. Further actions determined depending on the cause of the bleeding. If it can be stopped, the patient is left under supervision for some time, and sometimes it becomes necessary to remove the uterus.

Bleeding after menopause

Menopause occurs in women at different ages; most often, menopausal manifestations make themselves felt after forty-five years. Normally, if there are no diseases of the genital organs, then menstruation stops by itself, becoming less and less in duration and less in volume. By some time they disappear completely.

However, during this period, a woman should be attentive to her health, since there is a certain risk of bleeding. Reasons why bleeding occurs after menopause:

atrophic vaginitis associated with estrogen deficiency. When the level of this hormone in the blood decreases, changes in the vaginal mucosa occur, making it more susceptible to infections and erosions. Discharge with atrophic vaginitis is scanty, brownish, as if at the end of the cycle;
Tumors (benign and malignant) can also cause bleeding. The average age of patients with this diagnosis is over 60 years, and half of them have malignant neoplasms bleeding from the genitals was observed;
changes in the endometrium, the appearance of vascular fragility, blood stagnation in the pelvic organs.

Menstrual bleeding

Menstrual bleeding accompanies every representative of the fair sex during childbearing age. Thus, the female body prepares to receive a fertilized egg. During the first two weeks of the cycle, a woman’s body actively produces estrogen, which is responsible for the growth of the endometrium and the growth of follicles. At the moment of ovulation, the egg leaves the follicles and moves along fallopian tubes, descending into the uterine cavity. It is here that she most often encounters sperm.

The fertilized egg tries to sink into the enlarged endometrium. If fertilization does not occur and the egg does not attach to the walls of the uterus, then it is excreted from the body in the blood. During menstruation, bleeding reaches approximately 80 ml, but this figure is individual and may vary. Along with the blood, the slightly overgrown inner layer of the uterus, which was preparing to receive the embryo, is also excreted. Endometrial detachment and spotting may be accompanied by pain, especially in the first days of menstruation.

This process is designed by nature in such a way that every month the uterus is renewed as much as possible to ensure the vital activity and safety of the new embryo.

What to do if there is heavy bleeding

If there is no uterine bleeding visible reasons, is not associated with menstruation, then if the amount of hemorrhage is insignificant, you can try to stop it yourself. To do this, you need to lie down in bed, put a pillow or cushion under your feet, and cold on your lower abdomen. After stopping the bleeding, a visit to the doctor is required to find out the cause of the hemorrhage. The doctor may prescribe vitamins, iron supplements, and hormonal contraceptives.

Vaginal blood that appears outside of menstruation should not go unnoticed. After all, most often the cause of its appearance is disease. And severe bleeding can even be life-threatening. Let's look at several common reasons why a woman bleeds from her vagina.

After love...

The fact that rudeness can provoke injuries to the vagina and cervix is understandable. It is also clear that such a phenomenon (the appearance of blood) is considered normal if this is the girl’s first experience. Bloody discharge after sexual intercourse occurs during loss of virginity. But if this happens to a woman who has been sexually active for a long time, then most likely she has problems with the cervix.

It could be a polyp, cyst, precancerous or even cancer. Unfortunately, diseases of the cervix are most often asymptomatic, and the woman herself cannot find out for herself what is happening inside her. That is why you need to visit a gynecologist at least once a year for an examination and cervical smear test.

If you have bleeding from your vagina after sex, more than once, for no reason, that is, it has nothing to do with menstruation, you need to visit a doctor. There are even special rooms for the prevention and treatment of cervical diseases. Don't delay!

Contraception is to blame

Many women choose as a method of contraception unwanted pregnancy hormonal pills. It's convenient, safe and effective. But this method of contraception has many disadvantages - the need to take pills strictly according to the schedule and side effects. Such phenomena include bleeding from the vagina. It shouldn't bother you if it smears a little. Usually after 3-4 months of taking the drug everything goes away. As a last resort, you can switch to tablets with a slightly higher concentration of hormones.

Intermenstrual bleeding can also occur if you miss a pill. If a woman simply forgot to take 1 or more tablets. Moreover, in such a situation pregnancy may well occur.

What we wrote earlier applies to regular contraception. But blood may also appear some time after taking the emergency contraceptive pill. This is a very common side effect.

The age is...

Girls often experience so-called juvenile bleeding in the first 2-3 years after their first menstruation. The reasons for this are manifold: physical activity, poor or vitamin-depleted nutrition, stress, hormonal imbalances, as well as gynecological and non-gynecological diseases. If such a situation arises, and even more so if blood clots appear from the vagina, you need to go to an appointment with a gynecologist. An examination will be carried out (for virgins through anus) and ultrasound of the genital organs. If necessary, the girl will be referred for consultation to other specialized specialists. Do not forget that bleeding, especially if it is heavy and/or prolonged, causes anemia and sometimes even threatens life.

Bleeding in an expectant mother

Blood from the vagina during pregnancy is a symptom of threatened miscarriage or placental abruption. This sign, even if only a few drops of blood are released, is a reason to urgently visit a doctor. Perhaps there is still something you can do and save the pregnancy.

On the other hand, a small amount of blood before labor may be normal if it is bloody streaks in the mucus plug that comes out of the cervix shortly before the baby is born. Also, a slight spotting may be normal if a gynecological examination was performed before childbirth. During this period, the cervix begins to dilate and can bleed easily when physically applied to it.

