Having your nasal passages all clogged up is pretty common in pregnancy, and it is quite natural to get worried if you also start having nosebleeds. However in truth, epistaxis (medical term for nosebleed) [13] is a common sign of pregnancy [1], occurring any time in the early, as well as later pregnancy.

What causes nosebleeds in pregnancy?

Like most of the other pregnancy complaints, nosebleeds are also blamed on the elevating hormone levels. Your blood volume increases in the first trimester, remaining high throughout the third trimester, so the fetus can easily get all the nutrients necessary for proper development [2]. The higher estrogen and progesterone hormones increase the blood flow to all the organs and tissues, including all the mucous membranes in your body. The extra blood flow causes the nasal mucus membranes to get swollen and tender, leading to nosebleeds [3].

You are more likely to have the symptom if you are carrying twins, have a sinus infection, allergies or cold. Dry environments like air-conditioned rooms, airplane cabins and cold weathers are other significant risk factors [4].

How to prevent nosebleeds during pregnancy?

  • Drinking plenty of fluids to keep your systems hydrated
  • Avoiding blowing your nose too forcefully
  • Avoiding inhaling heavy perfumes or smoke as these might irritate your nasal passages [5]
  • Avoiding using decongestant medications without consulting your doctor
  • Using a humidifier to prevent dryness and congestion [6]
  • Using a lubricant, like petroleum jelly, to moisturize the insides of your nose [7]
  • Vitamin C helps to strengthen your capillaries, reducing the chances of nosebleeds. So, including lots of vitamin C rich fruits and vegetables (e.g. kiwi, tomato, bell pepper) in your diet can be a useful remedy. You may also consult your doctor about taking a vitamin C supplement [3].

How to stop a nosebleed while pregnant?

No special treatment is required in most cases, as the symptom can be cured with simple first aid techniques. Here is an easy way to stop the bleeding on your own by helping the blood clot [7]:

  1. Sit straight and pinch your nose firmly just over the nostrils, breathing through your mouth
  2. Stay in this position for 10-15 minutes while keeping the pressure
  3. Now lean forward keeping your mouth open, letting the blood drip down your nose, or you can spit it into a bowl
  4. Lie down on one side in case you feel faint
  5. Make sure not to lie on your back when you get the symptom as it might lead to nausea, vomiting and coughing up blood by letting the blood go down your throat into your stomach

The bleeding is most likely to stop within 20 minutes if you follow the above steps properly. You can further assist the blood clotting process by applying an ice pack over your nose and cheek with the free hand [4].

Taking the following measures for the next 24 hours keeps the nosebleeds from starting again:

  • Always lying down flat
  • Avoiding any strenuous activities and exercise
  • Avoiding picking or blowing your nose
  • Avoiding any hot or alcoholic beverage as these may dilate the blood vessels in the nose

When to call the doctor?

  • Getting frequent heavy nosebleeds that refuse to go away [8]
  • Experiencing posterior nosebleeds (bleeding from the back of your nose) [9] as it might indicate conditions like gestational hypertension or some blood clotting disorder
  • Nosebleeds accompanied by dizziness, fainting and headache (might indicate conditions like diabetes, anemia, high blood pressure and preeclampsia) [10]
  • Nosebleed along with diarrhea

Nosebleed ICD-9 and ICD-10 codes

The ICD-9 code used for indicating the symptom is 784.7 [11], while its ICD-10 code is R04.0s [12].

[ref]

  1. http://kidshealth.org/parent/question/infants/nosebleed.html
  2. http://www.parentdish.co.uk/pregnancy-and-birth/nosebleeds-in-pregnancy-why-causes-prevention-what-to-do/
  3. http://www.whattoexpect.com/pregnancy/symptoms-and-solutions/nasal-congestion.aspx
  4. http://www.babycenter.com/0_nosebleeds-during-pregnancy_255.bc
  5. http://www.justmommies.com/articles/nose-bleeds-pregnancy.shtml
  6. http://www.marchofdimes.com/pregnancy/congestion-and-nosebleeds.aspx
  7. http://www.babycentre.co.uk/a255/nosebleeds-in-pregnancy
  8. http://pregnant.thebump.com/pregnancy/pregnancy-symptoms/articles/nosebleeds-during-pregnancy.aspx
  9. http://www.corephysicians.org/news-and-health-library/health-library/otorhinolaryngology/otla3956/
  10. http://symptomchecker.webmd.com/multiple-symptoms?symptoms=dizziness%7Cheadache%7Cnosebleed&symptomids=81%7C115%7C349&locations=2%7C2%7C6
  11. http://www.icd9data.com/2013/Volume1/780-799/780-789/784/784.7.htm
  12. http://apps.who.int/classifications/icd10/browse/2010/en#/R04.0
  13. http://www.medterms.com/script/main/art.asp?articlekey=3290 [/ref]