Discharge during pregnancy. Infections and inflammatory processes

Brown discharge can occur during pregnancy at any stage - from the first days after conception to childbirth. Such symptoms almost always indicate serious pathology and requires urgent medical care. It is important to know why brown discharge occurs - this is the only way to find its cause and avoid the development of complications.

What is brown discharge?

Vaginal discharge Brown- It's just blood. A similar shade occurs with minor bleeding. The discharge is usually scanty, spotting, visible as drops on underwear or panty liners. Less often they become moderate and require the use of absorbent intimate hygiene products.

Brown discharge may occur at the beginning of bleeding, and then it will intensify over time. Vaginal discharge will become abundant, the color will change to scarlet, dark cherry. Blood clots may appear. During pregnancy, this condition poses a threat to the life of the woman and the fetus. Emergency required health care!

Brown discharge may also indicate the end of bleeding. The process has already stopped, and only a slight discharge of blood remains. These discharges most often occur when partial detachment placenta with the formation of a retroplacental hematoma. Such bleeding is no longer dangerous, but a woman cannot be left without attention. Doctor's supervision is indicated - in a hospital setting and then in a antenatal clinic.

Physiological reasons

Normally, the appearance of brown discharge is allowed only in one case - in the first stage of labor. With the onset of contractions, the cervix begins to stretch and gradually open. Contractions – rhythmic contractions myometrium - last from several hours to a day. This is a rather painful process, accompanied by minor tears in the cervix and damage to its mucous membrane. Against this background, slight brown discharge from the genital tract appears - a sign that everything is going according to plan and labor is continuing.

Discharge from the genital tract is not always brown. The appearance of streaks of scarlet blood is often noted, which also indicates dilatation of the cervix. The discharge is scanty, in the form of drops of blood on underwear or pads. Gain similar discharges indicates the development of complications:

• placental abruption ahead of schedule;
• uterine rupture (including along the scar).

If bleeding increases, you should consult a doctor as soon as possible. Treatment of complications that arise is carried out in the maternity ward.

Complications of pregnancy

There are several conditions that can lead to brown discharge:

Implantation bleeding

After fertilization, the formed embryo moves through the fallopian tubes and reaches the uterine cavity on the 7-8th day. Here it spends some time looking for a good place and penetrates the mucous membrane. It is believed that this process is accompanied by slight brown discharge from the genital tract - implantation bleeding.

Not all gynecologists share the same opinion on this issue. Some doctors consider implantation bleeding to be normal and advise their patients not to worry about it. Other doctors indicate that there are no bloody discharge should not occur during pregnancy, and this is nothing more than a failure during implementation ovum into the wall of the uterus - and a sign of an imminent miscarriage.

The truth is probably somewhere in the middle. In order not to miss development dangerous pathology, it is important to carefully monitor your feelings a week after conception. If the discharge that appears lasts no more than a day and does not cause discomfort, there is no need to worry. If bleeding increases, you should consult a doctor to rule out pregnancy complications.

Incipient miscarriage

Bloody discharge from the genital tract is the leading symptom of miscarriage early stages. This condition is preceded by an increase in the tone of the uterus and the appearance of nagging pain in the lower abdomen, in lumbar region, in the crotch. As long as the fertilized egg is tightly adhered to the wall of the uterus, no pathological discharge is observed. The appearance of brown or scarlet blood spots indicates that the fertilized egg has partially or completely moved away from the uterine wall, and the woman’s body is trying to get rid of the fetus.

When a miscarriage begins, brown discharge is observed only on early stages. They quickly become scarlet or cherry, abundant, often with clots. Further development events are possible in two scenarios:

1. The bleeding stops, and a hematoma forms between the fertilized egg and the wall of the uterus. Scarlet discharge is replaced by brown, the woman’s condition improves. The embryo usually survives, and the pregnancy continues safely. It is possible that the situation will repeat itself after some time.
2. The bleeding intensifies, and an abortion develops. The fertilized egg exfoliates from the endometrium, and the embryo dies. Vacuum aspiration of the fertilized egg and curettage of the uterine cavity are performed. IN in rare cases the embryo, together with the membrane, completely leaves the uterus on its own, and surgical intervention not required.

