What causes vaginal bleeding during pregnancy. How to differentiate between normal and abnormal bleeding. When should you seek medical attention for bleeding during pregnancy. What are the potential complications associated with pregnancy bleeding.

Understanding Vaginal Bleeding in Early Pregnancy

Experiencing vaginal bleeding during pregnancy can be alarming, especially when you’re 10 weeks pregnant and notice blood clots. However, it’s crucial to understand that bleeding is relatively common, particularly during the first trimester. Approximately 20% of women experience some form of bleeding within the first 12 weeks of pregnancy. While often not a cause for immediate concern, it’s essential to be aware of potential causes and know when to seek medical attention.

Common Causes of First Trimester Bleeding

• Implantation bleeding
• Cervical changes
• Infections
• Miscarriage
• Ectopic pregnancy
• Molar pregnancy

Is implantation bleeding normal during early pregnancy? Implantation bleeding is a common and usually harmless occurrence. It typically happens within 6 to 12 days after conception when the fertilized egg attaches itself to the uterine lining. This type of bleeding is generally light and brief, lasting from a few hours to a couple of days. Some women may mistake it for a light period, potentially delaying their realization of pregnancy.

Distinguishing Between Normal and Abnormal Bleeding

How can you tell if pregnancy bleeding is normal or a sign of a problem? While some bleeding can be normal, it’s important to pay attention to the amount, duration, and accompanying symptoms. Normal bleeding is usually light and brief, without severe cramping or pain. Abnormal bleeding may be heavier, accompanied by severe pain, or persist for an extended period.

Signs of Potentially Serious Bleeding

1. Heavy bleeding (soaking through a pad in an hour)
2. Severe abdominal or pelvic pain
3. Dizziness or fainting
4. Fever or chills
5. Tissue passing through the vagina

Can bleeding with clots indicate a miscarriage? While bleeding with clots can be a sign of miscarriage, it’s not always the case. Miscarriage is most common during the first 12 weeks of pregnancy and is often accompanied by strong cramps in the lower abdomen. However, if an ultrasound shows a heartbeat, over 90% of women experiencing first-trimester bleeding will not miscarry. It’s crucial to consult your healthcare provider for a proper evaluation.

Ectopic Pregnancy: A Serious Concern

What is an ectopic pregnancy and how does it relate to bleeding? An ectopic pregnancy occurs when the fertilized egg implants outside the uterus, typically in the fallopian tube. This condition affects about 2% of pregnancies and can be life-threatening if left untreated. Symptoms of an ectopic pregnancy include vaginal bleeding, strong cramps or pain in the lower abdomen, and lightheadedness. Prompt medical attention is crucial if an ectopic pregnancy is suspected.

Recognizing Ectopic Pregnancy Symptoms

• Vaginal bleeding or spotting
• Severe abdominal or pelvic pain, often on one side
• Shoulder pain
• Weakness, dizziness, or fainting

How is an ectopic pregnancy diagnosed and treated? Diagnosis typically involves a combination of blood tests, ultrasound, and physical examination. Treatment options depend on the severity and location of the ectopic pregnancy but may include medication or surgery. Early detection and treatment are crucial for preserving fertility and preventing life-threatening complications.

Bleeding in the Second and Third Trimesters

Is bleeding in late pregnancy more serious than in early pregnancy? Generally, bleeding during the second and third trimesters is considered more serious and requires immediate medical attention. While less common than first-trimester bleeding, it can signal potential complications for both mother and baby.

Potential Causes of Late Pregnancy Bleeding

• Placenta previa
• Placental abruption
• Uterine rupture
• Vasa previa
• Premature labor

What is placenta previa and how does it affect pregnancy? Placenta previa occurs when the placenta sits low in the uterus and partially or completely covers the cervix. This condition is rare, affecting only about 1 in 200 pregnancies in the late third trimester. Placenta previa can cause painless bleeding and requires immediate medical attention, as it can lead to complications during delivery.

Placental Abruption: A Serious Complication

What is placental abruption and why is it dangerous? Placental abruption occurs when the placenta detaches from the uterine wall before or during labor. This condition affects approximately 1% of pregnancies and can be dangerous for both mother and baby. Symptoms include vaginal bleeding, abdominal pain, and back pain. Immediate medical attention is crucial to ensure the safety of both mother and child.

Risk Factors for Placental Abruption

• High blood pressure
• Smoking or drug use
• Advanced maternal age
• Previous placental abruption
• Abdominal trauma

How is placental abruption diagnosed and treated? Diagnosis typically involves a combination of physical examination, ultrasound, and monitoring of fetal heart rate. Treatment depends on the severity of the abruption, gestational age, and the condition of both mother and baby. In some cases, immediate delivery may be necessary to prevent complications.

Premature Labor and Bleeding

Can vaginal bleeding be a sign of premature labor? Yes, vaginal bleeding in late pregnancy can sometimes indicate the onset of labor. A few days or weeks before labor begins, you may notice the passage of the mucus plug, which can contain small amounts of blood (known as “bloody show”). However, if bleeding and labor symptoms occur before the 37th week of pregnancy, it’s essential to contact your healthcare provider immediately, as this could indicate preterm labor.

