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Why is my wife bleeding in the 7th month of pregnancy?

Wednesday, 21 October 2009
Answered by: Dr B Shakuntala Baliga MD (AIIMS), FICOG
Professor and Senior Consultant Gynecologist & Colposcopist Mazumdar-Shaw Center for Cancer Research & Narayana Hrudayalaya Multispecialty Hospital, Bangalore
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Q. My 26 years old wife had heavy bleeding with clots in the 7th month of pregnancy. We had no intercourse during pregnancy. The doctor told us that a part of placenta got separated and she needs to do a c-section. As the baby’s weight is 1100 grams, the doctor didn't give guarantee to the baby. Then we went to another hospital and the doctor there told us that its not so serious. She was admitted in the hospital for 2 weeks and discharged after everything was fine. In between she had 5 ultrasound scans. She started having pain in the mid of the 8th month and the doctor suggested for normal delivery after checking. But the baby died after 5 minutes of delivery because the cord was tightly coiled around the baby’s neck (two rounds).
  1. Why was there abnormal bleeding in the 7th month of pregnancy?
  2. Will this affect baby?
  3. Since there were 5 scans done in a month’s period, why did the doctor not observe the cord wrapped around the baby’s neck?
  4. Would the baby have survived if we went for a c-section?

A. 
  1. As it has already been mentioned, the bleeding was due to separation of the placenta. It is sometimes associated with high blood pressure, trauma (like fall, blow on stomach, car accident etc), a small fibroid in the uterus, too much water in the womb (polyhydramnios) and in many instances without any reason.
  2. If the area of separation is too big, it can lead to fetal distress and even death of baby (even before it is born). Sometimes, this condition can be life threatening to the mother also.
  3. Sometimes the cord wraps around the baby's neck only later (may not have been there before the scans).
  4. It is difficult to comment in retrospect whether the baby would have survived with C-section. The gynaecologist takes a decision for or against a C-section taking several factors into consideration - difficult and unethical for someone not present at the time and place of emergency to comment.
I suggest you should look forward and try and get over this. I know it is easy for me to say this, but it does not help thinking over what has happened, isn't it? Also, you should be a pillar of support for your wife who is probably suffering a lot after this. Avoid a pregnancy for at least another 1 year. Ensure your wife takes good vitamin supplements. Taking folic acid and antioxidants is said to prevent recurrence. Be under the care of an experienced gynaecologist next time, and register for delivery in a tertiary hospital with good NICU facilities.

A. 
  1. As it has already been mentioned, the bleeding was due to separation of the placenta. It is sometimes associated with high blood pressure, trauma (like fall, blow on stomach, car accident etc), a small fibroid in the uterus, too much water in the womb (polyhydramnios) and in many instances without any reason.
  2. If the area of separation is too big, it can lead to fetal distress and even death of baby (even before it is born). Sometimes, this condition can be life threatening to the mother also.
  3. Sometimes the cord wraps around the baby's neck only later (may not have been there before the scans).
  4. It is difficult to comment in retrospect whether the baby would have survived with C-section. The gynaecologist takes a decision for or against a C-section taking several factors into consideration - difficult and unethical for someone not present at the time and place of emergency to comment.
I suggest you should look forward and try and get over this. I know it is easy for me to say this, but it does not help thinking over what has happened, isn't it? Also, you should be a pillar of support for your wife who is probably suffering a lot after this. Avoid a pregnancy for at least another 1 year. Ensure your wife takes good vitamin supplements. Taking folic acid and antioxidants is said to prevent recurrence. Be under the care of an experienced gynaecologist next time, and register for delivery in a tertiary hospital with good NICU facilities.

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