Ultrasound helps confirm the diagnosis. At ultrasound examination you can determine the degree of chorionic detachment, assess the condition of the embryo and hear its heartbeat. If the heart is beating, conservation therapy is carried out. In other situations, treatment is not indicated.

It is important to know! On the Internet you can find many stories about how a woman’s menstruation did not stop during pregnancy. Expectant mothers say that periods come exactly on time or with slight deviations, but almost always turn out to be more meager. But there can be no menstruation during pregnancy. The ovaries do not work, ovulation does not occur, the endometrium does not exfoliate. What women mistake for menstruation turns out to be a sign of an incipient miscarriage - a condition requiring urgent medical attention.

Regressive pregnancy

The appearance of scanty brown discharge without nagging pain in the lower abdomen may be a sign of a non-developing (frozen, regressing) pregnancy. With this pathology, the embryo dies, but complete detachment of the fertilized egg from the uterine wall does not occur. Brown and scarlet discharge occurs 3-4 weeks after the death of the fetus and indicates the imminent development of infection. If help is not provided, the fertilized egg will begin to decompose, which will lead to infection of the uterine cavity, peritonitis and sepsis with fatal.

The diagnosis can be confirmed by examination:

• blood test for hCG (hormone level is below normal);
• ultrasound examination (the fetal heartbeat is not detected, the size of the embryo does not correspond to the gestational age).

The only treatment is surgical - removal of the fertilized egg and curettage of the uterine cavity. A dead embryo is not able to exit on its own, and this cannot be done without the help of a specialist.

Ectopic pregnancy

Ectopic (ectopic) pregnancy is the location of the fetus outside the uterine cavity. The fertilized egg can attach in a place not intended for its existence - in the fallopian tube, less often in the ovary or on the peritoneum. The embryo is doomed to death. At 4-8 weeks, chorion detachment or rupture of the fetal sac occurs. This process is accompanied by the appearance of brown or scarlet discharge from the genital tract and other symptoms:

• nagging pain in the lower abdomen (usually on one side);
• increased body temperature;
• severe weakness;
• decreased blood pressure;
• cardiopalmus;
• loss of consciousness.

Surgical treatment is removal of the fertilized egg. In the early stages, only the embryo can be removed, preserving fallopian tube or ovary. The larger the size of the ovum, the more difficult it is to perform organ-preserving surgery. Often the entire fallopian tube or ovary is removed.

Operations during abdominal pregnancy require special skill of the doctor, since the fertilized egg is often attached to large vessels. This cannot be done without the help of an angiosurgeon.

Placental abruption

Detachment from the wall of the uterus of a normally located placenta occurs in the second half of pregnancy. The reason for this dangerous condition gestosis becomes arterial hypertension or other severe pathology. Abdominal trauma can also lead to this. As a result, bleeding develops initial symptom of which there may be slight brown discharge from the genital tract.

When the first signs of placental abruption appear, the woman is hospitalized in the obstetric hospital. An emergency ultrasound is performed to assess fetal viability. If the fetus is alive, conservation therapy is prescribed. In case of massive bleeding, emergency treatment is indicated C-section.

Placenta previa

Normally, the placenta is located in the fundus or body of the uterus along the anterior or back wall. The edge of the fetal place is located higher internal pharynx by 7 cm or more. If the placenta is located too low and blocks the exit from the uterus, they speak of previa. This condition is accompanied by painless bleeding throughout pregnancy and can lead to the development of anemia.

Complete placenta previa is an indication for cesarean section. Otherwise, the fetus will not be able to leave the uterine cavity. With partial overlap of the uterine os natural childbirth possible, but they are accompanied high risk bleeding. The final method of delivery is selected after examination.

