The Complete Egg

The before, during and after of a molar pregnancy, with a side of chemo and a 12 month wait before ttc. And most recently: experience of a healthy pregnancy.

Saturday, September 09, 2006

Bleeding obsessions: staining, spotting and the like.

God, everytime I bleed now I start to panic. I don't know why because I feel like I've been staining, spotting, or bleeding off and on for the past 3 months. I've never relaxed about it. Everytime it seems like it's been cause for concern.

I remember when I was first asked the midwife, "what is the difference between spotting and staining?" I can't even remember the answer. I don't think I knew that there were different ways to describe bleeding. And then there was the whole: "Am I soaking a pad every one or two hours?" I didn't really know. I asked the nurse after my d&c in the recovery room, "So, is that soaking?" as she's watching me change my pad. "Yes, that's soaking." So we're talking big pad and thoroughly drenched. Okay. So here are the few things that I've learned about bleeding during pregnancy, during a miscarriage, during a molar pregnancy, after a d&c and while on chemo for Gestational Trophoblastic Neoplasia (GTN) Of course this is anecdotal and for interests sake. Call your doctor with any concerns:

Bleeding during pregnancy (8,320,000 hits on Google):
- makes you run to the computer to do a Google search
- can happen and you can still have a healthy pregnancy
- you call your care provider but you may or may not feel reassured
- often happens after sex (intercourse)
- brown blood is old blood and does not seem to cause as much concern, red blood is a more worrisome signal
- gush of red blood with cramping could signal miscarriage (it did with me)
- soaking a pad every hour (blood is pouring) is a signal to go to the hospital where they usually do an u/s and will suggest a d&c if it shows that baby has stopped growing or miscarriage is underway (although many women find that they can miscarry naturally).
- If you don't know if you are soaking a pad and are worried, you could go in to emergency and tell them that you are pregnant (or miscarrying) and you are soaking a pad every hour
- some midwives seem reluctant to say you are/will be miscarrying and you figure it out when you actually birth everything
- brown/prune coloured bleeding during pregnancy, combined with high hcg levels and any of nausea, vomiting, extended uterus/abdomen can signal molar pregnancy (ultrasound and hcg levels will usually confirm)

Bleeding during miscarriage:
- the whole miscarriage process can take a few days where tissue/placenta/fetus are passed at different points and bleeding can continue for a week
- Go to the hospital at any sign of fever or excessive bleeding
- Often your health care provider will want you to have an ultrasound to determine if you have passed everything on your own and do not require a d&c
- Many women can miscarry naturally on their own and even though it's a hard decision to make, I think that it's best to avoid the d&c if possible
- I got my period 4 weeks after my miscarriage but I've heard that it can take longer (4 to 9 weeks)
- Some people find that accupunture helps after a miscarriage

Bleeding after D&C
- In the first week, I bled red blood, then spotted, then bled red blood. I was told that bleeding red blood (like a period flow) is normal but soaking a pad every hour was cause to call the doctor immediately or go to the hospital
- I started bleeding after moving tables and things around in my classroom and I started realizing that I needed to listen to my body and if things caused bleeding then I would take it easy and not do those things (my doctor said the bleeding wasn't related to moving heavy things but I disagree)
- 2 weeks post d&c, I passed some clots with cramping and bleeding (some women on the forum said that this happened to them and they were told that it signaled that you would have a big drop in hcg hormone levels because the mole tissue was dying. Other women said that bleeding was evidence that the mole tissue was continuing to grow and proliferate. The verdict's out on that one. For me, my levels went up after that. My doctor sent me to an ultrasound to see if there was tissue remaining. The u/s showed that their was increased blood flow to an area of my uterus but there did not appear to be any tissue remaining. Seems like the trophoblast cells were continuing to grow and be fed with blood)
- many women bleed off and on following their d&c's and it seems to be really individual. It can last for awhile (even up to 8 or 9 weeks)
- they say to expect a period in 4 to 6 weeks but this is very individual as well and many women seem to have different wait times. They are in touch with their doctors about this.

Bleeding during Chemo treatment for GTN (Gestational Trophoblastic Neoplasia):
- my doctor did tell me to expect bleeding during my first treatment of chemo. I did bleed both brown and red blood during the first two weeks after the first chemo session. This supposedly indicates that the trophoblastic cells are dying and sloughing off. It is also been associated with a drop in hcg levels (this happened for me)
- some women from the forums said that they got their period while on chemo (they knew it was their period because it came regularly every 28 days) and birth control pills

I got my period 9 days after reaching hcg levels of "zero". This is while still on chemo. I heard to expect your period anytime after your levels are at 100 or less but that every woman's body is different.


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