Intrapartum vaginal bleeding

[jennf83]

I had a patient the other night who was a cervidil induction. She was sleeping throughout the night and rang for us in the morning. She had moderate amt of bright red bleeding. In nursing school we were always taught thats s/s of placenta previa, which she did not have according to u/s. What could have caused that to happen? We ended up calling the doc, and he came up and checked her and she expelled an egg size clot. She continued to bleed throughout labor and had PPH, according to her labor nurse. Also, in nursing school they said to never check a lady with bleeding, but the nurses checked her after they looked at the u/s that said where the placenta was. Was that ok to do?

[redbeads]

lady partsl bleeding is very common during an induction and labor and it is usually from the capillary vessels in the cervix. As the cervix thins out and dilates, this can cause a moderate amount of bright red bleeding, and even some small clots. Some women also have what is referred to as a "friable cervix" which is more prone to bleeding with any type of cervical manipulation, be it from placing a ripening agent, to a vag. exam, to intercourse. Checking her, especially knowing that there is no placenta previa, is perfectly appropriate.

Curious to know what her cervix started out at and what is was in the morning.

[jennf83]

They started cervidil around 9 pm and she was about 2cm, and then when we checked her in the morning she was 4cm.

[redbeads]

Interesting that she had Cervidil for ripening if she was already 2 cm, but it seemed to work!

[jennf83]

Yeah, thats what I thought...or maybe she was 3 cm, I dont remember, I know she was around there!

[shortstuff31117]

As previous poster said, she could have just had a very friable cervix. She also may have had a small abruption...