It's a disease

If a woman has bleeding from the vagina, but not menstruation, this may be a sign of adenomyosis and/or uterine fibroids. These are very common female gynecological diseases. And they are determined simply - using ultrasound and hysteroscopy.

Unfortunately, both diseases are incurable. More precisely, the only radical treatment is removal of the uterus or, in the case of fibroids, its removal. But the symptoms spontaneously begin to disappear during menopause, when the ovaries stop working, or during pregnancy, since both diseases are hormone-dependent. Until this point, if there are no contraindications, the woman can take oral contraceptives or replacement pills. hormone therapy. In most cases, this makes a woman’s life much easier. Pain and bleeding stop.

Bleeding may be caused by various gynecological problems.

diseases, pathology of pregnancy, childbirth and early postpartum

rioda. Bleeding from a woman’s genital tract occurs much less frequently

associated with injury or diseases of the blood system and other systems.

BLEEDING IN DISEASES OF THE GENITAL SYSTEM. In gynecological

patients bleeding may be associated with various functional and

organic diseases of the genital organs. There are cyclic and

acyclic bleeding. The former (menorrhagia) are characterized by cyclic

emerging bleeding from the genital tract, longer (more than

5-6 days) and more abundant (blood loss more than 50-100 ml) in contrast to

normal menstruation. Acyclic bleeding occurs between

menstruation (metrorrhagia). In case of severe disorders, it is impossible to detect a cyclic

personality bleeding, so patients lose their understanding of menstruation

cycle and inform the doctor about bleeding that occurs at the most inopportune

limited time. Such bleeding is also called metrorrhagia.

Bleeding such as menorrhagia occurs with endometritis, uterine fibroids,

endometriosis. With these diseases, the contractile mode changes -

uterus, which determines the intensification and prolongation of menstrual flow

bleeding. Menorrhagia occurs much less frequently in cancer of the body.

ki. Sometimes cyclic bleeding can be a symptom of diseases

other systems (Werlhof's disease, cardiovascular diseases, illness

no liver thyroid gland and etc.).

Symptoms Lengthening the period uterine bleeding and an increase in the number

quality of lost blood. As a result of recurrences of such bleeding,

develop posthemorrhagic anemia (see). Along with menorrhagia-noted-

There are also other symptoms inherent in a particular disease.

Diagnosis. In acute endometritis, the patient may have an increase in temperature

rature, pain in the lower abdomen. During vaginal examination in case of acute

the inflammatory process is found to be slightly enlarged and painful

uterus; Often the infection simultaneously affects the uterine appendages (salpi-

nogoophoritis). Chronic endometritis occurs without a temperature reaction

and is rarely accompanied pain symptom. For chronic endometritis

the uterus is slightly enlarged or normal sizes, dense, bare-

painful or weakly sensitive to palpation. Characteristics

the disease is associated with a complicated course of post-abortion (more often)

or postpartum (less often) period.

With multiple uterine fibroids, patients, in addition to menorrhagia, may complain

be based on pain (with necrosis of the node) or dysfunction of the urinary tract

zyra or rectum, if the growth of the nodes is directed towards these organs.

Submucosal (submucosal) mimoma of the uterus is accompanied not only by cyclic

ical, but also acyclic bleeding. During vaginal examination

find an increase in the size of the uterus, which has an uneven tuberous surface

surface, dense consistency, painless on palpation. When sub-

With mucosal fibroids, the size of the uterus may be normal.

Endometriosis of the uterine body is accompanied not only by the phenomena of menorrhagia,

but also severe painful menstruation (algomenorrhea). Algodis-

menorrhea is progressive. During vaginal examination you

is an enlargement of the uterus. Cervical endometriosis leads to

the occurrence of menorrhagia, but is not accompanied, unlike endometriosis of the body

uterus soreness. Endometriosis of the uterine body is characterized by its enlargement

size (up to 8-10 weeks of pregnancy), while unlike fibroids on the surface

The uterus is smooth, not lumpy. Relatively often, endometriosis

ki is combined with endometriosis of the ovaries and retrocervical cells.

Bleeding such as metrorrhagia is most often dysfunctional

nature, less often they are associated with organic lesions of the uterus (body cancer,

cervical cancer) or ovarian cancer (extrogen-producing tumors).

Dysfunctional uterine bleeding (DUB) is not associated with extrauterine

nital diseases or organic processes in the genitals,

a are caused by disorders of the menstrual cycle regulation system: hypo-

thalamus - pituitary gland - ovaries - uterus. Most often, functional disorders

of this nature arise in the central links of cycle regulation (hypothala-

mus and pituitary gland). DMK - polyethylological fertilization. The basis of pathogenesis

DMC are caused by stressful moments, intoxication (often of a tonsillogenic nature)

tera), violations endocrine function etc. In most cases, DMC is

are anovular, i.e. occur in the absence of ovulation in the ovaries -

atresia and persistence of the follicle. In atresia, follicles develop into

for a short time and do not undergo ovulation. As a result

there is no corpus luteum that produces progesterone, under the influence of which

when secretory transformations of the endometrium occur and

menstruation. Follicular atresia is accompanied by low production of est.

