What to do if you have painless vaginal bleeding in late pregnancy

It is very abnormal if painless vaginal bleeding occurs in the late pregnancy. So what should you do if you have painless vaginal bleeding in the late pregnancy? Next, this article will introduce you to what to do if you have painless vaginal bleeding in late pregnancy, for your reference only. Friends who want to know more about this may wish to take a look! Please see the detailed introduction below.

What should I do if I have painless vaginal bleeding in late pregnancy? The principles of treatment are to inhibit uterine contractions, stop bleeding, correct anemia and prevent infection. The decision is made based on the amount of vaginal bleeding, the presence or absence of shock, the number of weeks of gestation, parity, fetal position, whether the fetus is alive or not, whether labor is imminent, and the type of placenta previa.

1. Expectant treatment

The purpose is to prolong the gestational age while ensuring the safety of the pregnant woman, so that the fetus reaches or approaches full term and improves the perinatal survival rate. The patient should be hospitalized and rest in bed, lying on the left side, and receive oxygen at regular intervals to increase the oxygen supply to the fetus. Try to maintain pregnancy up to 36 weeks. During the waiting process, the pregnant woman should be kept in a good mood, blood should be prepared for use, and sedatives, blood tonics or blood transfusions should be used appropriately. If necessary, give uterine contraction inhibitors such as salbutamol sulfate and magnesium sulfate. For women who are >32 weeks pregnant, dexamethasone 5-10 mg should be given intravenously or intramuscularly twice a day for 2-3 days to promote fetal lung maturity. If heavy vaginal bleeding or recurrent bleeding occurs during the observation period, the pregnancy should be terminated.

2. Termination of pregnancy

1. Cesarean section

Indications include pregnant women with repeated massive bleeding leading to anemia or even shock; gestational age is over 36 weeks; and fetal maturity examinations indicate that the fetus has mature lungs. Complete placenta previa should be delivered by cesarean section, while partial or marginal placenta previa in primiparas is also likely to be delivered by cesarean section in recent years. Cesarean section is the safest and most effective way to treat placenta previa, and it is also an emergency treatment method for severe bleeding from placenta previa. Correcting shock before surgery, and replenishing blood volume with infusion and blood transfusion can not only rescue the patient, but also improve the fetal hypoxia in the uterus.

2. Vaginal delivery

It is only suitable for patients with marginal placenta previa, occipital presentation, little vaginal bleeding, and who are expected to complete delivery in a short time. Artificial rupture of membranes can be performed under blood preparation and fluid infusion conditions, and the fetal head can descend to compress the placenta to achieve the purpose of hemostasis. If the presenting part does not descend ideally after rupture of membranes and there is still bleeding, cesarean section should be performed immediately.

3. Emergency transfer

If there are no rescue conditions such as blood transfusion and surgery, the vagina should be immediately stuffed with gauze under disinfection, the abdomen should be bandaged with pressure, and the patient should be escorted by medical staff to a hospital with conditions for treatment.

The above is an introduction on what to do if you have painless vaginal bleeding in late pregnancy. I believe that after reading the above introduction, you already know what to do. When painless vaginal bleeding occurs in the late pregnancy, it must be taken seriously. If the fetus is not yet full-term, try to find ways to stop the bleeding and prolong the fetal life. If the fetus is full-term, the pregnancy can be terminated by cesarean section or vaginal delivery.