9 wks preg/twins bleeding

  Dear Doctors,
         I am preg with my 9th preg. The last pregnacy lasted 10 weeks with bleeding in Nov. Now Im preg again, a wanted one, and at 9 wks the bleeding started. I went to hospital and they did a Ultra/S and found twins. She gave me progeserine suppository and sent me home on bed rest for a week untill she shes me again. The first day was bright red and went to brown and pink. Three days of Bed/R and the bleeding is very slight but stringy like brown, is this normal? and where does the blood come from? What else can I do to help? I know its in Gods hands.
  
                                                    Sharon
Dear Sharon:
Bleeding at this time in pregnancy has several possibilities: there is a normal transfer of hormone support from the corpus luteum (means yellow body, the place on the ovary where the egg was released) to the placenta (afterbirth). If this transition is inefficient, a temporary lull in the hormone levels can contribute to bleeding. The placenta is constantly searching for more and more nurtition to support the growing pregnancy. It does this by invading small blood vessels. As contact is made with these vessels, some blood may leak outside the placenta and present as vaginal bleeding.
The blood comes from mother and not from baby. It is leaked from the "placental lake", the pool of blood behind the placenta that transfers nourishment to the baby and carries waste away from the baby.
When blood changes from red to brown to pink, it means the rate of bleeding is slower and the amount of bleeding is less.
There are no specific treatments: bed rest is most helpful; progesterone therapy is used because this is the hormone that is made first by the corpus luteum and then by the placenta.
There are specific laboratory tests that search for problems with the blood clotting system: these are named lupus anticoagulant and anti-cardiolipin. They sometimes explain this problem.
Maternal Fetal Medicine and Reproductive Endocrine physicians. both subspecialists in Obstetrics and Gynecology, have experience with these problems. HFHS has several of these physicians in the Medical Group.
Keywords: Bleeding, first trimester; recurrent abortion