Nosebleeds During Pregnancy: When You Should Be Concerned

Updated on December 7, 2017
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Kate is a mother of two and a former registered nurse (RN). She has a Bachelor of Science degree in biology from Sonoma State University.

Pregnancy can be a time of great joy. It can also be a time of great anxiety and worry. Your body is constantly changing and it is difficult to determine what is normal and what is cause for alarm. Epistaxis, the medical term for a nosebleed, is a common complaint during pregnancy.

Approximately 20 percent of women will experience an occasional nosebleed during their pregnancy. Many of these occur during the first trimester.

I have experienced this condition first hand and it can be quite scary especially when it occurs in the first few weeks of a new pregnancy. I have learned a significant amount from my research and doctor visits after experiencing my first prenatal nosebleed. You may be happy to learn, that it is rarely a cause for concern.

Increased blood flow is the most common cause of nosebleeds during pregnancy.
Increased blood flow is the most common cause of nosebleeds during pregnancy.

Causes

The nose has a rich vascular supply. These tiny blood vessels are located close to the skin surface making them very easy to damage. Dry air and nose picking are the most common causes of nosebleeds.

A woman's blood volume can increase by as much as 50 percent during pregnancy. This increased circulation brings necessary nourishment to the baby. It also expands the small vessels in the nose. In turn, this increased pressure on the blood vessels makes them more susceptible to rupture.

The term edema prompts mental images of swollen feet, ankles and the dreaded cankle. Your nose is affected by the same malady during pregnancy. Increased blood volume can cause swelling of the nasal passage resulting in chronic congestion. This unpleasant side-effect usually appears around 16 weeks and may last until delivery. Nosebleeds are usually the result of frequent nose blowing.

Nosebleeds are an unpleasant nuisance but epistaxis during pregnancy is generally a benign condition and there is no cause for alarm.

Many causes for nosebleeds are not directly related to pregnancy.

  • The common cold and air-born allergies may induce a nosebleed.
  • A trauma to the nose is a frequent cause of nosebleeds.
  • Inhaling chemical agents such as ammonia or other cleaning products may irritate the nasal membrane. These agents should always be avoided during pregnancy.
  • Prescribed blood thinners or frequent use of aspirin may induce nosebleeds. Discuss this with your physician. He may adjust your dosage or recommend an alternative pain reliever.

Prevention

Nosebleeds are not inevitable during pregnancy. Taking a few precautions may prevent or lessen their occurrence.


  • Drinking plenty of fluids is good general advice and is especially true during pregnancy. Keeping the nasal membranes well hydrated reduces the potential for nosebleeds.
  • Try to keep your mouth open while sneezing and gently blow your nose to reduce pressure on the blood vessels.
  • Use a lubricant such as petroleum jelly or a nasal spray to keep the area moist.
  • A humidifier adds moisture to the air you breathe. This is especially beneficial in dry climates.
  • Use prescribed lubricant and nasal sprays as directed. More is not better.

Treatment

Nosebleeds can be frightening. It may seem there is an endless blood flow and you may worry it will never stop. Do not panic. You can easily treat your nosebleed at home.

  • Sit down. Lean slightly forward taking care your head remains positioned above your heart.
  • Pinch your nostrils closed and breathe through your mouth. Remain in this position approximately 15 minutes. This should slow or completely stop the nosebleed.
  • Apply ice to your nose. The cold will constrict the blood vessels and stop the blood flow. A package of frozen vegetables works well as it conforms to the shape of your nose.

It is important to remain sitting. Do not lay down or tilt your head back. This angle may allow blood flow to your throat. Swallowing blood can induce feelings of nausea and vomiting.

Medical Care

Although epistaxis is generally a benign condition there are instances when it is prudent to seek medical treatment. In rare cases, nosebleeds may be a symptom of an underlying condition. Pregnant women are at a greater risk for hypertension, diabetes and stroke. Seek immediate medical treatment if a nosebleed accompanies any of these conditions or symptoms.

  • Seek emergency care if persistent chest pain or labored breathing accompanies a nosebleed. It is not unusual for anxiety to induce some discomfort but prolonged or severe pain should be investigated.
  • Consult a physician after a head trauma that induces a nosebleed. This does not include a minor accidental blow to the nose.
  • Seek emergency attention if there is any numbness, tingling in the extremities or facial drooping. These could be an indicator of stroke and time is of the essence.
  • Nosebleeds with symptoms of fatigue, feeling lightheaded or confusion should be treated as soon as possible.
  • Seek immediate attention if there is a loss of consciousness.
  • A trip to the emergency room may be prudent if there is a heavy blood flow and the bleeding can not be controlled after 30 minutes.


Some symptoms should be examined but do not require emergency attention. Always discuss medical concerns with your physician. Many people are hesitant to mention minor symptoms or concerns for fear of feeling foolish. Do not allow embarrassment keep you from asking questions. Knowing the answers will reduce your anxiety.

  • Report frequent nosebleeds to your doctor.
  • Note repeated unexplained bruises.
  • A pale complexion and nosebleeds may indicate anemia. This is fairly common during pregnancy. Your physician may prescribe an iron supplement.

First Trimester Nosebleeds

Many women will experience bleeding from the nose during the first trimester or even first week of pregnancy. Additional concern about epistaxis is understandable when it occurs this early in a pregnancy. However, this is almost always benign and not a cause for concern. In fact, nosebleeds is one of the early signs of a new pregnancy.

Often many women will only experience bleeding from the nose in the first trimester and will not experience it again. Remember, your body is adjusting itself to being pregnant and is just starting to increase the blood flow. Your nasal tissue is often the weak link and can be the first sign of this increased blood flow.

Watch for the same symptoms as you would if the nosebleed occurred later in your pregnancy to know if there is any cause for concern and when in doubt, contact your physician.

Conclusion

It is normal to be acutely in tune with your body during pregnancy. You notice babies and pregnant women every place you go. You read countless books on pregnancy and childbirth. Every mother you know seems anxious to share their own experiences good and bad. It is easy to project all of this newly acquired information onto your own pregnancy. This is not uncommon. Medical students are especially prone to this kind of self-suggestion. It is often referred to as Medical Student Syndrome.

Try not to become overly preoccupied with every ache or body change you experience during your pregnancy. This can lead to increased stress and anxiety which is not good for you or your baby. Take note of nosebleeds but keep it in perspective. Nosebleeds are common whether you are pregnant or not. Do not allow needless worry to overshadow the miracle of your pregnancy.

Sources Used

"Nosebleed Causes." July 3, 2015. Mayo Clinic. Retrieved December 7, 2017.

"Noseblees - Prevention." (n.d.) WebMD. Retrieved December 7, 2017.

"Nosebleeds During Pregnancy" (n.d.) American Pregnancy Association. Retrieved December 7, 2017.


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© 2017 Kate Daily

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