Hamil Tapi Masih Keluar Darah Menstruasi, Mungkinkah?

Hamil Tapi Masih Keluar Darah Menstruasi, Mungkinkah?

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Bagi sebagian perempuan, kehamilan adalah hal yang ditunggu-tunggu. Di tengah kebahagiaan tersebut, terkadang perempuan dikejutkan dengan munculnya darah dari vagina yang menyerupai darah menstruasi. Mungkinkah mengalami menstruasi saat hamil?

 

Penyebab keluarnya darah saat hamil

Secara logika, orang yang hamil tidak mungkin mengalami menstruasi. Menstruasi terjadi karena luruhnya dinding rahim yang menebal karena tidak terjadi pembuahan. Karenanya, darah yang keluar saat kehamilan bukanlah darah menstruasi melainkan pendarahan lain.

Berikut ini kemungkinan penyebab seseorang mengalami pendarahan vagina saat hamil:

1. Pendarahan implantasi

Keluarnya darah di awal kehamilan umumnya terjadi akibat pendarahan implantasi. Kondisi ini dapat terjadi pada trimester pertama kehamilan, terutama sekitar 6-12 hari terjadinya pembuahan.

Pendarahan implantasi terjadi ketika telur yang berhasil dibuahi mencoba menempel pada dinding rahim. Pada beberapa perempuan, kondisi ini menyebabkan munculnya flek hingga pendarahan. Pendarahan dapat berlangsung selama beberapa jam saja hingga beberapa hari.

2. Kehamilan ektopik

Pada kehamilan ektopik, sel telur yang dibuahi tidak menempel pada rahim melainkan pada organ lain, umumnya pada tuba falopi. Selain tuba falopi embrio juga dapat menempel pada indung telur, leher rahim hingga rongga perut.

Kehamilan ektopik perlu segera ditangani karena janin akan sulit berkembang dengan normal. Kondisi ini kerap menyebabkan pendarahan yang disertai nyeri hebat di panggul atau perut.

3. Kehamilan mola

Kehamilan mola atau yang dikenal dengan hamil anggur adalah kondisi kehamilan dimana sel embrio tidak dapat berkembang dengan semestinya. Pada hamil anggur, tidak terbentuk janin atau kantung ketuban, plasenta menjadi tidak normal dan berkembang dengan cepat dengan adanya kista. Kista kemudian tumbuh berkelompok seperti anggur jika dilihat dengan USG. Kondisi ini yang menyebabkan kehamilan ini dikenal dengan hamil anggur.

4. Plasenta previa

Jika pendarahan terjadi pada trimester kedua dan ketiga, salah satu kemungkinan penyebabnya adalah plasenta previa dimana plasenta berada di bagian bawah rahim sehingga menutupi sebagian atau seluruh jalan lahir. Kondisi ini dapat menyebabkan pendarahan hebat sebelum persalinan.

5. Plasenta lepas dari dinding rahim (abruptio placenta)

Lepasnya plasenta dari dinding rahim hanya terjadi sekitar 1 persen dari semua kehamilan di dunia. Normalnya plasenta terlepas dari dinding rahim setelah bayi keluar, namun pada abruptip placenta, plasenta lepas dalam kondisi bayi masih di dalam kandungan. Kondisi ini dapat menyebabkan pendarahan di masa kehamilan. Umumnya kondisi ini dialami oleh ibu hamil yang memiliki tekanan darah tinggi atau baru mengalami trauma seperti benturan atau tabrakan.

 

Apa yang harus dilakukan ketika terjadi pendarahan saat hamil?

Munculnya pendarahan saat hamil tidak selalu disebabkan oleh kondisi yang berbahaya, namun kondisi ini selalu menimbulkan kekhawatiran. Beberapa hal yang bisa dilakukan antara lain:

1. Istirahat penuh. Hindari melakukan pekerjaan berat dan perbanyak waktu berbaring

2. Hindari melakukan hubungan intim selama pendarahan masih berlangsung

3. Gunakan pembalut untuk mengetahui seberapa banyak pendarahan terjadi. Perhatikan juga warna darah yang keluar, misalnya merah muda, kecoklatan atau merah segar.

Jika pendarahan terjadi dalam volume yang banyak dan disertai dengan gumpalan-gumpalan, serta diikuti rasa pusing dan pingsan, kedinginan, maka segera periksakan ke instalasi gawat darurat untuk mendapat penanganan.

 

Writer: Ratih

Edited by: dr. Anita Larasati Priyono

Last Updated: 6-Sep-2021

 

Sumber:

  1. Johnson TC. Bleeding During Pregnancy. WebMD. 2020 June. https://www.webmd.com/baby/guide/bleeding-during-pregnancy
  2. Mummert T, Gnugnoli DM. Ectopic Pregnancy. 2021 Aug 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30969682.
  3. Langhe R, Muresan BA, Akpan E, Abdul Wahab NA. Atypical presentation of molar pregnancy. BMJ Case Rep. 2018 Sep 27;2018:bcr2018225545. doi: 10.1136/bcr-2018-225545. PMID: 30262528; PMCID: PMC6169626.
  4. Anderson-Bagga FM, Sze A. Placenta Previa. 2021 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30969640.
  5. Fadl SA, Linnau KF, Dighe MK. Placental abruption and hemorrhage-review of imaging appearance. Emerg Radiol. 2019 Feb;26(1):87-97. doi: 10.1007/s10140-018-1638-3. Epub 2018 Aug 29. PMID: 30159815.
  6. Chertoff J, Nwadike VR. What Causes Spotting in Pregnancy?. Healthline. 2021 May. https://www.healthline.com/health/pregnancy/spotting-in-pregnancy
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      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
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      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
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      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
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      Backtrace
      • view::web.v2.partials.article-popular:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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      Backtrace
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      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
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      Bindings
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      Hints
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      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new5.46msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 10068 and `categories`.`deleted_at` is null
      Bindings
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      Hints
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      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
    • related-article.blade.php#8aicare_prod_new5.78msselect `categories`.*, `category_post`.`post_id` as `pivot_post_id`, `category_post`.`category_id` as `pivot_category_id`, `category_post`.`created_at` as `pivot_created_at`, `category_post`.`updated_at` as `pivot_updated_at` from `categories` inner join `category_post` on `categories`.`id` = `category_post`.`category_id` where `category_post`.`post_id` = 10005 and `categories`.`deleted_at` is null
      Bindings
      • 0: 10005
      Hints
      • Use SELECT * only if you need all columns from table
      Backtrace
      • view::web.v2.partials.related-article:8
      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • vendor/livewire/livewire/src/Mechanisms/ExtendBlade/ExtendedCompilerEngine.php:22
      • vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:72
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      Hints
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      Backtrace
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      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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      Hints
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      Backtrace
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      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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      Backtrace
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      • vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
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