Bleeding and Cramping at 21weeks (Loss mentioned)

This is my first post on the forum as I've felt like I've had a textbook twin pregnancy until recently. Last Friday, on my anniversary, my husband and I had intercourse. I was not particulary "active" if you know what I mean just due to getting bigger and uncomfortable. I was suprised to see when we were done that there was some bleeding. I had heard that bleeding would be likely after intercourse or an exam so I didn't worry. I continued to have bloody discharge all day Friday and then all day Saturday. Sunday morning, it was still there so I called the nurse who requested I come in and get checked. When I got there, they said they didn't see any new blood but that they wanted to monitor me for some small contractions they saw on the monitor. After receiving a Brethine (spelling) shot, I was sent home. On Monday, bleeding continues and is now reaching my underwear instead of just coming out on toilet paper so I started wearing a medium/heavy pad. Then Tuesday, it seemed to increase even more, so I called my OB that afternoon who wanted to see me Wednesday morning for an ultrasound. The Wednesday ultrasound showed no bleeding inside and that the babies were fine. They did not check me and said that sometimes women just bleed during their pregnancy and that they would think any disruption from the intercourse should have long since cleared up. On Wednesday, I filled 4 pads during the day and that night another two. Also, in the middle of night after one of my bathroom trips, I had a gush of brownish/red fluid. It was so much that I could feel it when it started to come out and it was streaming down my legs as I headed to the bathroom. My husband got really upset and insisted that I go back to the doctor this morning. So my doctor visit this morning consisted of a cervix check where the OB said my outside cervix was open, but that my inside cervix is closed. Other than that, he said to just call him if anything changed. He gave me no direction on bed rest, pelvic rest, or what might be going on. Even though I have told them at the visits yesterday and today that I am having quite a bit of cramping in my lower abdomen, they haven't monitored me for contractions.

Logic tells me that pelvic rest is in order since I continue to bleed and today have filled now 6 pads, but do you think I should put myself on bedrest? I am considering finding a specialist to give me another opinion but I hate to be a worry wort. This is baby #4 & 5 for me and I have never experienced anything like this although my others were singletons. Any advise or prior experience would really be appreciated and sorry for such a long post!

Stephanie

 

I'd find another OB and or Peri quickly....I think I'd go to the ER and ask to be seen by a different OB or perinatologist if possible. You should not be bleeding that much...

 

i am a L&D nurse and i don't think you're receiving appropriate care. i'd contact another doctor, preferably a perinatologist/MFM. are you already seeing one? they need to check your fluid levels and the outside of your cervix shouldn't be open at this point. most of the docs i work with would have you on hospitalized bedrest at this point. the bleeding is a difficult thing if they can't find out where it's coming from, plus it's also subjective unless you're actively saturating pads at the hospital. you need to be under the care of a perinatologist. hope you can find someone soon!

 

No, I am not seeing anyone other than my OB, but my sister in law works as an RN at a high risk OB office and said that she was shocked at the lack of advice I'd been given. I'm going to make some calls tomorrow and see if I can get in somewhere soon. Thanks for your response!

 

:hug: Stephanie!
I agree, I would look at being seen by another OB or Peri. FOR SURE.
If you are continuing to bleed or have any concerns on your sypmtoms please go get seen at the ER until you are able to see another Dr.
Keep us posted OK?

 

I hope and pray you have gone to the ER by now. Heck I was there after bleeding for less than 24 hours, much less days on end. Please, please go to the ER NOW. They will properly monitor you and the babies. I really, really hope the bleeding is nothing, but the leaking/gushing fluid has me very concerned. Please update us if you can.

 

I had similar bleeding at 5 weeks, 7 weeks, and 11 weeks with my last child and one thing that I found is that the doctors and nurses almost questioned my reporting of the bleeding events. It was almost like they thought I was exaggerating until I showed them the pads and my thick jeans which were soaked with blood. At week 11 my u/s tech at the doctors office was able to actually catch the bleeding on the u/s and it showed up behind the placenta. Because of this they sent me over to triage at the hospital. By the time I got there though I had bled most of the blood out, and there was nothing visable on the u/s. The resident that examined me clearly questioned whether or not anything had been there... U/S are 'real time' and it's almost like doctors won't believe it unless they see it themselves. That resident told me to 'go home, put your feet up and act like you have the flu..'... I was appalled by her apparent lack of concern. When I spoke with my doctor later, who had spoken first hand with my u/s tech, she advised me with much more caution. Pelvic rest... and modified bed rest..no vaccuming, no laundry, off your feet as much as possible, limited stairs... on your feet to prepare a meal for 20 minutes is fine, but no more than that...