Reasons not related to pregnancy

The following conditions can lead to the appearance of brown vaginal discharge at any stage of gestation:

Pathology of the cervix

Contact brown discharge occurs with erosion or polyp of the cervix and is the only symptom of the pathology. The following situations can provoke bleeding:

• intimacy;
• gynecological examination;
• taking a smear from the cervix;
• introduction of suppositories and vaginal tablets;
• douching;
• transvaginal ultrasound.

The diagnosis is made by examination in the mirrors. The type of formation can be clarified during colposcopy. Often the polyp turns out to be decidual (grown from the placenta), and erosion is a functional ectopia. Such conditions do not require treatment and go away on their own after childbirth. If bleeding is frequent, cauterization of the lesion may be suggested during pregnancy.

Inflammatory processes of the genital tract

Brown discharge with a yellowish or brown tint occurs with colpitis or cervicitis. Inflammation of the vagina and uterus often leads to minor trauma to the mucous membrane of the genital tract. Pathological discharge caused by the proliferation of various microorganisms, mix with drops of blood, which leads to the appearance of characteristic symptoms.

Associated symptoms:

• pain during intercourse;
• itching and burning in the vagina;
• possible increase in body temperature.

The diagnosis is made after microbiological examination of discharge from the vagina and cervix. Treatment is selected taking into account the identified causative agent of the disease.

Uterine fibroids

A benign tumor of the uterus, located in the submucosal layer, can lead to bleeding during pregnancy. Their expression can vary - from scanty brown to bright scarlet. IN the latter case the pregnancy is quickly terminated, since the existing fibroid does not allow the fetus to develop and interferes with the attachment of the fertilized egg. If the embryo survives, the fibroids are treated after birth.

Brown discharge is almost always a sign of bleeding. If such a symptom appears, you should consult a doctor as soon as possible. Refusal of medical care leads to the development of complications and creates real threat life of a woman and fetus.

During pregnancy, expectant parents and the attending physician are always concerned. Brown discharge indicates the presence of stale blood. The appearance of brown bleeding is always associated with the risk of an impending miscarriage. When pregnancy is desired and planned (especially after long-term treatment infertility), the appearance of brown discharge can be a bit of a shock for a couple.

It has been noted that the likelihood of brown discharge in the first trimester of pregnancy is higher for women who became pregnant through assisted reproductive technology (ART). Sometimes, after several embryos are placed in the uterus, one or two embryos may undergo reverse development, a phenomenon called “vanishing twin” and may cause brown discharge. Sometimes brown discharge (not bleeding!) may not pose a danger to either the fetus or the mother. According to medical research 1 in 5 pregnant women experience some spotting during the first trimester of pregnancy. Every pregnant woman should know the cases in which brown discharge or bleeding may appear, and in which cases urgent medical attention is needed.

First trimester of pregnancy - brown discharge - causes

Implantation bleeding
It has been noted that one in four pregnant women experience what is called implantation bleeding, which occurs when a fertilized egg implants or attaches to the lining of the uterus. Typically, implantation bleeding occurs between 10-14 days after conception, this process is necessary for pregnancy to occur. Upon implantation a small amount of blood is always released, since when the embryo is immersed in the uterine mucosa, damage to small vessels occurs, however, only some women observe bloody discharge. Implantation bleeding usually occurs a few days before the expected menstruation and is usually manifested by spotting light brown discharge that lasts 1-2 days.

Early miscarriage

First trimester of pregnancy - brown discharge

Most unpleasant reason bleeding in the first trimester of pregnancy is a miscarriage. If brown or reddish bleeding continues for several days and is combined with discomfort, pain in the back and lower abdomen, it is better to consult a doctor immediately, only in this case you will have a chance of saving the pregnancy.
Medical studies show that 30% of pregnant women are at risk of miscarriage. Very early miscarriages usually occur due to genetic abnormalities of the fetus, most of these miscarriages occur before the woman realizes that she is pregnant. Such a miscarriage is called early or subclinical and looks like a normal (somewhat heavy) menstruation.