Rogenov. In contrast, persistence is characterized by a long

rapid development of the follicle with the formation of significant amounts of estro-

gene hormones. With persistence, ovulation and development also do not occur.

tia of the corpus luteum. In pathologically overgrown under the influence of estrogens

endometrium arise vascular disorders leading to necrotic

changes in the mucous membrane; the overgrown endometrium begins to shed

escape from the walls of the uterus, which is accompanied by prolonged and often abundant

bleeding. There is a delay before bleeding occurs

menstruation for 2 weeks or more.

DMCs arise in various age periods woman's life: during

formation of menstrual function (juvenile bleeding) during childbearing

ny period and in the premenopausal period (menopausal bleeding).

Symptoms The occurrence of bleeding is usually preceded by a temporary

amenorrhea lasting from several weeks to 1-3 months. Amid the delay

bleeding appears during menstruation. It can be abundant or scanty

long, relatively short (10-14 days) or very long (1-2 months).

Absence of pain during bleeding is typical for DUB. Prolonged bleeding

disease, especially of a recurrent nature, leads to the development of secondary

anemia. Anemia occurs especially often during juvenile bleeding in

girls with infantilism traits.

The diagnosis is based on medical history (indications of stressful situations

ations, intoxications, inflammatory diseases of the genital organs, etc.),

the presence of characteristic delays in menstruation with subsequent occurrence

prolonged bleeding. Vaginal examination reveals a small

enlargement of the uterus (this sign is absent in juvenile age) and acid

significant change in one or two ovaries.

Differential diagnosis of DUB largely depends on

age of the patient. In juvenile age, DMC must be differentiated

from blood diseases (Werlhof's disease), estrogen-producing tumors

ovary (granulosa cell tumor). During childbearing age, MMC should be

distinguished from bleeding due to the onset or incomplete spontaneous

free abortion, ectopic pregnancy (see), hydatidiform mole, ho-

ryonepithelioma, submucous uterine fibroids, cancer of the cervix and uterine body. IN

premenopausal age DMC must be differentiated from cervical cancer

ki and body of the uterus, uterine mima, estrogen-producing ovarian tumor

(granulosa cell tumor, thecoma).

The diagnosis of Werlhof's disease is made on the basis of a blood test for thrombus

bocytes (thrombocytopenia). A hormonally active ovarian tumor is determined by

detected during vaginal examination, as well as when using endoscopy

chemical (laparoscopy; culdoscopy) and ultrasound methods. When self-

In voluntary abortion, an enlarged and softened uterus is found, slightly open

cervix and other signs of pregnancy. Ectopic pregnancy ha-

characterized by severe pain symptoms, internal blood

course, unilateral enlargement of the uterine appendages, their sharp painful

ness and other symptoms. Uterine fibroids are diagnosed based on their

increase, the presence of a characteristic bumpy surface, dense consistency

tendencies. For the diagnosis of submucosal mimoma, they are used in hospital conditions.

Nara additional research methods (hysteroscopy, hysterography,

ultrasonography). Cervical cancer is detected during examination

patient using mirrors. Endometrial cancer is diagnosed mainly based on

new data from uterine curettage. Hydatidiform mole and chorionepithelioma

are rare, so differential diagnosis DMK with these

diseases is of little practical importance.

Urgent Care. In case of menorrhagia due to extra-

genital disease, endometritis, uterine fibroids and endometriosis are administered

uterine contractants. For minor bleeding, limit

by administering drugs orally; for stronger drugs, parentere-

ral. Oxytocin is administered intramuscularly, 1 ml (5 units) 1 - 2 times a day.

Methylergometrine is also administered intramuscularly (1 ml of 0.02% solution). At

administration of oxytocin, the uterus relaxes again after a rapid contraction,

which leads to renewed bleeding. When administering methylergometrine

uterine contractions are longer in nature, which is more reliable with

from a hemostasis point of view. Methylergometrine can be administered after a while

time after administration of oxytocin. For bleeding caused by fibroids

uterus, the introduction of substances that cause strong contractions of the muscles of the uterus

ki should be performed with great caution due to the risk of ischemia and

necrosis of the tumor node. For relatively minor menorrhagia, contractile

the uterus is given orally: ergotal 1 mg 2-3 times a day, ergometrine

maleate 0.2 g 2-3 times a day. With more severe menorrhagia, these benefits

parathas are administered parenterally. Along with drugs of the ergot group, they are administered

vikasol (1-2 ml of 1% solution intramuscularly), calcium gluconate (10 ml of 10%

solution intramuscularly), aminocaproic acid (50-100 ml of 5% solution

intravenously). For minor bleeding, this drug is given orally (from

calculation 0.1 g per 1 kg of body weight), having previously dissolved the powder in

sweet water. Usually, with the help of such measures it is possible to weaken, but not

stop the bleeding completely. Along with drug therapy

apply cold to the lower abdomen (ice pack for 20-30 minutes after a break -

For DUB, symptomatic therapy described above usually or does not provide

expressed positive result, or causes temporary hemorrhage

pouring effect. Therefore, immediately after hospitalization or in case of emergency

day delay in hospitalization along with the introduction of uterine contractions

agents and drugs that increase blood clotting must be started

use of hormonal hemostasis. In patients with juvenile uterine

bleeding, stopping bleeding begins immediately with hormonal he-

Mostaza. During childbearing age, this treatment method is usually used

only after they are convinced of the absence of precancer or endocrine cancer

metry (the need for preliminary diagnostic curettage!).

