Pregnancy Bleeding

Pregnancy bleeding is a concern for a woman throughout her pregnancy. There are many possible causes for bleeding in pregnancy. Some of them may pose a serious risk for you or your baby, and some of them not serious at all. It is important to identify the cause of the pregnancy bleeding so that appropriate action can be taken. All bleeding during pregnancy should be evaluated by your OB provider. About 20% of pregnant women have vaginal spotting or bleeding in the first 12-20 weeks of pregnancy and about 2% experience vaginal bleeding after 20 weeks of pregnancy.

What Should I Do if I Notice Pregnancy Bleeding?

Depending upon the cause of the bleeding, different things will be recommended. Initially you should start marking your calendar with when you are bleeding and how much. If you bleeding is heavy, or bright red, call your OB Health Professional immediately and discuss it with them. If it is spotting and light, it isn’t an emergency, but still needs to be discussed with your OB provider. If you fall or receive a blow to your abdomen, you also need to discuss this with your OB health care provider.

Different Types of Bleeding During Pregnancy

One of the first types of pregnancy bleeding is called implantation bleeding. After having a regular period, and then no period, a small amount of spotting can be very concerning for a couple seeking a pregnancy. The bleeding might occur at any time once the egg becomes fertilized. After implantation, the lining of the uterus (endometrium) becomes thicker, engorged with blood and the placenta begins to form. So, a little bit of spotting can be recorded and watched to see if it continues, or just provides more clues to when conception occurred.

Miscarriage

Miscarriage is the loss of your pregnancy and usually occurs in the first three months of pregnancy, at a rate of about 15 % of pregnancies. Symptoms would include vaginal bleeding, perhaps starting with spotting, low abdominal cramping. The bleeding and cramping can stop, and the pregnancy can proceed, or increase and the miscarriage proceeds. One miscarriage usually isn’t significant as far as future fertility, but is it still very concerning, especially for a couple seeking a pregnancy.

Sometimes an ultrasound will show a little bleeding around the placenta, a pool of blood between layers. Sometimes this leads to a miscarriage, though frequently bed rest helps the placenta to heal and the pregnancy proceeds.

Ectopic Pregnancy

An Ectopic pregnancy or tubal pregnancy occurs when the fertilized egg, rather than traveling to the uterus, becomes embedded elsewhere, typically in the fallopian tube. As the fertilized egg grows, it can rupture the tube causing vaginal and internal bleeding, pain, weakness, and even shock. Immediate medical attention is necessary for an ectopic pregnancy

Infection

Vaginal infections and bladder infections are also a common source of pregnancy bleeding. The cervix also becomes very friable, which means it can bleed easily because of the increased blood flow. If you have intercourse, there can also be a small amount of bleeding also. Sometimes there is a small polyp or lesion which might bleed more in early pregnancy.

Bleeding Later in Pregnancy

As your baby grows, the previous concerns decrease, but other bleeding can occur for other reasons.

Incompetent Cervix

Sometimes the cervix opens up early without labor. This is called an Incompetent Cervix or might be the result of an infection, or a large fibroid tumor growing within the uterus.

Preterm Labor

Sometimes there can be blood-tinged mucous from bloody show, a sign of labor. If a bloody show occurs before 37 weeks it could be an early sign of preterm labor, and needs to be discussed with your OB care provider as soon as possible.

Placenta Previa

Placenta previa occurs when the placenta is very low in the uterus, either partially or totally covering the cervix. A first sign can be bleeding and sometimes pain, and this is commonly seen on ultrasound. If an early ultrasound shows the placenta being low lying, a follow up ultrasound might confirm the placenta has moved out of the way of the cervix.

Placenta Abruption

Placenta abruption is when the placenta begins to pull away from the side of the uterus, and the baby can be deprived of oxygen. Bleeding might be heavy, sometimes bright red, and there might or might not be pain. Sometimes placenta abruption is related to smoking or the use of a stimulant or other recreational drug.

Evaluations and Management for Bleeding in Pregnancy?

Diagnostic tests for bleeding will probably include a pelvic exam, pregnancy test, blood work and ultrasound. If an ectopic pregnancy seems likely, a laparoscopy might be performed which allows your OB provider to look inside of your abdomen and try to determine the cause of the bleeding.

Treatment will vary, depending upon the determined cause. If there is an infection, or the cause is minor, medications and perhaps bed rest are all that will be required. If your baby isn’t growing at all and you are having a miscarriage, or you have an ectopic pregnancy, then your provider will have several different options for you. Sometimes a D & C is recommended, sometimes medications are offered, and sometimes you spontaneously miscarry. With and ectopic pregnancy, sometimes surgery is necessary. Early diagnosis and treatment helps to avoid surgery.

Ultrasounds can show the placenta and the relationship of the baby to the placenta. Sources of bleeding can be seen also. Your provider will also monitor the fetal heart rate, and do blood tests, especially if you are bleeding heavily. If your placenta is pulling away from the side of the uterus, this is considered an emergency. A low lying placenta might indicate a cesarean birth is indicated. These are all things your OB provider will discuss with you.

What Are Some Helpful Questions I Can Ask My OB Health Care Provider?

• What do you think is the cause of the pregnancy bleeding?
• Could this be an ectopic pregnancy or a miscarriage?
• What can be done to stop the bleeding?
• What can be done to protect the baby?

Additional Pregnancy Articles

• Ectopic Pregnancy
• Miscarriage
• High Risk Pregnancy
• Frequently Asked Pregnancy Questions
• Signs of Pregnancy.

• Winter Maternity Clothing
• Maternity Polo Shirts
• Summer Maternity Fashion
• Gender Selection and Conception
• Conception Myths

• How Soon Can I Take a Pregnancy Test
• Natural Ways to Induce Labor
• How to Conceive a Boy
• How to Conceive a Girl
• Early Pregnancy Symptoms

• Pregnancy Related Problems
• Placenta Previa
• Miscarriage
• Category:Pregnancy Problems
• Implantation Bleeding