need help - hospital admission and steroids w 2nd tri bleeding -- is this common/typical??

[naturalmummy]

So, i am posting this on behalf of my SIL who is 24 weeks pg (same as me) and just spent 36 hours in the hospital after a not-so-severe bleeding episode. She woke up bleeding in the AM, one gush and then more like light bleeding/spotting for the rest of the day. It has since stopped. I have searched previous posts and learned more about SCH and cervical bleeding, which seem to be the 2 main possible causes. I'm sure there are others that no one can pin point. My SIL is an emotional wreck and I want to offer her some reassurance and based on everything I've read, i think her chances for normal healthy pg are very strong. But she is young, first pg, no friends or fam (other than me) who have had babies. So i need to help. My question is, has anyone spent or heard of spending that much time in the hospital for observations? The other scary/trauma-causing thing is that they administered steroids twice to help the baby's lungs develop more quickly in case they "needed to deliver early." I am sure premature labor is more of a possibility with bleeding, but when everything with the baby looked FINE on the U/S and monitoring (heartbeat), and they couldn't see a SCH or placenta issue (which i think is fairly common that they can't see on US)...why would they go that route so quickly?? Everything I have read with similar symptoms has involved a trip to the ER and then being sent home on pelvic rest. My SIL was kept and monitored in the hospital overnight and was sent home for 2 weeks of fullblown bedrest. I think that whole experience has made things so much more emotionally difficult for her and there really aren't any other extenuating circumstances but maybe I am being ignorant??? Any info/advice is MUCH appreciated!!!!

[naturalmummy]

i am going to try birth professionals forum?!

[umm.hafsah]

Did they do a cervical measurement with the ultrasound? It could be nothing to worry about but personally I had something similar and it turned out to be what they like to call 'incompetent cervix' and I had PTL from 26 weeks. Now I need a preventative cerclage with every subsequent pregnancy. And I did get the steroids when I started labor at 26 weeks to boost the baby's lung development and was glad I did. I was on bedrest 20 weeks (didn't have a cerclage the first time) and in the hospital on bedrest for several weeks as well and it was pretty serious stuff. I know this is likely no tthe case with her but it is something to rule out if she is having signs of PTL.

[naturalmummy]

cervix was fine. no previa or weakness or any signs of PTL. but thanks for that perspective. i have heard about your condition as well, that's not suspected here. Thanks!

[OkiMom]

Maybe the hospital was being overcautious? Was she having contractions while she was there?

[tracymom1]

Its kind of like "which came first, the chicken or the egg".  Bleeding can cause contractions and contractions can cause bleeding in a number of various circumstances.  I was hospitalized for bleeding at 22 weeks and they could not find a reason right away but it turned out that I had a vasa previa which was only detected by a special color flow doppler ultrasound.  Starting at 24 weeks I was given steroids as well.  Most likely they are being a little overly cautious, but with pregnancy you just never know until you know.  Strange things can happen, and everything is usually just fine, but sometimes complications do arise and medical professionals try very hard to figure it out.  In my case, I was very glad that I had so much intervention because without it my son would not have survived.  On the other hand, I basically had a UC with my next baby and had almost no medical intervention.  Every pregnancy is different, thats for sure!  Good luck to her!

[naturalmummy]

i should have clarified - no contractions and no previously detected previa.  This color flow doppler sounds interesting. Is that something you can request? doesn't sound like a standard intervention. Thanks!

[Lisoula]

Yes - steroids are common practice with any bleeding episode after 24 weeks (which is the time of viability for most.) 

And yes, two doses is the norm.  If she would stabilize and then have another episode of bleeding, or any other complication that might threaten an early delivery prior to 33 weeks, they may even suggest a third "rescue" dose.

[MeepyCat]

I just wanted to add:  once they do the first dose of steroids, they usually try to hold on to you for 24 hours to do the second.  It's a pain, but that was probably the thinking behind most of her stay.

[Lyss]

Adding, too, that when I've had bleeding (all before 20 weeks), they've emphasized to me how bleeding irritates the uterus.  Even if she doesn't have contractions now, another bleeding episode (or even leftover blood) can trigger them. 

Placental abruption, too, is extremely dangerous. 

[tracymom1]

I had the color flow doppler done at a level 3 neonatal hospital.  I don't think it is something done at most hospitals, but I had a high risk specialist recommend it because of the amount of bleeding I had.  It is usually done by a doctor of maternal-fetal medicine or with a doctor in the room so that they can see it and interpret it immediately.  I believe it is something that is done only if they have a specific reason - it is expensive and time-consuming.  For me, it was only done after my 2nd episode of bleeding because they could not find a reason why.  Clearly something was wrong and we had to get to the bottom of it.

Hopefully your SIL will spend a couple of weeks off her feet and and everything will go back to being completely normal.  Keeping my fingers crossed for her!!