Though slight bleeding or spotting during the third trimester can be caused by trauma or coitus. Other possible causes of bleeding during the third trimesters are; Abruptio Placenta (premature separation of the placenta), Placenta Previa and Pre-Term Labor.

 

Premature Separation of Placenta (Abruptio Placenta)

Premature separation of a placenta is the detachment of the placenta from the uterine wall after the 20th week and before the baby is born. Sometimes it may occur as late as during the first or second stage of labor. The placenta is originally implanted correctly in the right position but suddenly it begins to detach, leading to bleeding. 

 

Though the cause of Abruption Placenta is unknown, there are various risks factors that predispose a woman to having one. Such as;

Abruption Placenta Signs and Symptoms

During the initial separation, the woman experiences a sharp, stabbing pain. If she is already in labor, she experiences a double pain (pain that is more severe than the one been caused by the contractions). Other women do not experience pain but only tenderness when uterine is palpated.

 

Apart from the painful vaginal bleeding, other signs of Placenta Abruptio are:

Abruptio Placenta Treatment

Abruption Placenta is usually an emergency condition and the main goal of treatment is to make sure the mother receives adequate oxygen to prevent fetal anoxia. Baby and the mother are monitored regularly for possible complications. The woman is also kept on lateral position to minimize pressure on the venacava and to improve the fetal circulation.

 

Depending on the degree of separation, if the separation is minimal (grade 0 to 1) with slight bleeding and there is no evidence of fetal distress or hemorrhage, pregnancy may be allowed to continue. Otherwise, in moderate and severe separation (grade 2 and 3), the pregnancy must be terminated since the baby cannot receive adequate nutrients, oxygen and to prevent maternal shock. If vaginal delivery is not possible, a casarean birth is performed.

 

The woman is then closely monitored for signs of DIC (disseminated intravascular coagulation). A possible post partum complication.

 

Placenta Previa

Placenta Previa is implantation of placenta in the lower uterine segment. There are four different types of placenta previa, depending on where it is implanted;

Risks Factors for Placenta Previa

Placenta Previa Signs and Symptoms

Most cases of Placenta Previa are diagnosed early enough before any symptoms occurs during Ultrasound Test. Bleeding usually occurs at around 30 weeks, when the placenta is not able to stretch enough to accomodate the changing shape of the lower segments or the cervix.

 

Unlike in Abruptio Placenta where there is painful vaginal bleeding. In Placenta Previa, the bleeding is painless, bright red, and occurs suddenly and it is not associated with increased level of activities or participation in sports.

 

Placenta Previa Treatment

The woman is assessed of the amount of bleeding and the time the bleeding began. If the woman is already in labor, there is presence of fetal distress or bleeding, delivery must be performed, regardless the gestational age of the baby. If none of the above signs is present and the baby is below 36 weeks, the woman is allowed to continue with pregnancy but she is closely monitored.

 

Basically, the woman will remain in the hospital under closer monitoring and bed rest for 48 hours. If the bleeding stops, she may be sent home but advised to take bed rest and continous monitoring the fetal heart sounds and the mother is maintained. The other cause of bleeding during the third trimester is pre-term labor.