Morning sickness during pregnancy characterized by nausea and vomiting is common. However, blood in vomit during pregnancy, also known as hematemesis, may indicate an underlying problem.
The condition may be caused due to different reasons, such as a tear in the food pipe, peptic ulcer, irritated esophageal lining, and others. If you experience hematemesis, it is important to seek prompt medical attention.
Read the post for more information on the causes of hematemesis, the symptoms accompanying it, its diagnosis, complications, treatments, and things you can do at home to relieve the symptoms.
What Is Hematemesis (Vomiting Blood)?
Hematemesis refers to vomit that has a significant amount of bright red or gritty coffee ground blood. Usually, the bright red blood indicates any bleeding from the upper gastrointestinal tract, mostly from the esophagus, stomach, or duodenum. Coffee-ground hematemesis occurs when the stomach acids convert hemoglobin to hematin (1).
Is It Normal To Vomit Blood During Pregnancy?
Vomiting blood during pregnancy is not normal, and you should see a doctor in case you are vomiting chunks of blood. It may happen when you have severe morning sickness that irritates the esophageal lining, thus leading to bleeding (2). Gastrointestinal infections or other severe diseases may also lead to blood in the vomit. Should you see blood in your vomit, visit your doctor immediately for a proper diagnosis and remedy.
What Causes Hematemesis In Pregnancy?
Common causes are likely to be:
- Severe gastritis or peptic ulcer: Gastritis (inflammation of the stomach lining) or peptic ulcers (painful sores in the inner stomach lining) cause a burning sensation in your tummy and damage the artery. This could lead to blood vomiting.
- Esophageal varices: These are the enlarged veins in the lower esophagus (food pipe), which bleed but may not cause any pain. They are usually caused by hypertension (high blood pressure ) or alcoholic liver disease (liver is damaged due to long term alcohol exposure). If the doctor suspects this, that doctor may ask you to get admitted to the hospital immediately.
- Tear in the food pipe: Prolonged retching can cause a tear in the esophageal lining, thereby resulting in bleeding.
- Severe gastro-esophageal reflux disease (GORD): Stomach acids leak out into the esophagus and irritate the lining, causing it to bleed.
- Swallowed blood: In some cases, you are likely to swallow blood that might come out as blood vomiting. A severe nosebleed could be one such example.
Less common causes are likely to be:
- Swallowing poisons such as arsenic or corrosive acids
- Cancer of stomach or esophagus
- Blood conditions such as thrombocytopenia, hemophilia, leukemia, and anemia
Signs And Symptoms That May Accompany Blood Vomiting
Along with blood in the vomit, you may experience some other symptoms depending on the cause of the bleeding. They could be (4):
- Rapid heartbeat
- Blurred vision
- Clammy skin
- Reduced urine output
- Pain in upper abdomen
Diagnosis For Blood Vomiting During Pregnancy
Your doctor may ask about the color of the blood vomit, and the history of any injuries you have had in the present or past. Diagnostic tests performed during pregnancy are similar to tests performed on non-pregnant women. Only your doctor can suggest the required imaging test to diagnose the actual cause.
Some of the imaging tests you may be recommended include:
- Ultrasound scan
- MRI scan
- Nuclear medicine scan
- Blood tests
Complications Of Vomiting Blood
Some of the common complications of blood vomiting could be (5):
- Choking, when the blood may collect in the lungs and impair your ability to breathe effectively.
- Aspiration, where vomited blood is again drawn in through airways.
- Anemia, deficiency of red blood cells may develop when there is rapid blood loss through vomiting.
To avoid these complications, pay attention when you are vomiting to check if there is blood, especially when you experience some of the symptoms mentioned above.
Treatment Of Hematemesis During Pregnancy
Management will depend on the severity of vomiting
In case of minimal blood loss, your doctor may prescribe medications. If there is significant blood loss, you might need a blood transfusion or a drip. In severe life-threatening cases, emergency resuscitation or a blood transfusion may be needed.
Treatment usually depends on the cause of blood vomiting. It may involve endoscopy to stop the bleeding by sealing an internal wound or emergency surgery to control severe bleeding (6).
Can You Prevent Throwing Up Blood While Pregnant?
- Maintain personal hygiene by washing your hands frequently before handling food, after using the toilet, or after handling the trash or contaminated surfaces.
- Avoid being in contact with anyone who has gastroenteritis.
- Do not prepare or handle food if you have GI infections.
- Avoid public pools if you have infections
- Avoid raw foods and cook meat thoroughly.
- Avoid spicy foods that irritate the stomach or cause acid reflux.
- Quit smoking and alcohol
- Avoid overeating
- Avoid inducing vomiting when you have too much nausea
Home Remedies To Deal With Blood Vomiting
Vomiting blood during pregnancy may warrant strict medical supervision. Loss of blood makes your body weak, which is not good for your baby’s health. Moreover, a bloody vomit also leaves an unpleasant feeling in your mouth.
Here are a few helpful remedies that might relieve you from the nauseous state in pregnancy:
- Saline water: Your body may deplete from fluids or undergo dehydration after recurrent vomiting. You may have to get intravenous fluids or ORS (oral rehydration solutions) that has electrolytes to gain the lost fluids and recover.
- Drink lots of water: Consider drinking more water, fruit juices, electrolyte solutions to recover from dehydration.
- Eat a well-balanced diet: A proper diet gives you the right amounts of essential nutrients and minerals to keep you healthy. You may feel nauseated when you wake up in the morning. Eating a toast or cracker might mitigate the feeling and could also offer energy.
- Avoid oily food, eat less: Stay away from fatty or spicy foods that could trigger bouts of vomiting during pregnancy. It is better to have boiled and somewhat bland foods. Eat small portions throughout the day and avoid eating large quantities before sleeping.
- Rest enough: Nausea due to vomiting can create stress, lack of sleep, and fatigue. Rest as much as you can and avoid stress as it could help in healthy fetal growth too.
Is Vomiting Blood A Sign Of Miscarriage?
Vomiting blood is not a sign of miscarriage. Vaginal bleeding, discharge, cramping, and a feeling of weakness are the usual symptoms you may experience in case of a miscarriage (10).
Blood in vomit during pregnancy is not normal, requiring medical attention. It is bright red if the bleeding occurs from the upper gastrointestinal tract, such as the esophagus. Blood from the stomach may appear coffee ground color due to stomach acids. Sometimes this can be due to severe morning sickness causing tears or irritation of esophageal tissue resulting in bleeding. However, it is always better to seek medical care since gastrointestinal infections, and other conditions can cause blood vomiting (hematemesis).
Infographic: Reasons Why You Might Vomit Blood While Pregnant
There are several weird pregnancy-related complications, including nausea and vomiting throughout gestation. But, if you notice blood in the vomit (hematemesis), it could indicate an underlying issue. Look at the infographic below to learn about all the possible causes that may lead to blood vomiting while pregnant.
- Chapter IX.10. Gastrointestinal Bleeding and Peptic Ulcer Disease; University of Hawaii
- Vomiting blood; U.S. Department of Health and Human Services National Institutes of Health (2018)
- Vomiting blood (haematemesis); NHS (2019)
- Hematemesis; Medical University Of South Carolina
- Gastrointestinal Bleeding; National Institute Of Health
- Vomiting Blood: Care and Treatment; Cleveland Clinic (2018)
- Symptoms-Miscarriage; NHS (2018)
- Diarrhoea and vomiting; Department of Health; Government of Western Australia
- Severe Morning Sickness (Hyperemesis Gravidarum).
- MISCARRIAGE; March Of Dimes