Nosebleeds During Pregnancy

Pregnancy is the most joyous period for a female, and it is also the phase where the female’s body undergoes various changes. A variety of reproductive hormones act on multiple organs and prepare it to make a survivable and thriving environment for the developing fetus. Progesterone and estrogen, also termed as the pregnancy hormones of females, act on the blood vessels of the body.

Changes in the body during pregnancy include expansion of various systems to provide space for accommodating the fetus. Blood production levels of the body also increase. The circulatory system also expands in response to the hormonal actions and increase the blood volume in a woman’s body. Dilation of the blood vessels of the body is an essential function of the hormone estrogen.

Rise in the blood volume during pregnancy can be around 50-60 percent more than the normal values. Blood volume increase in the body to supply essential nutrients to the developing child. The nose comprises of rich blood supply with many tiny blood vessels present on the surface. These small blood vessels present in the nose expand and get engorged with blood.

The blood vessels are made up of thin walls, and a sudden rise in the blood volume increases pressure on the fragile walls. This increased pressure makes the blood vessels highly susceptible to rupture under pressure. Rupture of the blood vessels of the nose is termed as ‘epistaxis.’ Exposure to dry air and even frequent nose picking can cause epistaxis.

Nose bleeding can occur from either one or both nostrils depending on the vessel wall condition and amount of blood volume increase. It can be observed right from the 1st trimester itself and sometimes is also considered to be a symptom of an undetected pregnancy. It is, however, a more common finding of the 2nd trimester and lasts up to the end of pregnancy in some cases.

Women conceiving for the first time can get alarmed about the bleeding and may rush to the physician. In case of an undetected pregnancy, the physician can conduct a pregnancy test and confirm. Epistaxis is instead a benign finding in pregnancy and not a concerning symptom. Sometimes epistaxis can only be seen in the 1st or 2nd trimester of the pregnancy when the body is adapting to the changes caused by expansion of vessels of the circulatory system.

During pregnancy, other reasons besides the increase in blood volume and expansion of blood vessels that cause epistaxis are also observed. Frequent allergic reactions in women prone to allergies from different allergens require regular use of anti-histamine sprays. These sprays disrupt the normal composition of the nasal membrane and can cause a spontaneous rupture of the fragile, thin blood vessels.

An infection in the nasal cavity or even a bout of cold can cause the drying up of the surface of the blood vessels and the mucous membrane. Decreased lubrication further increases the chances of a nosebleed. Frequent exposure to cold weather or dry and cold environment can also cause the mucous membranes to dry up and thus lead to a nosebleed. Sometimes, certain medical conditions like hypertension, bleeding or clotting disorders that may be genetic or acquired can also cause epistaxis.

A nosebleed can invoke an anxious response from an expecting mother, considering the fact that blood flow from the blood usually causes a person to panic. In case of pregnancy, a woman is naturally more worried about the child’s health. However, nosebleeds are not harmful to the baby. Only if there are frequent episodes observed with suspicion of anemia, additional treatment from the physician apart from the commonly used home remedies is advised. The various measures that can help efficiently to stop a nosebleed at home itself are as follows:

#1. When a nosebleed episode begins, the person should be made to sit down at a comfortable place immediately. Head should be tilted slightly in a forward direction.

#2. Both the nostrils of the person should be held together between the index finger and the thumb and pinched. Pinching of the nose arrests blood flow by blocking its release.

#3. When the nostrils are held together and pinched, breathing should be done from the mouth for around 10 to 12 minutes. Mouth breathing should be undisturbed and continuous, with no release of fingers to check for the cessation of blood flow from the nose. Releasing the nose abruptly from a pinch can interfere with blood clotting.

#4. Avoid ingesting the blood released in the nose during a nosebleed episode by leaning forward.

#5. While pinching with one hand, the other hand can be used to apply an ice pack over the nose. Since epistaxis is due to dilation of blood vessels, application of ice can help to constrict the dilated vessels and stop further bleeding.

#6. After a period of 10-12 minutes, pinching should be stopped. Cessation of bleeding should be checked and if necessary, then pinching should be done again after a rest period of about 4-5 minutes. Breathing should continue from the mouth.

#7. Proper hydration of the body during pregnancy is necessary. Mucous membranes of the nasal cavity have a less chance of drying up in a well-hydrated Drinking adequate quantity of water is essential in a pregnant woman.

#8. A saline spray, made up of little salt added in water can help in relieving the nasal congestion and also keep the nasal cavity moist. Drying of the nasal passages can be prevented with a saline spray thus reducing the risk of an epistaxis episode.

#9. Consumption ample amounts of Vitamin C rich foods during pregnancy helps in increasing the production of collagen in the body, which is responsible for moistening the mucous lining of the nose. Vitamin C is found in large quantities fresh orange juice or lime juice, which are one of the best remedies for nosebleeds.

#10. Nasal passages can be kept moist without irritating them by application of petroleum jelly. A little amount should be applied on the inside of the nostrils to prevent drying of the passages and thus preventing nose bleeding.

#11. Consuming foods containing high amounts of zinc and Vitamin K also prevents nose bleeding.

Frequent episodes of epistaxis should be reported to the physician. Also, massive bleeding from the nose in a single episode with blood entering the blood should also be reported, and medical help should be taken immediately. Pregnant women with a pre-existing blood disorder or hypertension should visit the physician regularly.