Αιμορραγία στην εγκυμοσύνη

Τι μπορεί να προκαλέσει αιμορραγία κατά τη διάρκεια της εγκυμοσύνης;

Κολπική αιμορραγία ή κηλίδες αίματος, κατά τη διάρκεια της εγκυμοσύνης, μπορεί να έχει πολλές αιτίες. Μερικές είναι σοβαρές και κάποιες άλλες δεν είναι. Αιμορραγία μπορεί να εμφανιστεί νωρίς ή αργά στην εγκυμοσύνη.

Πολλές γυναίκες έχουν κολπική αιμορραγία ή κηλίδες αίματος κατά τις πρώτες 12 εβδομάδες της κύησης. Αιμορραγία του τραχήλου της μήτρας μπορεί να συμβεί κατά τη διάρκεια του σεξ. Μια λοίμωξη του τραχήλου της μήτρας μπορεί επίσης να προκαλέσει αιμορραγία. Ελαφρά αιμορραγία σταματά συχνά από μόνη της.

Ωστόσο, η αιμορραγία κατά τη διάρκεια της εγκυμοσύνης, μπορεί να σημαίνει κάτι πιο σοβαρό. Μπορεί να είναι σημάδι πρόωρου τοκετού ή ακόμα και αποβολής.

Πώς ελέγχεται η αιμορραγία κατά τη διάρκεια των αρχικών σταδίων της εγκυμοσύνης ;

Εάν αιμορραγία συμβεί στα πρώτα στάδια της εγκυμοσύνης, ο γιατρός θα σας κάνει μια γυναικολογική εξέταση. Θα ερωτηθείτε πόσο αίμα έχετε χάσει και πόσο συχνά έχει συμβεί. Θα ερωτηθείτε αν είχατε κανένα πόνο, και εάν ναι, την εντόπιση και την έντασή του.

Ένα τεστ αίματος μπορεί να γίνει για τη μέτρηση της ανθρώπινης χοριακής γοναδοτροπίνης (hCG). Αυτή την ουσία την παράγει ο οργανισμός σας κατά τη διάρκεια της εγκυμοσύνης. Μπορείτε να υποβληθείτε σε περισσότερες από μία εξετάσεις επειδή τα επίπεδα της hCG αυξάνονται κατά τη διάρκεια της εγκυμοσύνης. Σημαντικός είναι και ο τύπος του αίματος σας, επίσης, θα εξεταστείτε για να διαπιστωθεί αν χρειάζεστε θεραπεία για Rh ευαισθητοποίηση. Ο υπέρηχος μπορεί να χρησιμοποιηθεί για να βρεθεί η αιτία της αιμορραγίας. Κάποιες φορές η αιτία δεν είναι δυνατόν να βρεθεί.

Πότε συμβαίνει η αποβολή;

Αποβολή μπορεί να συμβεί οποιαδήποτε στιγμή κατά το πρώτο μισό της εγκυμοσύνης. Πιο συχνά συμβαίνει στις πρώτες 13 εβδομάδες. Συμβαίνει στο 15-20% των κυήσεων.

Ποια είναι τα σημάδια και τα συμπτώματα της αποβολής;

Τα ακόλουθα σημεία και συμπτώματα μπορεί να υποδεικνύουν μια αποβολή:

Κολπική αιμορραγία

Κράμπες και πόνος χαμηλά στην κοιλιά (συνήθως ισχυρότερος από τις κράμπες της περιόδου)

Ιστός περνά από τον κόλπο

Πολλές γυναίκες που έχουν κολπική αιμορραγία έχουν λίγες ή καθόλου κράμπες. Μερικές φορές η αιμορραγία σταματά και η εγκυμοσύνη συνεχίζεται. Άλλες φορές η αιμορραγία και κράμπες μπορεί να γίνουν ισχυρότερες, οδηγώντας σε αποβολή.

Ποια είναι η θεραπεία μετά από μια αποβολή;

Αν κάποιοι ιστοί παραμένουν στη μήτρα, η αιμορραγία συνεχίζεται . Ο γιατρός σας μπορεί να συστήσει στη συνέχεια μία ή περισσότερες θεραπευτικές επιλογές. Η φαρμακευτική αγωγή μπορεί να χρησιμοποιηθεί για να σας βοηθήσουν να αποβάλλετε τον ιστό. Ο ιστός μπορεί να αφαιρεθεί με διαστολή και απόξεση (D & C). Επίσης, μπορεί να απομακρυνθεί με μια συσκευή αναρρόφησης. Αυτό ονομάζεται απόξεση αναρρόφησης. Μερικές φορές περισσότερες από μία επιλογή είναι απαραίτητες.

