Vaginal bleeding or spotting during pregnancy can have many causes. Some are serious and some are not. Bleeding may occur early or late in pregnancy.
Many women have vaginal spotting or bleeding in the first 12 weeks of pregnancy. Bleeding of the cervix may occur during sex. An infection of the cervix also can cause bleeding. Slight bleeding often stops on its own.
However, bleeding during pregnancy may mean something more serious. You may have a higher chance of going into labor too early (preterm labor) having an infant who is born too small, or having a miscarriage.
If you are bleeding in early pregnancy, your health care provider may do a pelvic exam. You will be asked how much blood you have passed and how often bleeding has occurred. Your health care provider also will ask whether you have had any pain, and if so, its location and severity.
A blood test may be done to measure human chorionic gonadotropin (hCG). This substance is made by your body during pregnancy.
You may have more than one test because hCG levels increase throughout pregnancy. Your blood type also will be checked to see if you need treatment for Rh sensitization. Ultrasound may be used to find the cause of the bleeding. Sometimes the cause is not found.
Miscarriage can occur any time in the first half of pregnancy. Most often it occurs in the first 13 weeks. It happens in about 15–20% of pregnancies.
The following signs and symptoms may indicate a miscarriage:
Many women who have vaginal bleeding have little or no cramping. Sometimes the bleeding stops and pregnancy goes on. Other times the bleeding and cramping may become stronger, leading to miscarriage.
If some tissue stays in the uterus, bleeding often continues. Your health care provider may then recommend one or more treatment options.
Medication may be used to help you pass the tissue. The tissue may be removed by dilation and curettage (D&C). It also may be removed by a suctioning device. This is called suction curettage. Sometimes more than one option is needed.
Normally the fertiliesd egg should travel from the fallopian tube into the uterus for implantation.When this cannot happen and the gestational sac is implanted elsewhere,it is called an ectopic pregnancy.Ectopic pregnancy most commonly implants in one of the fallopian tubes.
An ectopic pregnancy causes pain and bleeding early in pregnancy.
A major risk with this type of pregnancy occurs if the fallopian tube ruptures. A rupture needs prompt treatment. There may be internal bleeding. Blood loss may cause weakness, fainting, pain, shock, or death.
Ectopic pregnancies are much less common than miscarriages. They occur in about 1 in 60 pregnancies. Women are at a higher risk if they have had • an infection in the fallopian tubes (such as pelvic inflammatory disease)
Most of the time light bleeding in late pregnancy imay be caused by an inflamed cervix or growths on the cervix. . Preterm labor also can cause light bleeding.
These may be treated with medication. However heavy bleeding in late pregnancy is an emergency and usually indicates a problem with the placenta. The two most common causes at this time are placental abruption and placenta previa.The pregnant patient with heavy bleeding should apply to her doctor or hospital as soon as possible .
The placenta is attached to the uterine wall. It may detach from the wall before or during labor. This may cause vaginal bleeding. It often causes pain, even if bleeding is light or not seen.The pain is usually constant and is different from regular or irregular uterine contarctions, because the uterus will not relax and it will stay contracted.
When the placenta becomes detached, the fetus may get less oxygen. Prompt care is needed.
When the placenta lies low in the uterus, it may cover the cervix. That means it partly or completely blocks the opening. This is called placenta previa. It may cause vaginal bleeding. This type of bleeding often occurs without pain.
Late in pregnancy, vaginal bleeding may be a sign of labor. A small amount of mucus and blood is passed from the cervix just before or at the start of labor.
This is called "bloody show." It is common. It is not a problem if it happens within 3 weeks of your due date. If it happens earlier, you may be going into preterm labor.
Other signs of preterm labor include the following: