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Lochia rubra (or cruenta) is the first discharge, composed of blood, shreds of fetal membranes, decidua, vernix caseosa, lanugo and membranes. It is red in color because of the large amount of blood it contains. It lasts 1 to 4 days after birth, before easing to light "spotting". [7] [unreliable source?]
Light spotting early on in pregnancy can be a result of the fertilized egg implanting into the uterus. Additionally, during pregnancy, the blood supply to the cervix increases, which can cause the cervix to be more friable and bleed more easily than a non-pregnant woman's cervix. Because of this, some light spotting after intercourse can be normal.
During pregnancy, vaginal discharge volume increases as a result of the body's increased levels of estrogen and progesterone. [13] [2] The discharge is usually white or slightly gray, and may have a musty smell. [13] [2] The normal discharge of pregnancy does not contain blood or cause itching. [13]
Hemorrhoids are common in pregnancy as a result of constipation and increased intra-abdominal pressure. Hemorrhoids can cause bleeding, pain, and itching. [32] Treatment is symptomatic, including improving underlying constipation. Symptoms may resolve spontaneously after pregnancy, although hemorrhoids may remain in the days after childbirth. [33]
Endometritis is inflammation of the inner lining of the uterus (endometrium). [6] Symptoms may include fever, lower abdominal pain, and abnormal vaginal bleeding or discharge. [1] [4] It is the most common cause of infection after childbirth.
In addition, early pregnancy bleeding has sometimes been included as gynecologic hemorrhage, namely bleeding from a miscarriage or an ectopic pregnancy, while it actually represents obstetrical bleeding. However, from a practical view, early pregnancy bleeding is usually handled like a gynecological hemorrhage.
The first step in work-up is to rule out a tumor or pregnancy. [5] [3] Medical imaging or hysteroscopy may help with the diagnosis. [2] Treatment depends on the underlying cause. [3] [2] Options may include hormonal birth control, gonadotropin-releasing hormone (GnRH) agonists, tranexamic acid, NSAIDs, and surgery such as endometrial ablation ...
The bleeding can be from the uterus, cervix, vagina and other tissue or organs located near the vagina. [4] Postcoital bleeding can be one of the first indications of cervical cancer. [5] [6] There are other reasons why vaginal bleeding may occur after intercourse. Some women will bleed after intercourse for the first time but others will not.