Vaginal Bleeding During Pregnancy, Third Trimester

A small amount of bleeding (spotting) is relatively common in pregnancy. Sometimes bleeding may be "normal." Bleeding in the third trimester can be very serious for the mother and the baby, and should be reported to your caregiver right away. It is very important to follow your caregiver's instructions.

CAUSES

Possible causes of bleeding during the third trimester:

  • The placenta may be partially covering or completely covering the opening to the cervix (placenta previa).

  • The placenta may have separated from the uterus (abruption of the placenta).

  • There may be an infection or growth on the cervix.

  • You may be starting labor, called discharging of the mucus plug.

  • The placenta may grow into the muscle layer of the uterus (placenta accreta).

DIAGNOSIS

Your caregiver may do:

  • Pelvic exam in the delivery room, called a double set up (being ready to do an emergency cesarean delivery, if necessary).

  • Blood tests, to see if you are anemic (not having enough red blood cells).

  • Ultrasound and fetal monitoring, to see if the baby is having problems.

  • Ultrasound, to find out why you are bleeding.

TREATMENT

  • You may need to remain in the hospital.

  • You may be given an IV (intravenous) while you are in the hospital.

  • You may be put on strict bed rest.

  • You may need a blood transfusion.

  • You may be placed on oxygen.

  • The baby may need to be delivered immediately.

HOME CARE INSTRUCTIONS

  • Your caregiver may order bed rest (getting up to go to the bathroom only). At this time, you may need to make arrangements for the care of children and for other responsibilities.

  • Keep track of the number of pads you use each day and how soaked (saturated) they are. Write this down.

  • Do not use tampons. Do not douche.

  • Do not have sexual intercourse or any sexual activity that may cause an orgasm, until approved by your caregiver.

  • Follow your caregiver's advice about lifting, driving, physical and social activities.

  • Eat a balanced and nutritious diet.

  • Get plenty of rest and sleep.

  • Do not drink alcohol or smoke.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You experience severe cramps or pain in your back or belly (abdomen).

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • You develop chills.

  • You have a gush of fluid from the vagina.

  • You pass large clots or tissue. Save any tissue for your caregiver to inspect.

  • Your bleeding increases or you become light-headed or weak.

  • You pass out.

  • You feel less movement or no movement of the baby.