Nosebleeds During Pregnancy – When Should You Worry?

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Dr. Deepinder Kaur (Obstetrician and Gynaecologist)
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Nosebleeds During Pregnancy

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The female body undergoes a lot of physical changes during pregnancy. During this period, the circulatory system of the body expands to accommodate the baby. As a result of this, blood circulation increases, and the nasal blood vessels expand. These blood vessels are quite delicate, and the increased blood supply becomes a primary reason for nose bleeding during pregnancy. Let’s take an in-depth look at how nosebleeds take place during a pregnancy.

Are Nosebleeds Common In Pregnancy?

The technical term for a nosebleed is epistaxis. Amongst the problems faced by women during pregnancy, nosebleeds are fairly common. Almost 20% of pregnant women suffer from it, as compared to 6% of non-pregnant women. An occasional nosebleed should not be cause for alarm, and can prove to be harmless in most cases. Most doctors are of the opinion that nosebleeds in early pregnancy are common due to pressure on the nasal blood vessels. As long as you are not losing too much blood through nosebleeds, you should be okay.

Causes of Pregnancy Nosebleeds

The following are common causes of nosebleeds during pregnancy:

  • The delicate vessels in your nose are under tremendous pressure due to the increased blood supply during pregnancy. In fact, the blood volume increases by as much as 50%, due to which the tiny vessels in the nose expand. Since they rupture easily, they can cause nosebleeds.
  • Medical conditions like hypertension, clotting, or an injury could be a cause of nosebleeds.
  • You can get a bloody nose during pregnancy when you have a cold, allergies, a sinus infection, or even when the nasal membranes dry out. This could happen during cold climate, or if your home/office is air-conditioned.
  • Incessant nose-picking is also a cause of nosebleeds during pregnancy, and should be avoided.
  • Inhaling cleaning products or chemical agents can irritate the nasal membrane. Using chemicals like ammonia and harsh acids used for removing stains or for deep cleaning be completely avoided during pregnancy.
  • Use of aspirin and blood thinners can be probable causes of nosebleeds. Your doctor can suggest an alternative or change the dosage, so it is recommended that you consult with him or her if you are taking any of these.
  • Air-borne allergens can lead to nosebleeds.
  • Although there is no method of avoiding a common cold, it is best to take precautionary measures like abstaining from excessive cold drinks, frozen eatables like ice cream, etc.

How to Stop a Nosebleed

You can practice the following things when your nose begins to bleed during pregnancy:

  • Sit down as soon as the bleeding begins. Ensure that your head is at a higher level that of your heart.
  • Do not lie down or bend backward, as the blood may enter your mouth.
  • Hold/pinch the bleeding nostril for about 10 minutes.
  • Bend forward, and breathe through the mouth for the time being.
  • Ensure you hold the nostril for at least 7 to 8 minutes, and do not release it to check if the bleeding has stopped.
  • If you feel faint, lie down on your side, not on the back.
  • Keep track of the time taken for the nosebleed to stop, as it shouldn’t exceed 20 minutes. Use it as a benchmark for timing if the nosebleed repeats.

How to Stop a Nosebleed

Preventing Nosebleeds While Pregnant

As the age-old saying goes, “prevention is better than cure”. You can do the following things to ensure that you don’t get nosebleeds during pregnancy:

  • Don’t blow your nose too hard. Do your best to blow it gently, to prevent a nosebleed. Blow your nose only when necessary, as frequent blowing could lead to bleeding.
  • Keeping the mucous membranes hydrated is the key to avoiding nosebleeds. Ensure you keep yourself hydrated through the day.
  • If you live in a dry climate, or during winter, make liberal use of a humidifier. It is worthwhile to invest in one, if you do not already have one. The chances of a nosebleed are dramatically reduced, due to the moistened air it creates.
  • Smoke can initiate a sneezing bout, so stay away from it.
  • If your doctor has suggested a decongestant or a medicated nose spray, make sure you follow the instructions exactly as given. Overuse can lead to a negative effect. Make sure the spray does not dry out your nasal passage, as this could increase the irritation further.
  • Try sneezing with your mouth open, to divide the immense pressure of the sneeze and give your nose some relief.
  • It is important to keep the nose from drying out completely. Use a lubricant like petroleum jelly, or saline sprays and drops. Special water-based OTC lubricants can also do the trick.

Can Nosebleeds Affect Your Pregnancy?

Nosebleeds do not have a telling impact on your pregnancy or the manner of giving birth to the baby. However, you may be advised to opt for a C-section delivery instead of a normal one. This is done if you experience nosebleeds quite frequently, especially post the second trimester till the delivery.

If you have nosebleeds during pregnancy, there is a 10% chance of the same increasing after the birth of your baby. However, nosebleeds are mostly limited to the time period of your pregnancy, and automatically stop after you give birth, without any additional medications.

When to Worry About Nosebleeds In Pregnancy

While nosebleeds in pregnancy are common, you should be worried if it leads to certain health issues. It is prudent to seek quick medical attention under such conditions. In your pregnant state, you will be at a higher risk for diabetes, stroke, and hypertension. You should be worried if nosebleeds are accompanied by any of the symptoms mentioned below:

  • If the nosebleed is accompanied by laboured breathing or a persistent chest ache, you should consult a doctor immediately. A slight discomfort may be fine, but if the pain is quite severe or prolonged, it should be checked.
  • Facial drooping, tingling, or any kind of numbness can be indicators of a stroke, and should be addressed without delay.
  • Seek medical attention if you feel like you might lose consciousness.
  • Feelings of confusion post nosebleeds should receive quick medical attention, as should light-headedness.
  • Any kind of injury or trauma that leads to nosebleeds should be immediately investigated.

When to Worry About Nosebleeds In Pregnancy

When Should You Call the Doctor?

Pregnancy is the time when a little injury or illness might turn into a bigger issue, as your health is somewhat delicate. Nosebleeds are common in pregnancy, but if they are frequent and long, you must speak to your doctor to eliminate any major problems lurking behind them. It is best to call your doctor and ask for a quick check in case of the following:

  • The blood flow is quite heavy.
  • The bleeding doesn’t stop after 20 to 30 minutes of holding or applying pressure on the nose.
  • The bleeding causes heavy breathing and leads to breathlessness.
  • You get a nose bleed in case of a head injury. Call the doctor even if the bleeding is low.
  • You feel disoriented, lightheaded, or fatigued.
  • There is mild discomfort or chest pain.
  • Your skin turns pale due to bleeding.
  • You must call the doctor if you have high blood pressure, as the blood flow can increase.
  • Speak to the doctor if the steps mentioned under “how to stop a nosebleed” do not work, and the bleeding continues.

When you are pregnant, you should try to be completely attuned to the needs of your body. With so many pregnant women and new mothers around, there certainly won’t be any dearth of well-meaning advice. However, do not become too perturbed about every changing experience. This will lead to unwanted anxiety and stress. Of course, you should take a note of nosebleeds, but remember it is common during pregnancy. Keep track of your symptoms, and call your doctor immediately when necessary.

Also Read: Epilepsy in Pregnancy: Symptoms, Complications & Treatment

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