Vomiting Blood During Pregnancy

A common yet relatively unknown problem that many women experience in their pregnancy is vomiting blood. Although vomiting blood in the early stages of pregnancy is normal, it could be a sign of an underlying condition. Experiencing morning sickness or vomiting for a long period of time could cause vomiting of blood during pregnancy. If you are pregnant and vomit severely, it could rupture your oesophagus lining, and the blood may spew out. There is no reason to panic as it could be treated. However, there are some serious conditions which could lead to vomiting of blood during pregnancy. These conditions could be a sign of worry and must be diagnosed and treated appropriately.

What Is Hematemesis (Vomiting Blood)?

Vomiting blood during pregnancy is known as hematemesis and it may happen because of various medical reasons ranging from a small nosebleed or serious bleeding of the intestine. Hematemesis is not characterized by the presence of streaks of blood in the bile. In this condition, the blood looks black or dark brown in colour similar to ground coffee. Vomiting blood in the first trimester of pregnancy is common, as morning sickness is at its worst then. The bleeding occurs due to a tear in the oesophagus and the bleeding in the upper gastrointestinal tract is primarily caused by the force of the previous vomiting.

Facts About Hematemesis

Here’s what may happen when you vomit blood during pregnancy.

• Bleeding in the upper gastrointestinal tract is one of the main causes of hematemesis during pregnancy.
• Vomiting continuously can increase the risk of melaena – a condition which leads to black and tarry stools with the presence of blood.
• Haematin acid is the main cause of the presence of blood in vomit.
• When some large blood vessels bleed heavily, fresh blood appears in the vomit.
• Vomiting of blood causes dizziness and slight abdominal pain.
• Vomiting blood could lead to a drop in blood pressure levels.
• Vomiting forcefully leads to a sudden mucosal tear in the oesophagus (called the Mallory-Weiss tear), which can also lead to hematemesis.

Causes of Hematemesis During Pregnancy

Vomiting blood during pregnancy has several factors associated with it. Some of the common causes of vomiting of blood during pregnancy are as follows:

1. Gastritis: An inflammation of the stomach causes harmful bacteria, Helicobacter pylori, to infect the inner lining of the stomach, which leads to gastritis. Acute gastritis leads to minor inflammation whereas chronic gastritis causes chronic inflammation. This disorder may eventually lead to excessive vomiting of blood, which is often red in colour. It may also be accompanied by abdominal pain and weakness.
2. Dehydration: One of the main reasons why you may vomit blood during pregnancy is dehydration. When the body runs out of fluid, it exerts excess pressure causing the vomit to spew bile pigments and blood. Lack of fluids causes nausea and lead to vomiting.
3. Starvation: It is a known fact that an expectant woman needs to have smaller meals at regular intervals to satisfy her hunger. If you starve yourself during pregnancy, your empty stomach could make you feel sick and you might vomit blood. It may sound strange, but if you don’t eat enough during pregnancy, your body may rebel by vomiting.
4. Rupture of the Oesophagus: It is very common to feel nauseous and vomit repeatedly during pregnancy. But constant episodes of vomiting, especially forceful ones could cause a rupture in the oesophagus. This injury could result in stains of blood in the vomit.
5. Unhealthy Diet: A lack of a well-balanced diet during pregnancy can also lead to vomiting of blood. It is not uncommon if you feel like throwing up after meals or early in the morning if you are not following the diet chart. The body has its own way to fight back against things that it cannot accept.
6. Hypertension: Pregnancy usually leads to hypotension but if the woman has hypertension, then it may lead to vomiting of the blood, but this happens rarely. Portal hypertension can also lead to hematemesis. Doctors always suggest pregnant women to take ample rest and stay in a peaceful and happy environment. Stress can lead to an upset stomach, eventually leading to vomiting of blood.
7. Food Poisoning: Food poisoning is a gastrointestinal problem. Eating stale or toxic food can put you at an added risk during pregnancy. Ensure that you are cautious about hygiene and wash your fruits and vegetables well before eating them. Stay away from foods that could trigger allergies and complications.
8. Medications: Taking over-the-counter medicines for pain like aspirin and Ibuprofen can lead to irritation and bleeding. Taking these medicines reduce the production of mucus and irritate the lining of the stomach. Aspirin is known to clot the blood and interfere with the function of blood platelets. Prenatal vitamins are also known to cause nausea and vomiting.
9. Rupture of the Gastrointestinal Tract: Vomiting puts pressure on the chest, oesophagus, and abdomen. The sudden increase in pressure causes a rupture in the intestinal tract. This results in vomiting causing chest inflammation. You might experience chest pain, sweating, and shortness of breath if there is a rupture in the gastrointestinal tract.
10. Cirrhosis: Drinking alcohol excessively or autoimmune diseases like hemochromatosis (absorption of the excess amount of iron in the blood) leads to cirrhosis. Cirrhosis leads to the dilation of blood vessels, which start rupturing and affect the oesophagus too. Cirrhosis is a serious condition affecting the health of the liver, and people affected with this disease tend to vomit large quantities of bright red blood.

What Is the Colour of the Blood in the Vomit?

Here’s how the blood may appear if you vomit during pregnancy.