Until I took this advice seriously my uterus did not have a chance to heal. Once I finally got off my feet as much as possible the bleeding stopped.

At 21 weeks you absolutely should not be having this issue. Most of the time with a subchorionic hemmorage (bleeding from the placenta) it clears up by week 20. For it to start up like this makes me wonder if your placenta is low lying... if it partially covers the cervix you could have bleeding which lasts until the placenta moves up. I did have blood loss and a chunk of tissue come out when I was 15 weeks with my twins, and that was caused by my baby A's low lying placenta. But for this to just start up at 21 weeks would make me very concerned.

I agree with the others that you need to seek another opinion. You need to keep on calling your doctor or another doctor at the practice. The squeaky wheel gets the grease as they say.

 

:hug: Sorry you are having to worry about this. I agree, I would find a new OB and peri fast.

 

P.S. The doctor really should've had you in for another u/s this morning. It makes no sense at all to do a manual cervix check this early...why on earth didn't he have you in for a vaginal u/s. That would've given the info on your cervix without messing around with things...and it would've allowed them to see any blood in the uterus.

The cramping, BTW is not so concerning as the bleeding. If you are bleeding then you WILL have cramping...that's a normal part of that whole ball of wax. It's not the cramping that will cause the issues, it's the bleeding. But even after my bleeding had stopped for weeks I had cramping due to the dried blood clot in my uterus. People tend to get really nervous over cramping in pregnancy, but it really is a normal thing if you have any bleeding from your uterus.... it's the bleeding they need to figure out! They really should've done another u/s this morning. I can't understand why a doctor would've had ordered one for you. I had one every time I bled...and even after that I was in for an u/s every two weeks, and for growth scans later to make sure the baby was growing properly due to the compromised placenta.

Are you going to a perinatologist yet?? If not you really need to insist on being seen by one. They will take this matter more seriously I'm sure.

 

Do not follow your Ob's advice.

I would head to the ER asap....

Please keep us updated.

 

Gosh I keep re-reading your first post...if you've filled 6 pads already from your doctor's appointment this morning you need to call them back again. You need to insist on coming back in for an u/s. This just isn't normal at all...and it's even stranger that they wouldn't have checked you with an u/s. And by all means no matter what they tell you put yourself on bedrest! There is no scientific evidence that it works, which is why many doctors won't put women who bleed on bedrest... But the problem is you will never be able to design a study to look at the same woman in the same pregnancy who bleeds just the same on bedrest vs. not on bedrest. There simply is no way to study the issue. But I've encountered many, many women with bleeding issues during pregnancy who testify that their bleeding did not resolve itself until they put themselves on bedrest. Same thing happened to me!

 

I'm so sorry you're going through this. I would contact a hospital with a high-risk peri practice who can be consulted and go to L&D instead of the ER. I had a very BIG bleeding episode early on in this pregnancy 8.5 weeks, and went to my small, local ER. They were not much help at all. However, since that time I now go to a large hospital with it's own L&D triage (like an ER for preggo/high risk moms). I've had GREAT care there.

You should be getting an internal u/s to monitor your cervical length and to see if you are funneling. ITA that pelvic rest is a good idea (probably for the rest of the pregnancy, just my opinion), and I was put on full bedrest (except bathroom breaks) during my bleeding. I was diagnosed with a sub-chorionic hemotoma, but as someone said...these are usually resolved my 20 weeks but not always.

Let us know how you are doing, we're concerned for you!

 

Thank you all so much for your responses and much needed advice. I ended up going to L & D around midnight as my lower abdomen was contracting. I also was able to show the L & D nurse the blood that had accumulated on my pad just in my ride to the hospital. They could clearly see the contractions on the monitor and said that I was 1 cm dialated. After they saw three contractions I received a shot of terbutaline and the contractions stopped. This morning, they did an ultrasound and said babies fluids look good at around 11 each, could not see any issues with either placentas and spotted a fibroid in my cervix that they said could possibly be causing all these problems. My OB is keeping me for another 24 hours to see what new trick my body performs, so hopefully they are starting to take me seriously. My husband insisted on a referral to a peri this morning when talking to the doctor who seemed almost suprised that we would second guess his lack luster reactions to our experience so far. So as soon as I can, I am finding a NEW OB, and Peri. And if my doctor doesn't put me on bed rest after this, I'll just do it myself at least until the bleeding stops and I can get in to see a new doctor.

I'll update if anything changes!

 

I'm glad you went to L&D last night. :good: It is always good to get checked out. And the fibroid may be causing the bleeding, but I am glad they are keeping you for 24 hours and keeping an eye on you. And I agree with you, if your OB does not put you on bedrest after this, it never hurts to put yourself on it.


