Bleeding During Pregnancy

Description

There are many causes of vaginal bleeding in pregnancy. Some result in bleeding early in pregnancy, while others result in bleeding later.

Usually, slight bleeding will stop on its own. Sometimes bleeding may become serious and pose a risk to mother and fetus.

Many pregnant women have vaginal spotting or bleeding in the first 12 weeks of pregnancy. If there is vaginal bleeding early in pregnancy, a doctor will perform a pelvic exam. A blood test may be done to measure human chorionic gonadotropin (hCG), a substance produced during pregnancy. As the pregnancy progresses, hCG levels increase, so there may be more than one test. Ultrasound may be used to find the cause of the bleeding.

Sometimes the cause is not found. Special care may be needed if there is bleeding since there is a higher chance of going into labor too early (preterm labor) or having an infant who is born too small.

Bleeding in Early Pregnancy

Bleeding may be alarming but it does not necessarily mean that miscarriage is certain. If there is a problem with the pregnancy such as a congenital malformation, fetal death usually occurs and results in the passage of tissue and the end of the pregnancy. Miscarriage can occur any time during the first half of pregnancy, but most occur during the first 12 weeks. At least 20 percent of all pregnancies end in miscarriage.

If there is vaginal bleeding, cramping pain felt low in the abdomen, or tissue being passed through the vagina, there is a chance of miscarriage. Many women who have vaginal bleeding have little or no cramping. Sometimes the bleeding stops and pregnancy goes on. At other times, the bleeding and cramping continue, becomes stronger, and miscarriage occurs.

If a miscarriage is suspected, any tissue passed should be brought to the doctor's office for examination. If there is a miscarriage with some tissue remaining in the uterus, bleeding often continues. If this happens, the tissue may be removed by dilation and curettage (D&C;). This may involve dilating, or widening, the cervix and gently scraping tissue away from the lining of the uterus.

Another problem that may cause bleeding in early pregnancy is ectopic pregnancy. This is when pregnancy occurs outside the uterus, usually in a fallopian tube. Pelvic pain and vaginal bleeding may result. The tube may burst and there may be internal bleeding as well. Blood loss may cause weakness, fainting and even shock. A ruptured ectopic pregnancy requires prompt treatment.

Bleeding In Late Pregnancy

Any bleeding in late pregnancy can be suggestive of a serious problem. If this occurs you should notify your doctor or other health care provider immediately.

The causes of bleeding in the second half of pregnancy are different from those in early pregnancy. Common conditions causing minor bleeding include inflammation of or growths on the cervix. Bleeding can also be serious and pose a threat to the health of the woman or the fetus. It may require treatment in a hospital.

Heavy vaginal bleeding usually involves a problem with the placenta, the tissue that connects the mother and fetus. The two most common causes are placental abruption and placenta previa. Preterm labor can also cause vaginal bleeding.

Late in pregnancy, vaginal bleeding may also be a sign of labor. When the plug that covers the opening of the uterus during pregnancy is passed just before or at the start of labor, a small amount of mucus and blood is passed from the cervix. This is called "bloody show." It is common and not a problem if it happens within a few weeks of the due date. If it happens earlier, the mother may be going into preterm labor.

Other signs of preterm labor are:

• Vaginal discharge

• Pelvic or lower abdominal pressure

• Low, dull backache

• Abdominal cramps, with or without diarrhea

• Regular contractions or uterine tightening

Many women with bleeding in pregnancy are found to have minor conditions that need no treatment. At other times, bleeding can be the first sign of a serious problem. For this reason, it is very important that bleeding at anytime in pregnancy - early or late - be reported to the doctor. The health of mother and baby may depend on getting prompt treatment.

Questions to Ask Your Doctor

What is the cause of the bleeding?

Is this abnormal and cause for concern?

Could this be an ectopic pregnancy?

What can be done to stop the bleeding?

Is there going to be a miscarriage?

What can be done to protect the baby?

What are the signs and when should a doctor be called?