Usually the embryo is implanted and then develops in the uterus, but sometimes the implantation process occurs outside the uterus, most often in the fallopian tubes. Rarely, pregnancy can develop in abdominal cavity (abdominal pregnancy). In any case, if a pregnancy develops outside the uterus, it is called ectopic and can pose a real threat to the woman’s life. If you are pregnant and experience brown spotting in the first trimester along with persistent (or slowly increasing) weakness, cramping, and abdominal pain, you may have an ectopic pregnancy.
An ectopic pregnancy must be diagnosed as early as possible and, if necessary, urgent measures taken.

Abnormalities of the placenta
During the development of pregnancy, the chorion slowly grows and gradually turns into the placenta. The final formation of the placenta usually occurs towards the end of the first trimester of pregnancy.
Brown spotting may appear if placental abruption occurs. When placental abruption occurs, a retroplacental hematoma can form, which, as it empties, will produce a brown discharge. If the blood turns red, this indicates that the detachment is continuing.

Hormonal disorders
The most common causes of abortion in the first trimester are disorders hormonal levels. This may be a lack of progesterone or estrogens, as well as an excess of androgens (male sex hormones). In some cases, termination of pregnancy may be due to dysfunction of the thyroid gland.

Inflammation
Often during pregnancy, gynecologists observe inflammation of the cervix caused by various types vaginal infections, including sexually transmitted infections. During early pregnancy, changes in hormonal levels and increased blood flow make the cervical mucosa sensitive and easily vulnerable. In these cases, women may experience brown spotting or discharge without pain. Vaginal infections should be treated urgently.

Molar Pregnancy
Brown discharge, severe toxicosis, big sizes uterus in combination with abnormally elevated levels human chorionic gonadotropin human (hCG) are symptoms of molar pregnancy (hydatidiform mole).

Brown bleeding in the first trimester of pregnancy should not be ignored; this is a reason to immediately consult a doctor. There are so-called " critical deadlines termination of pregnancy”, at this time you need to be especially careful - this is the first 2-3 weeks - the period of implantation of the fertilized egg, but if the pregnancy is not induced, women do not notice this period, rejection occurs in the form of normal menstruation. Further critical period It is considered 8-12 weeks - this is the period of formation of the placenta. Another critical period should be considered the period of interruption previous pregnancies, if they were.

The period of bearing a baby causes the expectant mother not only positive emotions, but also a lot of not entirely pleasant worries. The first weeks after conception are the most important, because the female body changes dramatically and adapts to the needs of the nascent life. At this time, the fertilized egg undergoes implantation into top layer endometrium, and the placenta and amniotic fluid are just beginning to take shape. Therefore, during this period the fetus is most susceptible negative influence, and the risk of miscarriage is very high. To maintain your pregnancy, you need to be careful alarms and seek help in time. Pregnant women especially have a lot of questions about brown vaginal discharge. When they are caused by normal physiological changes after conception, and when do they indicate a pathological course of pregnancy? Let's figure it out.

After the egg has matured and fertilization has occurred, the woman’s hormonal background is completely restructured. Such changes affect the nature of discharge from the genital tract. Normally, in the first trimester, the discharge can be described as watery, moderately abundant, without color and unpleasant odor. They should not cause discomfort, burning or itching.

But not every woman has ideal hormonal levels and overall health. Often ladies in position notice brown discharge in the first trimester, and sometimes even before the planned delay of menstruation. There may be enough reasons for such discharge, but there is no need to worry in advance. Most often, this is the body’s normal reaction to sudden changes.

It is not at all difficult to distinguish dangerous secretions from physiological ones. You just need to pay attention to your well-being and the nature of these discharges. But you still need to consult a gynecologist.

Brown discharge as a primary symptom of pregnancy

Light brown discharge during pregnancy is one of the few symptoms that can be used to suspect conception before a delay occurs. But most women do not even notice this “bell” and find out about pregnancy a little later.

Such discharge should be painless, light brown in color, and odorless. They are caused by an increase in the amount of hormones that the ovaries actively produce and corpus luteum. They can be plentiful or very scarce, it all depends on the characteristics secretory function female body. The discharge disappears as soon as the body “gets used” to the embryo.