I'm glad your DH talked to your OB about a referral to a peri. :good:

 

I'm so glad they are using caution with you now!! How different things are from one place to another. At two of the ob/gyns I went to it was totally standard practice to refer twin patients to a peri, even with no complications. I don't see why the ob would be offended over that. They have better u/s equipment and better trained techs to take a closer look at the twins as they grow!

 

So glad you're doing better. You are DEFINITELY doing the right thing by inisisting on a peri. Hope your bleeding stops and you can go home soon!!!!

 

I am very glad you got some answers and the babies look good!

 

I completely understand what you are going through. My SIL was living with us and pregnant with a single baby. She started bleeding at 5 months. Her Dr didn't believe her and told her she should go home and take it easy. The second visit after bleeding the Dr told her to be on bed rest. The third time she went to the ER and the Dr there told her that she needed more exercise, that was a huge mistake. The fourth time she was bleeding bad enough they airlifted her to a major hospital in the city. The Drs there kept her for 24 hours and sent her home because she had stopped bleeding and they couldn't find anything wrong. 24 hours later she was back in the hospital bleeding and contracting. Her doctor finally believed her at this point and was so mad at the Drs in the city for sending her home that she called the city Drs and yelled at them until they understood what was going on. She ended up living in a hotel next to the city hospital for the last month and a half of her pregnancy just in case something happened. As soon as she hit 36 weeks they sent her home. The bleeding started within 24 hours and she was back at the local hospital where they had to do an emergency c-section to take the baby.

The Baby was a tad bit premature but perfectly healthy. They were never able to determine why she was bleeding.

The moral of my story is to keep going to doctors until you find one who believes you and will do something about it. The mess that my SIL went though was far to stressful and she was only having one baby. If there is a big city hospital near by with a good reputation you should try to get in to a doctor there. Don't take no for an answer your little ones are to important.

 

I'm really convinced that the reason this is sooo common is that in some cases the placenta bleeds and unless you catch the bleed 'in action' the blood will simply drain out and you'll see nothing out of the ordinary around the placenta. I think this because it's exactly what happened at 11 weeks with me. I went in bleeding to my regular office and the tech 'caught' the bleed in action on the screen... then 25 minutes later in triage there was nothing showing up at all because most of the blood had drained out of my uterus. Unless a huge clot forms behind the placenta you just can't see it... thus the reason why doctors don't believe their patients...by the time they come in there is just a trickle of blood and the docs chaulk it up to an irritated cervix... Yeah right...like my cervix can get a little irritated and drop out a pint of blood!!

In any case, the fibroid issue mentioned is another big cause for bleeding, so I'm glad she at least has a reason now to know 'why.' It's just much more reassurring.

 

I'm glad you went into the hospital to get checked out. Good for your husband for speaking up and demanding to see a peri.

 

I don't know if it would have helped, but we never made it to the Peri. Thomas Fletcher and Lowell Timothy were born on January 10th at 22 weeks and did not survive. Apparently, there was an abruption at the placenta of baby b that couldn't be seen on ultrasound.

I pray that anyone else that reads this posts will heed the warning of slowing down at the first sight of problems. If only they could have stayed in for a few more weeks, we might have not lost them.

I envy the families that are being born and the friendships that are made on this forum. May God bless all of you and your babies!

Stephanie

 

I am so sorry for your loss, so sorry, I was just checking in to see how you were doing and saw your post.

 

:hug: I am so sorry for your loss!

 

I'm sorry for your loss. :hug: :hug: :hug:

 

I am so very sorry for your loss. :grouphug:

 

Oh no, Stephanie. Words cannot express how terribly sorry and sad I am for your loss for your precious, precious boys. It makes me so angry at your doctor that he didn't support you while you were having symptoms. I will be praying for healing for you and your dh during this very devastating time.

 

I am so very sorry for your loss.

 

I'm so sorry. :cry:

 

Stephanie, I'm really, really sorry . Reading this makes me tear up . I desperately didn't want this to happen for you!

Please feel free to stay if you'd like .

 

I am so sorry for your loss. :hug:

 

I am very sorry for your loss. I will keep you, your husband, Thomas and Lowell in my thoughts. I wish you well during this difficult time.

 

I am so, so sorry. :hug:

 

:cry: I am so very very sorry for your loss Stephanie! You, your husband, and your precious angel babies will be in my thoughts and prayers! :hug:

 

No words can express how sad I feel for you and your family right now. I am so sorry that you have had to go through this. I pray for a healthy healing for you and much love to your family. :hug:

 

How terribly awful. My greatest sympathies to your family. Geez. I was really hoping this wouldn't happen. I am so sorry.