During the premenopausal period, stopping DUB in all cases begins with

for diagnostic separate (body and cervical canal) curettage

uterine mucosa. If such an intervention was undertaken

relatively recently, then if endometrial cancer is excluded, we can start in

order of provision emergency care stop bleeding with hot

monal drugs.

Estrogens for hemostasis are prescribed in large doses: 0.1% solution of est.

radiol dipropionate 1 ml intramuscularly every 2-3 and or ethinyl estre-

diol (microfollin) 0.05 mg every 2-3 and (tie more than 5 tablets per day -

ki). Hemostasis usually occurs within the first 2 days. Then doses of estro-

genes are gradually reduced and introduced over another 10-15 days. Combi-

lated estrogen progestogen drugs (bisecurin, nonovlon) are prescribed

for the purpose of hemostasis, 4-5 tablets per day at intervals of 2-3 hours. Usually

bleeding stops within 24-48 hours from the start of treatment. Then when

The number of tablets is gradually reduced (one per day) until the appointment

only one tablet per day. The general course of therapy is 21 days. Hemostasis with use

the use of pure gestagens (norkolut, progesterone) is used less frequently

due to the risk of increased bleeding in the first days of treatment, which is dangerous in

anemic patients.

With profuse bleeding due to advanced cervical cancer

sometimes when providing emergency care you have to resort to tight

vaginal ponade (see).

Hospitalization. Regardless of the cause of uterine bleeding with

profuse bleeding, the patient must be urgently hospitalized in a

non-ecological department.

In case of profuse bleeding, transportation

carried out on a stretcher, with large blood loss - with the head down

BLEEDING DURING PREGNANCY AND CHILDREN. Bleeding from the genitals

paths women can meet both in the first and second half

pregnancy. The causes of these bleedings are different.

In the first half of pregnancy, bleeding is mainly due to

spontaneous abortion. Significantly less bloody discharge from the mother’s

ki are associated with ectopic pregnancy (see), as well as with the development

trophoblastic diseases (hydatidiform mole and chorionepithelioma).

Symptoms Spontaneous abortion is accompanied by the appearance of blood

discharge from the genital tract, the severity of which depends on

depending on the stages of development of abortion.

With a threatened abortion, the patient complains mainly of heaviness below

abdomen, slight cramping pain; Often these phenomena are combined

with scanty spotting dark bloody discharge. With vaginal

examination, the cervical canal is closed, the uterus is soft, easily excitable,

its size corresponds to the period of pregnancy. The self-propagation that began

voluntary abortion is characterized by increased bloody discharge from the

galina and more intense cramping pain in the lower abdomen. At

vaginal examination reveals a slightly open external ma-

precise pharynx, the size of the uterus corresponds to the period of pregnancy.

Abortion in progress represents the next stage in the development of self-producing

free abortion, in which the fertilized egg exfoliates from the walls of the uterus and

expelled into the cervical canal. This stage of abortion is accompanied by significant

body bleeding. During a vaginal examination, discolourations are revealed

digging the external pharynx and the cervical canal, in the lumen of which a

blood clots and parts of the fertilized egg are formed. The size of the uterus is slightly smaller

gestational age.

Incomplete abortion is characterized by the expulsion of most of the fertilized egg.

and the presence of their remains in the uterus, as a result of which the uterus cannot contract

crawl. This stage is characterized by severe, sometimes profuse bleeding.

nim. The pain is minor. During vaginal examination, the cervical canal

ki are freely passable for a finger, the size of the uterus is always smaller than expected

expected period of pregnancy. Complete abortion (rare) is accompanied by

due to the expulsion of all parts of the fertilized egg from the uterus. As a result of this, blood

the course is significantly less than with an incomplete miscarriage. Lower abdominal pain

almost absent. The cervical canal is passable for the finger, the uterus is significant

strictly less term pregnancy, tight.

When an infection occurs, an infected miscarriage develops (usually

only incomplete). Clinical picture characterized by bleeding

pain in the lower abdomen, fever, chills, changes in the picture

blood (leukocytosis, shift leukocyte formula to the left, increase in ESR).

A vaginal examination should determine whether there is an infection.

limited (affecting only the uterus), or it has gone beyond this

organ (complicated febrile miscarriage, septic abortion). In case of complications

In a febrile abortion, the uterine appendages are most often affected,

which can be palpated during vaginal examination.

Emergency care and hospitalization. Patients with all forms of self-proliferation

voluntary abortions are subject to urgent hospitalization. In the presence of profuse

of bleeding, the doctor on the spot is forced to perform a digital

removal of the remains of the fertilized egg (see). To contract the uterus during abortion in

progress, incomplete and complete miscarriage, apply cold to the lower abdomen and contract

uterine-sparing agents (oxytocin 1 ml intramuscularly). Application of the drug

ergot group compounds (methylergometrine, ergotal, etc.) are contraindicated

due to the property of simultaneously causing spasm along with uterine contractions

her neck. In a hospital, treatment is determined by the stage of the process and installation

the presence or absence of infection. When threatening and started

During abortion, means are used to maintain pregnancy. At

In case of ongoing abortion and incomplete miscarriage, they resort to instrumental removal

remnants of the fertilized egg. Infected abortion is subject to intensive anti-

bacterial, infusion and desensitizing therapy. Scraping

uteruses are produced only for vital reasons (profuse bleeding

Bleeding in the second half of pregnancy and during childbirth is caused by

caught mainly by the incorrect location of the placenta (placenta previa)

cents), its premature separation from the walls of the uterus (premature

abruption of a normally located placenta), retained placenta or its

parts in the uterus, as well as partial placenta accreta. Expressiveness

bleeding can vary - from spotting to profuse

bleeding.

