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What is a bloody show

Each pregnancy is unique. One thing is certain, however. When you are pregnant, your body is continuously going through changes in preparation for delivery of your child. Many of the changes your body goes through during pregnancy are expected and predictable. However, even some of the expected bodily processes can be alarming if you're not prepared for them, or if you're not aware that they can occur.

'Bloody show' is a normal part of pregnancy. Most pregnant women experience some degree of 'bloody show' towards the very end of their pregnancy. Some women will experience a slightly bloody cervical discharge, while others may experience a rather blood-filled discharge. Many women, however, never experience it at all. All of these conditions are within the range of 'normal'.

All pregnant women form a mucus plug within the cervical canal. The purpose of this mucus plug is to form a protective barrier within the cervix to prevent harmful bacteria from passing into the uterus and harming the developing fetus. Towards the very end of pregnancy, the mucus plug is released in preparation for the labor process. The timing of this phenomenon is generally during or after the 36th week of pregnancy.

Throughout most of a pregnancy, the cervix remains thick and long. In preparation for delivery, however, the cervix becomes increasingly shorter and thinner. The medical term for this process of the cervix shortening and thinning is 'effacement'. While all pregnant women experience the effacement process prior to labor, there is quite a lot of variation as to how each woman experiences it.

During the effacement process, the mucus plug is loosened. When the mucus plug is released and passes through the cervix, it may or may not rupture tiny blood vessels in the process. This is why some pregnant women will see a red, pink or brown bloody discharge, but some may not have any awareness at all of what is happening. The plug may come out as a plug, a lump or simply as increased vaginal discharge over several days.

While passage of the mucus plug out of the body certainly indicates that the body is preparing for the labor process, it does not necessarily indicate that going into labor is imminent, and it is not cause for alarm. Labor could start in hours, or, labor could still be a week or more away. If the mucus plug has been released prior to the 36th week, you should probably contact your doctor. It is possible for intercourse or a vaginal exam to dislodge the mucus plug, so if the plug has passed out of the body sooner than it should, this should be investigated.

While presence of the 'bloody show' is generally not cause to immediately head for the hospital, there are circumstances during a pregnancy when the presence of blood does warrant a call to your doctor. The presence of more than a tablespoon of very bright red blood is one such circumstance that may indicate a serious obstetrical complication.

The leading cause of vaginal bleeding during pregnancy is an obstetric complication known as placenta praevia. This condition is the result of incorrect positioning of the placenta within the uterus. If the placenta is too low in the uterus, part of the placenta may shear off and a small section of it may then bleed. This painless, bright red vaginal bleeding commonly occurs between 24 and 32 weeks of gestation. While the bleeding may start out mildly, it may increase if the placenta begins to separate from the wall of the uterus.

While the cause of placenta praevia is unknown, it is hypothesized that it results from abnormal vascularization of the placenta. The underlying cause of this abnormality is thought to be result from scarring or atrophy of the uterine tissue from previous trauma, surgery or infection.

This condition is estimated to occur in approximately .5% of all labors and there are some common risk factors associated with the occurrence of the condition. The first of these is a previous occurrence of placenta praevia. A prior Caesarean delivery or D & C are other risk factors. Those who have given birth previously, particularly those who have gone through a large number of closely spaced pregnancies are also at increased risk. Smoking and alcohol use during pregnancy also increase the risk of placenta praevia.

If bleeding is relatively profuse, you should seek immediate medical attention. Profuse bleeding often indicates placental abruption, which is a serious complication of pregnancy. Placental abruption occurs when the placenta separates from the uterine wall. While this can occur any time after the 20th week of pregnancy, it most commonly occurs during the third trimester.

Although placental abruption can be indicated by profuse bleeding, the amount of bleeding can vary depending on the degree to which the placenta has separated. Loss of blood can threaten the mother's life, and the baby can suffer from a lack of oxygen. If blood remains trapped behind the placenta, this too can threaten the lives of both mother and child. Other indications of placental abruption include abdominal and/or back pain, contractions occurring every four to five minutes, and tenderness of the uterus.

As with placenta praevia, there are risk factors that increase the chances of placental abruption. Some of these risk factors are similar to those of placenta praevia. These include having delivered numerous children previously and uterine trauma from prior medical procedures. Occasionally, the condition can be attributed to injury of the abdomen resulting from an accident or an assault. Women over 40 and those suffering from high blood pressure or diabetes are also at increased risk. Sometimes the condition can be attributed to an unusually short umbilical cord.

Depending on the severity of the problem and how far along you are, the baby may be delivered early or treatment may be given to delay birth. Knowing which kinds of bleeding during pregnancy are normal or are cause for concern can make all the difference to you and your baby.

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