Implantation of a fertilized egg

As soon as a sperm penetrates the egg, it is immediately closed by a dense membrane and “sent” to the uterus through the fallopian tubes. Such a journey takes on average 7-12 days from the moment of ovulation, while the duration of this process is individual and depends on the woman’s hormonal background. When the fertilized egg reaches its destination, it implants in the upper endometrial ball. In order for the embryo to firmly attach, the endometrium becomes quite loose under the influence of progesterone. The implantation of the embryo causes micro-tears in the uterine mucosa, which provokes brown discharge. Normally, a brown smear can last no more than two days.

Important! If you are planning a pregnancy and brown discharge coincides with the possible date of implantation, be sure to limit physical and psychological stress for a couple of days. This way the embryo will be able to attach more securely to the uterus.

Mucus plug in the cervix

As soon as conception occurs, the woman’s reproductive center begins to actively protect the embryo from infections, maternal antibodies and harmful substances. To do this, the cervix begins to reproduce thick mucus, which tightly clogs the cervical canal in the cervix. This allows you to prevent pathogenic microorganisms from entering the uterus and stabilize the vaginal microflora that is comfortable for a woman. The mucus plug periodically separates old cells and thereby causes brown discharge during early pregnancy. This discharge can range from light beige to dark brown, which depends on the level of progesterone in the body.

"Memory" of the female reproductive system

The pregnancy hormone progesterone is responsible for the normal course of pregnancy. If a woman lacks this substance, the body may not perceive that she is pregnant and the woman may experience brown discharge during the period when menstruation is scheduled to occur. This does not pose a strong threat, but during such periods it is better to observe strict bed rest. For some women, such discharge may appear until childbirth.

If a woman is diagnosed with borderline low level progesterone, she is recommended to be treated in a hospital. The fact is that low progesterone often accompanied by high testosterone, which is not in the best possible way affects the course of pregnancy.

Brown discharge during pregnancy, like pathological condition of a woman

Brown discharge during the gestational period is not always natural. There are many pathological conditions in a woman who are capable of terminating a pregnancy and depriving a woman of the joy of motherhood in the future. Therefore, even the most slight discharge should alert the woman. In this situation, it is better to play it safe than to lose your desired baby.

Violation of the attachment of the fertilized egg

Special villi help the fertilized egg move through the fallopian tubes, throwing it around like a ball. When the embryo enters the uterine cavity, it must attach to its upper part with the help of a trophoblast. If the female hormonal system does not cope, the fertilized egg may take an incorrect position near the uterine os. As the fetus grows, the trophoblast will expand and form the placenta. Incorrect placental location will cause nagging pain and brown discharge in a woman. This condition in obstetric practice is called placenta previa. This requires treatment and constant monitoring, since the woman for a long time the risk of miscarriage and premature birth remains.

Ectopic pregnancy

Localization of the fertilized egg in in the wrong place leads to the fact that this pregnancy cannot end in delivery. The egg is implanted not in the uterine space, but in the tube or cervix, which makes subsequent pregnancy impossible and threatens the woman with death. If dark brown discharge is accompanied by intense pain syndrome on the one hand, you need to undergo a diagnostic test and determine the location of the fertilized egg.

A timely diagnosed ectopic pregnancy allows the embryo to be removed while preserving the fallopian tube. If the moment is missed, the tube ruptures under the pressure of the growing embryo, and the woman begins to bleed. This condition requires immediate surgical intervention.

Gynecological diseases

Various diseases of the reproductive system often develop against the background of hormonal disorders. Basically, a woman fails to become pregnant, but if conception occurs, then throughout the entire 9 months the woman experiences certain complications. Dark brown discharge during pregnancy, often mixed with blood, accompanying endometriosis, uterine myoma or fibroids, and cervical canal polyps. Before pregnancy, these diseases, different in nature, cause abundant mucous discharge. But, after conception, they can manifest themselves in special ways:

• With benign formations in the uterus (fibroids, fibroids), a woman is bothered by brown discharge on the days of her expected period outside of pregnancy.
• On the background hormonal changes Hormone-dependent polyps often appear in women in the first trimester. They provoke brown contact discharge. But in most cases, they are identified during inspection during registration and are immediately removed.
• With endometriosis, a woman notices abundant mucous discharge with blood inclusions. If a woman has increased uterine tone, the amount released may increase.