Symptoms Placenta previa is characterized by the appearance of bloody

discharge from the genital tract at the end of pregnancy or at the beginning of labor. Cro-

The bleeding is painless, which is very typical for this pathology. When on-

external obstetric examination reveals a high location of the pre-

lying part. With significant bleeding, the fetus quickly develops

signs of intrauterine hypoxia (decrease in heart rate, deaf

and arrhythmic tones). The uterus is always painful on palpation. Vaginal

research to clarify the diagnosis outside the maternity hospital is absolutely

contraindicated due to the risk of profuse bleeding!

In case of premature abruption of a normally located placenta, if

it occurs over a considerable period, the woman complains of pain in

abdomen and uterine tension. Blood appears from the external genital tract,

however, the degree of external bleeding does not correspond to anemia

patient, since a significant part of the blood accumulates between the uterus and

placenta (retroplacental hematoma). Sometimes external bleeding

there may not be. During external obstetric examination, the uterus is tense

and painful, especially on the side of the placenta. The fetus quickly

symptoms of intrauterine hypoxia increase. Significant detachment of the pla-

cents quickly leads to collapse (pallor of the skin, threadlike

rapid pulse, decreased blood pressure).

Bleeding in the third stage of labor is mainly associated with a violation

separation and discharge of the placenta. Under normal conditions, within 10-20 minutes

After the baby is born, the placenta separates from the walls of the uterus and

birth of placenta. This process is accompanied by moderate blood loss - in

average 100-200 ml (upper limit of physiological blood loss 250 ml

blood). Blood loss over 400 ml requires emergency care.

If bleeding occurs in the third stage of labor, first of all

you should make sure that the placenta has completely separated from the walls of the uterus. On the-

The most accurate technique is when the hand, placed with the edge above the pubis,

exert pressure on the lower segment of the uterus through the anterior abdominal wall

ku. If the umbilical cord does not retract into the vagina, then the last

poured from the walls of the uterus completely and is located in the uterus. If, when pressing,

When the umbilical cord is retracted with the hand above the womb, the afterbirth is pulled away from the walls of the uterus

shared incompletely. Depending on whether it separated or did not separate

afterbirth from the walls of the uterus, the procedure for providing emergency care will vary

Emergency care and hospitalization. With placenta previa and possible

In the event of bleeding, the patient must be urgently hospitalized

maternity hospital. In the hospital, a vaginal examination to clarify the diagnosis

Nose is performed only in the presence of a deployed operating room! At the same time

premature abruption of a normally located placenta, the patient is also not

must be urgently taken to the maternity hospital.

If bleeding occurs in the third stage of labor and there is a

positive signs of placenta separation, the woman should be offered

urinate, and then push, and the placenta is often born spontaneously

Surely the bleeding stops. After the birth of the placenta, his attention

carefully inspected. If the placenta lobules are intact, then external

uterine massage. If the placenta is not completely separated (signs of separation

placenta are negative) nothing should be done at home

any manipulations to separate and release the placenta, as this may

lead to increased bleeding. The woman should urgently be

to be taken to the maternity hospital.

In all cases of bleeding during pregnancy and

during childbirth, during transportation of the patient, cardiotonic drugs must be administered

medications and give oxygen to breathe. At heavy bleeding and develop

When the patient collapses in the ambulance, they begin blood transfusion.

Postpartum hypotensive bleeding usually occurs in the first

hours after childbirth and is mainly due to insufficient contractility

uterine activity due to abnormalities labor activity, overextension

uterine problems (large fetus, twins, polyhydramnios, etc.), infantilism, pre-

marching inflammatory diseases(metroendometritis), the presence of tumor

leu (fibroids).

Symptoms, hypotonic bleeding often begins in the third

during childbirth and then continues into the early postpartum period. In other

In some cases, bleeding occurs during an uncomplicated course of the third

period of childbirth. The main symptom is continuous bleeding from the vagina.

out ways. On external examination, the uterus is flabby, contracts poorly

response to external massage. Blood is released in portions. Leaking blood

forms clots, which distinguishes hypotonic bleeding from hypofibritis

nogenemic.

Diagnosis. Hypotonic bleeding should be distinguished from bleeding

in the early postpartum period associated with cervical rupture or

vaginal walls. When the cervix or vaginal wall ruptures, blood

scarlet color, the tone of the uterus remains good.

Emergency care and hospitalization. If hypotensive bleeding

occurred during home birth, urine should be released through a catheter

(if the woman does not urinate on her own), introduce uterine contractions

agents (oxytocin 1 ml intramuscularly or intravenously along with 20 ml

40% glucose solution, methylergometrine 1 ml intramuscularly), produce

external massage of the uterus, place an ice pack on the lower abdomen and in case

continued bleeding until the ambulance arrives, apply pressure

aorta with a fist. In addition, it is necessary to carefully examine the placenta and ensure

to live in its integrity.