Τι είναι η έκτοπη κύηση;

Μια έκτοπη κύηση συμβαίνει όταν το γονιμοποιημένο ωάριο δεν εμφυτεύεται στη μήτρα. Αντ ‘αυτού, εμφυτεύει κάπου αλλού, συχνά σε μία από τις σάλπιγγες. Μια έκτοπη κύηση προκαλεί πόνο και αιμορραγία νωρίς στην εγκυμοσύνη.

Τι κίνδυνοι συνδέονται με την έκτοπη κύηση;

Ένας σημαντικός κίνδυνος συνδέεται με τη ρήξη της σάλπιγγας. Μια ρήξη χρειάζεται άμεση θεραπεία. Μπορεί να υπάρχει εσωτερική αιμορραγία. Η απώλεια αίματος μπορεί να προκαλέσει αδυναμία, λιποθυμία, πόνο, σοκ, ή θάνατο.

Πόσο συχνή είναι έκτοπη κύηση ποιες γυναίκες είναι σε κίνδυνο;

Έκτοπες κυήσεις είναι πολύ λιγότερο συχνές από ό,τι οι αποβολές. Θα παρουσιαστεί σε περίπου 1 στις 60 εγκυμοσύνες. Οι γυναίκες διατρέχουν μεγαλύτερο κίνδυνο εάν είχαν:

μια μόλυνση στις σάλπιγγες (όπως φλεγμονώδης νόσος της πυέλου)

μια προηγούμενη έκτοπη κύηση

χειρουργική σαλπίγγων

Τι προκαλεί αιμορραγία αργά στην εγκυμοσύνη;

Κοινά προβλήματα που προκαλούν ελαφριά αιμορραγία περιλαμβάνουν οι φλεγμονές του τραχήλου της μήτρας . Αυτά μπορεί να αντιμετωπιστούν με φαρμακευτική αγωγή.

Βαριά αιμορραγία συνήθως περιλαμβάνει κάποιο πρόβλημα με τον πλακούντα. Οι δύο πιο κοινές αιτίες είναι η αποκόλληση πλακούντα και ο προδρομικός πλακούντας . Ο πρόωρος τοκετός μπορεί επίσης να προκαλέσει τέτοια αιμορραγία.

Τι είναι η αποκόλληση του πλακούντα;

Ο πλακούντας εφάπτεται στο τοίχωμα της μήτρας. Αυτό μπορεί να αποσπαστεί από το τοίχωμα πριν ή κατά τη διάρκεια του τοκετού. Αυτό μπορεί να προκαλέσει κολπική αιμορραγία. Συχνά προκαλεί πόνο, ακόμη και αν η αιμορραγία είναι ελαφριά ή δεν φαίνεται. Όταν ο πλακούντας αποκολληθεί, το έμβρυο μπορεί να πάρει λιγότερο οξυγόνο. Αποτελεί μια επείγουσα κατάσταση.

Τι είναι προδρομικός πλακούντας;

Όταν ο πλακούντας βρίσκεται χαμηλά στη μήτρα, μπορεί να καλύπτει τον τράχηλο. Αυτό σημαίνει ότι, εν μέρει ή πλήρως, μπλοκάρει το άνοιγμα. Αυτό ονομάζεται προδρομικός πλακούντας. Μπορεί να προκαλέσει κολπική αιμορραγία. Αυτό το είδος της αιμορραγίας συχνά συμβαίνει χωρίς πόνο.

Μπορεί η αιμορραγία να είναι ένα σημάδι τοκετού;

Αργά στην εγκυμοσύνη, κολπική αιμορραγία μπορεί να είναι ένα σημάδι του τοκετού. Μια μικρή ποσότητα της βλέννας και αίματος περνά από τον τράχηλο μόλις πριν ή κατά την έναρξη του τοκετού. Αυτό ονομάζεται “bloody show.” Είναι κοινό. Δεν είναι ένα πρόβλημα, αν αυτό συμβεί εντός 3 εβδομάδων από την πιθανή ημερομηνία σας. Αν αυτό συμβεί νωρίτερα, μπορεί να οφείλεται σε πρόωρο τοκετό. Άλλες ενδείξεις πρόωρου τοκετού είναι οι ακόλουθες:

Κολπικό έκκριμα

Αλλαγή του είδους της κολπικής έκκρισης (υδαρής, βλεννώδης , ή αιματηρή)

Αύξηση της ποσότητας της κολπικής έκκρισης

Πίεση στην πύελο ή το κάτω μέρος της κοιλιάς

Οσφυαλγία

Κράμπες στο στομάχι, με ή χωρίς διάρροια

Τακτικές συσπάσεις της μήτρας ή σφίξιμο

Αν έχετε κάποιο από αυτά τα σημάδια ή συμπτώματα, επικοινωνήστε με τον ιατρό σας ΑΜΕΣΩΣ

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