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What causes profuse bleeding in a 27-week pregnant woman?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

My wife is expecting her second child. Previously, I had one 18-month-old child. She was diagnosed with placenta previa and was admitted to the hospital twice for bleeding. She takes injection Susten (Progesterone) twice a week, injection Maintane (Hydroxyprogestrone) once a week, iron and calcium tablets, Dupagest, Lycored, and Arga powder. She is now bleeding after the water broke. She is now 27 weeks pregnant. She is currently in the hospital. Please support them as they proceed with this case, provide your valuable advice.

Answered by Dr. Uzma Arqam

Hello,

Welcome to icliniq.com.

I understand your concern.

According to your description and scan report (attachment are removed to protect the patient's identity), the placenta is low-lying and coverning the os (the opening of the uterus into the cervix), the baby is around 26 weeks old, and the membranes have ruptured. The baby is now hospitalized for emergency treatment. If the placenta is low-lying, it may bleed profusely if it has already bled twice, which is very concerning. If the membranes truely ruptured, there is a risks of infections, chorioamnionitis, stillbirth, extreamly difficult survival of developing baby because baby's lung are to weak to take breath and survive even with neonatal support. If the placenta still coverning the external os and membrane has ruptured, she requires emergency surgery to avoid life-threatening bleeding. Dexamethasone injections for baby's lung maturation can be given, but it depends on how long they can wait for the second dose because this situation is extreamly dangerous and requires immediate intervention. This case requires multidisciplinary discussions, support, intervention, and counseling of patients and attendants regarding all risks of baby survival and infections, the mother's heavy bleeding need for blood transfusion, and hysterectomy in severe conditions.

I hope you could understand severity of condition and need urgent multidisciplinary attention and intervention.

Thank you.

Answered byDr. Uzma Arqam

Medically reviewed byiCliniq medical review team

Published At March 29, 2023
Reviewed AtJuly 17, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Uzma Arqam
Dr. Uzma Arqam

Obstetrics and Gynecology

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