Bleeding in the 2nd and 3rd Trimesters of Pregnancy

Dr. Claude Allouche, Gynecologist Metros 2e-3e trim engl
Ahuza Clinic, Raanana
📞 058 726 02 64

Bleeding After the First Trimester: A Warning Sign

Any vaginal bleeding in the 2nd or 3rd trimester is abnormal and requires urgent evaluation. The main causes are:

  • Placenta previa
  • Retroplacental hematoma

Both conditions require immediate hospitalization.

A) Placenta Previa

1. What is it?

The placenta, which is normally attached to the upper part of the uterus, is implanted too low and may cover the internal opening of the cervix.

2. Symptoms

  • Heavy bleeding (bright red, possibly with clots), often recurrent.
  • Sometimes accompanied by painless contractions.

3. Treatment & Risks

  • Immediate hospitalization due to the risk of severe hemorrhage.
  • Medical monitoring:
    • Ultrasound to check the placenta’s position and fetal well-being.
    • Fetal heart rate monitoring.
    • Strict bed rest.
  • Delivery:
    • Vaginal delivery is possible if the placenta moves away from the cervix.
    • Cesarean section is required if the placenta still covers the cervix at term.

B) Retroplacental Hematoma

1. What is it?

A pocket of blood forms between the placenta and the uterus, causing placental abruption. This is a serious risk for the baby.

2. Symptoms

  • Dark, scant bleeding.
  • Severe, constant uterine pain (“rock-hard belly”).
  • Serious maternal symptoms: palpitations, dizziness, high blood pressure.

3. Treatment & Monitoring

  • Emergency hospitalization for close monitoring and appropriate treatment.
  • Ultrasound to locate the hematoma and assess the baby.
  • Delivery or cesarean section depending on severity.

What to Do if You Bleed During Pregnancy?

  • Any bleeding after 3 months of pregnancy is abnormal.
  • Go to the maternity ward immediately or call emergency services.

Doctors will assess:
✔ The amount of bleeding.
✔ The impact on the mother (blood pressure, pulse, signs of anemia or shock).

If necessary:
💉 IV fluids or blood transfusion.
🔍 Rapid diagnosis of the cause (placenta previa or retroplacental hematoma).

Important: If You Have a Negative Rh Factor

If you are Rh-negative, you will receive an anti-D immunoglobulin injection to prevent maternal-fetal alloimmunization.

Source: ameli.fr

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