After hospitalization in the maternity hospital, a complex of measures is urgently started.

measures to stop bleeding and compensate for blood loss. For this

perform a manual examination of the uterus (under ether-oxygen or acid

but-oxygen anesthesia or after intravenous administration of epontol), pro-

uterine contracting agents should be administered (mainly intravenously

through an IV). At the same time, a set of measures is carried out, such as

aimed at compensating blood loss (blood transfusions and blood substitutes)

lei), regulation of cardiac activity and the function of other vital

organs. In case of secondary bleeding disorders, which is often caused by

causes severe hypotonic bleeding, administer fibrinogen (6-8 g

intravenously), aminocaproic acid (5% solution 100 ml intravenously

pelno), a transfusion of warm donor blood is performed.

BLEEDING DUE TO INJURY OF THE FEMALE GENITAL ORGANS. Bleeding may

occur during defloration during the first sexual intercourse (usually

some bleeding is not profuse), as well as bruises and wounds as a result

fall, impact, etc.

Symptoms When the hymen ruptures, the patient complains of bleeding

discharge from the genital tract and pain at the vaginal opening. Upon examination

vestibule of the vagina, tissue swelling and bleeding from the torn

noah hymen. For bruises and damage to the external genitalia,

new external bleeding most often occurs due to injury

clitoral area (bleeding may be profuse). Traumatic re-

The reduction may be manifested by the development of a hematoma in the external genitalia

organs, while there is no external bleeding, and the patient complains

to bursting pain and inability to sit.

Urgent Care. Local application cold (ice pack on the

external genital organs), rest, painkillers (1 ml

50% analgin intramuscularly or 1 ml of 1% promedol solution subcutaneously). On

external genitalia are applied with a pressure bandage, less often it is necessary

resort to vaginal tamponade.

Hospitalization. For severe bleeding from a deep laceration

hymen, with injury to the clitoris, as well as with growing hematoma

external genitalia with damage to surrounding tissues is necessary

hospitalization in the gynecological or surgical department.

Bleeding from the genitals can be observed in a woman or a man both during and after sexual intercourse. This problem may be accompanied by severe pain and may not have any other symptoms. It all depends on the reason.

Causes of vaginal bleeding

Polyps of the cervical canal

Polyps in the cervical canal are benign growths on the mucous membrane of the cervix. They often bleed when touched because they are easily damaged.

The appearance of blood directly during penetration in women with polyps in the cervical canal is not common, but can sometimes occur, since they are quite fragile. More often, bleeding is noticed after sexual intercourse.

However, polyps in the cervix can cause bleeding during intercourse, a week after menstrual period or shortly before it. In addition, when irregular cycle they can cause spotting between cycles. This bleeding may occur as a postmenopausal effect.

Polyps in the cervical canal can become infected, which increases the likelihood of symptoms, including discharge, which is often when they are discovered.

Diagnosis and treatment

In most cases, polyps are discovered during regular gynecological examinations or during a PAP (smear) test.

Once confirmed, surgery is required to remove them. "Sometimes a polyp may appear on its own during sexual intercourse or menstruation," notes Harvard Medical School.

Antibacterial drugs are used if there are signs of an infected polyp.

Endometriosis

Endometriosis is a disease that affects reproductive organs, in which the inner layer of the walls of the uterus grows beyond its boundaries. If the tissue reaches the cervix or vagina, the woman may experience bleeding during or after intercourse.

Common symptoms of endometriosis include:

Pain during intimacy
Muscle spasms in the pelvic area
Premenstrual bleeding
Bleeding longer than usual (even without sex)
Bloating
Anxiety and depression or mood swings.

The exact reason why the lining of the uterus (endometrium) grows this way is not known. A large number of factors may be associated with the occurrence of this disease.

First pregnancy at an older age
Heavy menstrual bleeding or an unusually early start of periods in a teenager
Shorter regular cycles
Blood with endometrial cells reaches the fallopian tubes
Metaplasia
Heredity.

Whenever you suspect you have endometriosis or experience these symptoms, you should consult your doctor immediately.

Damage to blood vessels

The occurrence of bleeding may also indicate inflammation or damage to the blood vessels in the cervical canal. If you have such a problem, you must first visit a doctor before starting treatment.

Vaginal dryness

Another possible reason The discharge of blood during the process is dryness in the vagina. This causes pain and is usually accompanied by vaginal discomfort.

IMPORTANT: Do not get used to lubricants. Perhaps this is not the most The best decision this problem in general. Instead, you need to contact your gynecologist for help and advice on methods to improve the condition.

Bleeding from the penis

Men may also experience bleeding from the penis during sex with their female partners. Depending on what is causing it, the blood may come from internal parts or from outer shells. It may also cause pain.

Tight or broken frenulum

The frenulum is a small area of skin (between the foreskin and the penis) that is located on the underside. It can become tight with increasing sexual arousal and stimulation and can therefore be damaged during penetration.

Symptoms, such as pain when you make love, are obvious. Other signs may include phimosis (incomplete exposure of the glans) or inability to ejaculate completely and related health problems such as difficulty cleaning the genitals.

Uncircumcised boys and men are more susceptible to this problem (though not always). A torn frenulum does not always heal on its own, hence you may see drops of blood on the penis or repeated injuries (whether you are circumcised or not).

Treatment

If bleeding from the penis due to a torn frenulum occurs repeatedly, you should schedule an appointment with your doctor.

