Bleeding at 15 weeks of pregnancy

If you experience bleeding when you are 15 weeks pregnant, you should take it seriously, because bleeding symptoms should not occur during this period. Once it happens, it means that you may have threatened miscarriage. However, your emotions should not fluctuate too much. You should stay calm at this time to avoid miscarriage. You should also go to the hospital for a detailed diagnosis in time.

1. Miscarriage

If a woman of childbearing age has had regular menstruation in the past and experiences vaginal bleeding after amenorrhea, early abortion should be considered first. During threatened abortion, there is a small amount of vaginal bleeding, no abdominal pain or mild lower abdominal pain, and early pregnancy reactions. Examination may reveal that the cervix is ​​not open, the size of the uterus is consistent with the month of amenorrhea, and blood and urine pregnancy tests are positive.

If the fetus is dead or the cause of miscarriage has not been eliminated, vaginal bleeding increases with paroxysmal uterine pain, and the cervix is ​​open, it should be diagnosed as inevitable miscarriage. If the fetus is expelled but part or all of the placenta remains in the uterine cavity, hindering uterine contraction and causing continuous vaginal bleeding, it is diagnosed as incomplete abortion. Sometimes there may be heavy bleeding or even shock. At this time, the cervix is ​​relaxed and placental tissue can often be seen blocking the cervix. The above types of miscarriage are not difficult to diagnose based on medical history and examination.

2. Ectopic pregnancy

The most common ectopic pregnancy is tubal pregnancy. Vaginal bleeding is one of the main symptoms of tubal pregnancy. Because the fallopian tube lacks a complete decidua and is not suitable for the development of a fertilized egg, the embryo dies early and the embryonic sac separates from the tube wall and enters the abdominal cavity, which is called fallopian tube abortion. Or the fallopian tube ruptures and causes intra-abdominal bleeding, causing hemoperitoneum. After the embryo dies, the decidua loses the support of HCG and peels off from the uterine wall, causing vaginal bleeding.

Patients often have a history of infertility, and vaginal bleeding often occurs 6 to 8 weeks after amenorrhea. The amount of bleeding is small, but it continues until the fallopian tube lesions are removed. The uterine decidua can fall off completely and be discharged in the form of triangular tubular objects, called decidual casts, which have diagnostic value for fallopian tube pregnancy. When a fallopian tube pregnancy fails or ruptures, it causes hemoabdomen, which leads to severe abdominal pain, and excessive bleeding can cause shock. Examination showed that the uterus was normal in size or slightly larger. There was cervical tenderness after hemoabdomen, and a mass could be felt on one side with tenderness. Generally, it is not difficult to make a diagnosis for typical cases based on medical history and clinical manifestations. Ultrasound and laparoscopy can assist in diagnosis.

3. Hydatidiform mole

Vaginal bleeding is the earliest symptom of hydatidiform mole. It usually begins about 12 weeks after menstruation. It is dark red in color, with variable amount, and may be intermittent or continuous. However, heavy bleeding may occur at any time. If vesicles are seen in the discharged blood, the diagnosis can be confirmed. The patient has anemic appearance. During examination, the uterus is abnormally enlarged, exceeding the size for the month of pregnancy, and one or both ovaries are enlarged due to cystic changes. Because the proliferating trophoblastic cells produce a large amount of HCG, the blood and urine HCG levels increase, significantly exceeding the levels of normal pregnancy. Ultrasound examination showed an enlarged uterus with rich echoes and the uterine cavity was filled with bright and dense light spots like snowflakes. There was no image of the fetus and its appendages.