• If the bleeding is caused by an injury to the stomach or duodenum (first part of the small intestine), then the blood in the vomit may appear maroon or dark brown.

• If bleeding is caused by a tear in the oesophagus, the blood will appear red and fresh.

Signs and Symptoms of Hematemesis in Pregnancy

The colour and consistency of the blood vomited differs as per the cause of bleeding. Apart from bleeding, pregnant women also experience other symptoms which need to be given attention. Some of the common symptoms associated with vomiting of blood during pregnancy are:

1. Nausea
2. Abdominal pain and discomfort
3. Enlargement of pupils
4. Blurred vision
5. Dizziness or lightheadedness

How Is the Diagnosis Done?

For diagnosis, the doctor may ask you questions about the colour of the blood discharged or any injuries that you may have had in the past or present. To diagnose any internal causes, the doctor may need to conduct imaging tests to look deeper. Scans determine the injury and the extent of the damage caused to suggest appropriate treatment. Common imaging tests used by gynaecologists include:

• Ultrasound tests
• X-ray
• MRI (Magnetic Resonance Imaging)
• Nuclear medicine scan
• Endoscopy
• Blood tests

Complications Associated With Hematemesis While Pregnant

A few complications that arise because of vomiting blood during pregnancy are mentioned below.

1. Choking: You may often find yourself struggling to swallow food after an episode of vomiting or if you vomit continuously.
2. Anaemia: Due to the loss of blood, your body may become deficient in healthy red blood cells. You may suffer from loss of energy or anaemia. It is advisable to intake healthy and nutritious food to restore blood loss.
3. Stress or Depression: Vomiting blood during pregnancy can make you feel stressed or depressed. Stress may lead to further complications like pale skin, rapid breathing, dizziness, and low urine discharge.

Prolonged episodes of choking, stress or low levels of anaemia must not be ignored. It is best to consult a doctor to avoid any complication.

Treatment

The treatment begins after ascertaining the cause of bleeding and administering the appropriate line of treatment.

• After vomiting, there is a deficiency in optimum fluid levels. A pregnant woman will need to stay hydrated.
• If severe dehydration occurs, the patient would need to be admitted to a hospital to ensure she gets body fluids and supplements through intravenous saline.
• A healthy and nutritious diet will be suggested to ensure that the right amount of nutrients and minerals are being supplied to the mother and the baby.

If there is a huge amount of blood loss caused by vomiting, a doctor may prescribe the following treatments:

• Blood transfusions
• Administering oxygen
• Endoscopic treatment to determine any rupture and treat it accordingly
• Extraction of fluids through veins
• A surgical procedure in case of several internal haemorrhage or ulcer

Prevention

Prevention is better than cure, and it certainly stands true in case of vomiting of blood during pregnancy. A few steps that could help prevent vomiting of blood are:

• Avoid intake of alcohol as it causes inflammation of the stomach.
• Quit smoking.
• Avoid eating spicy food as it causes irritation of the stomach and acid reflux during pregnancy.
• Limit your intake of medicines especially painkillers, aspirin, etc.

Home Remedies

If you vomit blood and notice blood clots, you must consult a doctor. Loss of blood can make you feel weak. Vomiting blood may also leave an unpleasant taste in your mouth. Apart from medical advice, there are a few tips that you can follow to treat nausea and vomiting while pregnant.

1. Drink Fruit Juice: Regular intake of water and fruit juice can help you stay hydrated and recover from spells of dehydration. Electrolyte solutions are also a good alternative to combat dehydration. Keep yourself hydrated by drinking at least 2-3 litres of water in a day. Drinking water will help flush out the toxins from the body and also balance the production of urine in your body.
2. Follow a Balanced Diet: Unarguably, a diet which is well planned, balanced and proportionate in vital nutrients and minerals will go a long way in maintaining optimum energy levels and reducing nausea. So eat healthy foods and drink lots of water.
3. Opt for Small and Light Meals: Nausea is more common in the morning. Avoid having heavy meals at night and have a light breakfast to prevent nausea. Don’t overeat – stick to a fixed pattern of eating. For example, eat at a 3-4 hour interval to give yourself enough time to digest the food. Eating a lot at once might make you feel full and cause vomiting.
4. Avoid Oily Food: Curb your urge to gorge on fatty or spicy foods. Foods high in fat and spice can cause the stomach lining to swell and cause acidity. Stick to boiled foods which are low on spice.
5. Drink Ginger Juice: Drinking ginger juice is an age-old remedy for nausea and morning sickness. It is highly recommended to have ginger juice in the morning.
6. Prenatal Yoga: Prenatal yoga exercises or even light exercises have proven to be good for curing nausea.
7. Sleep Well: Get enough sleep at night and ensure that you do not feel suffocated or claustrophobic where you sleep. Ensure that you breathe well at night for a good night’s sleep.
8. Take Adequate Rest: Avoid stressing yourself – take ample rest and allow your body to relax and unwind to stay healthy during pregnancy.

Opt for natural remedies in case you suffer from nausea. If you find that your vomiting spells are not getting controlled by home remedies, then seek medical advice. If you do vomit blood, try and consult a doctor to rule out any issue in the beginning itself. Your doctor will guide you the best, so consult her if needed. Have a happy and healthy pregnancy!