Secondly, if you are not circumcised, it is recommended to go for clinical operations (as opposed to traditional methods circumcision). The last option is surgery, in which the frenulum can be released (the medical term for this operation is frenuloplasty).

Inflammatory infections, including STDs

If you experience painful ejaculation, urethra may be infected with sexually transmitted diseases (STDs). Inflammation of the prostate gland can also lead to bleeding during sex, especially if a man has more than one sexual partner.

Inflammation can be caused by bacteria or viruses.

Blood will be present after ejaculation as it may be released along with the semen. If your partner has an active infection that is an STD, you are at risk of infection. You should immediately consult a doctor for medical care.

Other reasons

Vaginal trauma
Penile injury
Using lubricants (intimate lubricants) to relieve vaginal conditions such as atrophic vaginitis or dryness
Infection of the prostate gland, in which blood can enter the secretion of the prostate gland
Damage to the prostate vein. Some partners may notice blood mixed with semen after penetration or ejaculation.
Cervical erosion. Moderate bleeding will occur if the penis touches the cervix during penetration. Often observed during pregnancy.

Facts about vaginal bleeding and intrauterine devices

An intrauterine device (IUD) has plastic strings that sit partially in the vagina, and it does not interfere with penile penetration or interfere with sexual intercourse. IUDs are usually placed during menstruation.

Usage intrauterine device as a means of contraception is one of the effective and safe means birth control. However, it is not a guarantee against contracting STDs. These inflammations can cause pain during sex or lead to bleeding, especially after sex.

Important, that copious discharge blood during the menstrual period can not only indicate cycle irregularity, but also indicate health problems such as STDs.

What to do if you have an IUD and are experiencing bleeding?

If you feel that something went wrong with the placement of the spiral, you should follow these steps:

Get help with the coil check procedure
Contact your doctor.

If you experience abdominal pain, bleeding after sex, or bad smell, you should do the following:

Take a pregnancy test
Seek clinical support or guidance for IUD care
Seek help for diagnosis.

Is bleeding a sign of cancer?

Symptoms early cancer The cervix is not easy to detect, but as cancer cells grow, new blood vessels appear. Unlike ordinary vessels, cancer cells in these blood vessels can make them brittle, making them easily damaged.

One of the symptoms of cervical cancer is abnormal bleeding which most often occurs after sexual intercourse.

If cancer cells grow into blood cells, they can spread from the cervix to the tissues of the pelvis. This means that the body's defense mechanism is reduced and it is susceptible to secondary infections.

Any sexually active woman is at risk. Although the exact cause of cervical cancer is not well understood, there are risk factors associated with its occurrence. One of them is the human papillomavirus (HPV).

Bloody discharge from the female genital organs during the period between menstrual bleeding, as a rule, is one of the symptoms of the development of pathology. Normally healthy woman such secretions should consist of small quantity mucus produced by the glandular tissue of the cervix.

It is transparent or in some cases slightly cloudy, which is not a pathology. After all, the quantitative and qualitative composition of mucous membranes vaginal discharge largely depends on what period of the menstrual cycle the gynecological examination was performed. The main function of such secretions is to clean and protect the vagina from pathogenic microflora.

When will bleeding become the norm?

Sometimes a woman turns to a gynecologist with a complaint about the appearance of scanty discharge from the genitals, which contains minor streaks of blood.

Moreover, it appears after the end of menstruation, about a week later. As usual, the doctor reassures the patient.

After all, this phenomenon is not a pathology, but an element of the norm.

Slight spotting indicates the beginning of the ovulation period and is evidence that the female egg is ready for fertilization.

As a result, the most favorable moment for conceiving a child comes for a woman.

As a rule, there is no pronounced presence of blood in the discharge during this period. By their nature, they remain slimy, but the mucus is no longer transparent, but has a slightly pinkish or brownish tint. The volume of discharge may increase slightly during this period.

These symptoms should not bother a woman. However, if the amount of blood in the vaginal discharge has increased and this symptom manifests itself for more than three days, then it is necessary to visit a gynecologist for consultation. Perhaps these are the first signs of the development of pathology.

Could this be a symptom of pathology?

If we talk about women's menstrual cycle, then normally it can last more than thirty days. Directly for the period menstrual bleeding takes no more than a week. During the rest of the period, the discharge should be transparent, that is, free of blood. Accordingly, the presence of bleeding during the intermenstrual period most often indicates the presence of pathology of the female genital area. What diseases can be accompanied by this symptom?

