Third trimester bleeding during pregnancy can be caused by various factors, including the mucus plug exiting the body, cervicitis, placental abruption, placenta previa, and preterm labor. It can indicate serious complications and requires medical attention.
Third trimester bleeding is when a woman experiences vaginal bleeding during the latter part of her pregnancy. The third trimester runs from week 28 until delivery. Bleeding can occur during the first trimester for no cause for alarm, but it can be a sign of serious complications during the third trimester.
The most common cause of third trimester bleeding is referred to as “bloody show.” This is when the mucus plug, a protective barrier at the opening to a pregnant woman’s uterus, exits the woman’s body. When this happens, the woman may notice bloody mucus leaking from her vagina. It is common for the bloody show to appear after 36 weeks of gestation. If a woman experiences additional symptoms or bright red period-like bleeding, she should seek medical care.
Cervicitis, or inflammation of the cervix, can also cause bleeding in the third trimester. Any trauma to the cervix could cause bleeding. Light spotting after intercourse or a vaginal exam is usually not a cause for alarm.
Another possible cause of third trimester bleeding is placental abruption, which occurs when the placenta detaches from the uterine wall. Placental abruption is quite rare and usually occurs during the last 12 weeks of pregnancy. Along with vaginal bleeding, a woman might experience stomach pain, contractions, uterus tenderness, and back pain. Placental abruption may require an emergency caesarean section and, in severe cases, the fetus may die. Risk factors for this condition include smoking, alcohol use, cocaine use, diabetes, high blood pressure, advanced maternal age, and a history of previous pregnancies.
Third trimester bleeding could also be caused by placenta previa, when the placenta is low in the uterus and partially or fully covers the cervix. Most women experience vaginal bleeding without any pain. In some cases, the placenta will dislodge from the cervix without intervention, but placenta previa often requires emergency care. Most women with this condition require a cesarean delivery. Risk factors for placenta previa include a history of multiple pregnancies, smoking, older maternal age, an abnormal uterus, and uterine scarring.
In some cases, third trimester bleeding could indicate preterm labor. If a woman experiences a bloody show before the 36th week of pregnancy, along with pressure in the lower abdomen, she may be in early labor. Other signs include a dull ache in the lower back, stomach cramps or twitching.
Bleeding during late pregnancy can indicate very serious medical problems. Some conditions pose a threat to the health and survival of the mother and fetus and may require emergency medical attention. If a woman experiences third trimester bleeding, she should contact her doctor.
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