Advice! Any hormone-dependent diseases can cause miscarriage or miscarriage. Therefore, it is very important to consult a doctor promptly regarding abnormal discharge.

Reproductive system infections

At the planning stage or when registering, women must be screened for sexually transmitted infections. But a normal pregnancy does not prohibit sexual intercourse, so the risk of “catching” an infection is always present. You can suspect a problem by dark yellow, sometimes green, discharge. They are accompanied by unbearable itching, burning, hyperemia of the external genital organs and a terrible putrid odor.

Important! Most pathogenic bacteria and viruses can cause genetic abnormalities in the fetus and fading of pregnancy. If you have brown discharge for a week or longer during pregnancy, be sure to consult a doctor to find out its nature.

Detachment of a fertilized egg

Progesterone deficiency weakens the ability of the fertilized egg to adhere to the uterine wall. Detachment of the embryo causes microtrauma to the vessels, which begin to bleed. Therefore, a woman notices discharge with different color intensities. They can be dark brown or scarlet. If a woman experiences pain with brown discharge during pregnancy, this may indicate a threat of miscarriage.

Fading pregnancy

Chromosomal abnormalities incompatible with life or sexually transmitted infections often cause embryonic death. Until 4-5 gestational weeks, it is quite difficult to determine this fact, so it remains to rely on the woman’s feelings. You can suspect fading pregnancy by scanty brown discharge, feeling unwell and toxicosis abruptly stopped.

On a note! It is impossible to save the pregnancy after it has died, so the woman undergoes gynecological curettage followed by histological examination embryo. This helps to establish the cause of his death and eliminate it.

Cervical erosion and vaginal microtrauma

The presence of a section of damaged epithelial cells on the cervix (erosion) in a woman is often indicated by brown discharge during pregnancy without pain. Their intensity may increase after sexual intercourse or a gynecological examination. If erosion is diagnosed for the first time during pregnancy, the woman must undergo cytological smears to rule out dysplasia. Since the vaginal mucosa is very susceptible to injury, after examination a woman may experience short-term brown discharge.

Spontaneous miscarriage

Unfortunately, not every pregnancy can be saved. For many reasons, a woman begins to detach the fertilized egg or an already formed placenta and the pregnancy is terminated. At first, when brown discharge only appears, the fetus can be saved, but in the case of open bleeding, the woman loses the child. Therefore, if you have brown discharge during pregnancy and pain, immediately go to the hospital for help.

What to do if brown discharge appears during pregnancy

Pregnancy is not the time for self-diagnosis, so any changes, including brown discharge, should be discussed with the treating gynecologist. If the discharge is combined with severe pain and the appearance of blood, you should immediately call ambulance without waiting for a scheduled visit to the doctor. While medical help is on the way, the woman needs to take a comfortable position, preferably lying with her legs slightly raised on a pillow. If the pain is very severe, you can take an antispasmodic, for example, No-shpa.

If the discharge is scanty and does not cause discomfort, it is quite possible to consult a doctor for scheduled inspection. The doctor will determine why they occur and advise what to do in such a situation.

Brown discharge in pregnant women can be interpreted in different ways. Therefore, only the obstetrician-gynecologist leading your pregnancy needs to determine the cause of their appearance. The only thing worth doing on your part is to visit the doctor on time, undergo all tests, eat well and adhere to a gentle regimen. Remember that the appearance of discharge is not a reason to panic, but only a signal that you need to see a doctor. Nowadays, most problems with discharge are easily solved with the help of modern drugs. Therefore, the chance to carry and give birth healthy baby very big.

Video “What discharge should alert a woman?”