Inflammation muscle tissue, forming the uterus, or in other words endometritis. It develops as a result of penetration of wound infection pathogens into the uterine cavity. As a rule, the cause of the disease is medical manipulation in the uterine area, for example, abortion. In addition to the characteristic discharge, a woman may complain of pain of varying intensity and, in some cases, an increase in body temperature. If treatment is not carried out on time, then subsequently acute symptoms subsides. The disease progresses to chronic form, which is characterized by periodic vaginal bleeding.
As a reason this symptom Endometriosis is often diagnosed. The pathology is caused by the uncontrolled growth of muscle tissue of the uterus. This disease is caused by various disorders hormonal levels patients. Most often, endometriosis occurs in women in the age group after forty years. Diagnose based on a simple examination this pathology hard enough. To do this, you will need to conduct an ultrasound examination or perform a laparoscopy.
may also appear when using tablet contraceptive medications. In this case, this is a sign that the doctor selected the wrong medicine for the patient. It is quite easy to eliminate bleeding that occurs for this reason. You just need to replace one drug with another.
Such bleeding can also be observed in the early stages of pregnancy, that is, already when the egg has attached to the uterine wall. However, most often this is a rather unfavorable symptom. It may indicate a miscarriage.
The presence of an intrauterine contraceptive device is often cited as the cause of bleeding. In this case, cause similar symptoms various pathologies, provoked by this contraceptive device. These can be inflammatory processes as a result of infection with pathogenic bacteria or cystic growths both in the uterus itself and in the cervical area.
A small amount of blood may appear in a woman’s discharge after sexual intercourse. As a rule, this is not caused by a disease, but is the result of minor trauma to the cervix or vagina during sexual intercourse. Such symptoms should cause concern if they occur frequently enough. In this case, a visit to the gynecologist is mandatory.
The appearance of bleeding in the middle of the cycle can be caused by significant hormonal disorders. Moreover, the level of a certain biologically active substance in this case is not constantly increased, but a single jump in its concentration is observed precisely at the moment of release of the egg, that is, at ovulation.
Bloody discharge from the vagina can be one of the symptomatic manifestations of a tumor process in the uterine cavity, for example, fibroids.

Other reasons for discharge

Bleeding also occurs in the first trimester of pregnancy. Sometimes they can be timed to coincide with the time when the usual monthly bleeding should begin.

If the discharge is scanty, then there is no need to worry. The doctor may advise you to do a control ultrasound examination, and then recommend reducing the intensity of sexual relations.

If the bleeding is profuse, then this is a symptomatic manifestation of the threat of miscarriage.

Therefore, it is necessary to hospitalize the woman in the pregnancy pathology department to prevent the threat of losing the child.

Such violations can be caused by significant physical activity or a woman's long-term depression.

Unusual vaginal discharge containing streaks or blood may appear after certain gynecological procedures, for example, after treating erosion with cauterization or when taking a biopsy.

The appearance of bleeding during pregnancy

Slight bleeding from the vagina at the time of implantation of a fertilized egg into the wall of the uterus is a fairly common phenomenon and is not pathological. In this case, the appearance of blood is explained by minor trauma to the mucous tissue and small vessels of the uterus. This type of bleeding is called implantation bleeding. It may appear about a week before the expected monthly bleeding. It does not last long and stops on its own. In this case, medical assistance is not required.

However, this is the only case when the appearance of blood from the vagina in a pregnant woman is not a sign of development pathological process. As a rule, the appearance of blood in the discharge is an unfavorable sign and requires immediate contact with a gynecologist for medical assistance.

What could cause this symptomatic manifestation? When a patient seeks medical help, the gynecologist assumes following reasons similar phenomenon:

The first thing you should be afraid of in the early stages of pregnancy is the threat of miscarriage.
For more later, for example, in the last trimester, this may be premature birth.
Incorrect placenta previa.

As you can see, the supposed diagnoses are quite threatening. If a woman develops one of them, it threatens not only her health, but also the life of the unborn child. Accordingly, at the first signs of bleeding, you should immediately consult your doctor, and if the symptoms increase, you do not need to wait, you must immediately call an ambulance.

In addition to bleeding, the following signs of pathology may appear:

increasing intensity of pain in the lower abdomen;
the woman begins to complain of weakness and dizziness;
clouding of consciousness may occur;
upon examination skin patients will be pale, covered with beads of sweat.

The presence of such symptoms is a sure sign of the onset of placental abruption and the development of internal bleeding.

The woman should be immediately hospitalized for medical care.

Discharge after childbirth

Minor bleeding in women, or also called lochia, in the postpartum period is not a pathology.

In appearance, they have a slight pinkish color and are similar in consistency to ichor. On average, they can be discharged from the genital tract for about one and a half months after birth.

Initially, they contain most of the blood and look very similar to the usual monthly bleeding. Gradually there is less blood, more mucous discharge predominates.

Therefore, it changes appearance secretions, they acquire yellow, and blood is quite rare in the form of streaks or smears. About a month after birth, the intensity of the discharge decreases.

In fact, this is no longer a discharge, but a periodic so-called spotting. This natural process and gynecological care is not required in this case.

In what cases is a consultation with a gynecologist necessary?

If bloody discharge continues to bother the patient for more than a month and a half after labor.
If the nature of the discharge has changed, for example, the amount of blood has increased; it turned from dark brown to scarlet; bleeding the vagina has acquired an unpleasant odor, and so on.
Appeared painful sensations in the lower abdominal region. They may be the first sign of infection of the uterus and the development of postpartum sepsis.

How is the diagnosis made?

Of course, stopping massive bleeding from the vagina should be done quickly enough. But if this is minor bleeding, then before treating the woman, it is necessary to find out the cause of this phenomenon. Diagnosis begins with an initial visit to the gynecologist, where the woman is interviewed and examined.

During the conversation, the attending physician clarifies when the first signs of the development of the pathological process appeared. What contributed to this? Attention is drawn to the presence of concomitant pathology, especially hormonal and metabolic disorders.

Next, a gynecological examination is performed. The woman is examined using special gynecological mirrors. In addition, a palpation examination of the pelvic organs is performed through the vagina and through the anterior abdominal wall. At this stage, a preliminary diagnosis is made.