Signs of Premature Labor

• Regular contractions
• Lower back pain
• Pelvic pressure
• Vaginal discharge changes
• Ruptured membranes (water breaking)

What should you do if you suspect premature labor? If you experience any signs of premature labor, contact your healthcare provider immediately. They may recommend monitoring at home or coming in for an evaluation. Early intervention can help prevent or delay preterm birth and improve outcomes for both mother and baby.

When to Seek Medical Attention for Pregnancy Bleeding

When should you call your doctor about bleeding during pregnancy? It’s always best to err on the side of caution when it comes to pregnancy bleeding. Contact your healthcare provider if you experience any vaginal bleeding, especially if it’s accompanied by pain, cramping, or other concerning symptoms. Immediate medical attention is necessary for heavy bleeding, severe pain, or any bleeding in the second or third trimester.

Steps to Take When Experiencing Pregnancy Bleeding

1. Note the amount, color, and duration of bleeding
2. Observe any accompanying symptoms
3. Avoid using tampons or having sexual intercourse
4. Contact your healthcare provider for guidance
5. Seek emergency care if bleeding is heavy or accompanied by severe pain

What tests might be performed to evaluate pregnancy bleeding? Your healthcare provider may perform several tests to determine the cause of bleeding, including:

• Physical examination
• Ultrasound
• Blood tests
• Fetal heart rate monitoring

These tests help assess the health of both mother and baby and guide appropriate treatment decisions.

Coping with Anxiety Related to Pregnancy Bleeding

How can you manage stress and anxiety caused by pregnancy bleeding? Experiencing bleeding during pregnancy can be emotionally challenging. Here are some strategies to help cope with anxiety:

• Educate yourself about common causes of pregnancy bleeding
• Communicate openly with your healthcare provider
• Practice relaxation techniques, such as deep breathing or meditation
• Seek support from your partner, family, or a support group
• Focus on self-care and maintaining a healthy lifestyle

Remember that many women who experience bleeding during pregnancy go on to have healthy babies. Staying informed and maintaining open communication with your healthcare team can help alleviate anxiety and ensure the best possible care for you and your baby.

Preventing Complications Associated with Pregnancy Bleeding

Are there ways to reduce the risk of bleeding during pregnancy? While not all causes of pregnancy bleeding are preventable, there are steps you can take to promote a healthy pregnancy and reduce the risk of complications:

• Attend all prenatal appointments
• Follow a healthy diet and exercise routine as recommended by your doctor
• Avoid smoking, alcohol, and illicit drugs
• Manage chronic health conditions, such as diabetes or high blood pressure
• Practice safe sex to prevent infections
• Avoid activities that may increase the risk of abdominal trauma

By taking these precautions and staying vigilant about your health, you can help minimize the risk of complications and promote a healthy pregnancy.

Understanding the causes and implications of vaginal bleeding during pregnancy is crucial for expectant mothers. While bleeding can be alarming, it’s important to remember that many women who experience it go on to have healthy pregnancies and babies. By staying informed, communicating with your healthcare provider, and seeking prompt medical attention when necessary, you can ensure the best possible care for yourself and your growing baby. Remember, every pregnancy is unique, and your healthcare team is there to guide you through any challenges you may face along the way.

Vaginal Bleeding and Blood Clots During Pregnancy

Written by Stephanie Watson

In this Article

• Bleeding in the First Trimester
• Bleeding in the Second and Third Trimesters
• What to Do If You Have Abnormal Bleeding During Pregnancy

Bleeding during pregnancy is common, especially during the first trimester, and usually it’s no cause for alarm. But because bleeding can sometimes be a sign of something serious, it’s important to know the possible causes, and get checked out by your doctor to make sure you and your baby are healthy.

About 20% of women have some bleeding during the first 12 weeks of pregnancy. Possible causes of first trimester bleeding include:

Implantation bleeding. You may experience some normal spotting within the first six to 12 days after you conceive as the fertilized egg implants itself in the lining of the uterus. Some women don’t realize they are pregnant because they mistake this bleeding for a light period. Usually the bleeding is very light and lasts from a few hours to a few days.

Miscarriage. Because miscarriage is most common during the first 12 weeks of pregnancy, it tends to be one of the biggest concerns with first trimester bleeding. However, first trimester bleeding does not necessarily mean that you’ve miscarried or will miscarry. In fact, if a heartbeat is seen on ultrasound, over 90% of women who experience first trimester vaginal bleeding will not miscarry.

Other symptoms of miscarriage are strong cramps in the lower abdomen and tissue passing through the vagina.

Ectopic pregnancy. In an ectopic pregnancy, the fertilized embryo implants outside of the uterus, usually in the fallopian tube. If the embryo keeps growing, it can cause the fallopian tube to burst, which can be life-threatening to the mother. Although ectopic pregnancy is potentially dangerous, it only occurs in about 2% of pregnancies.

Other symptoms of ectopic pregnancy are strong cramps or pain in the lower abdomen, and lightheadedness.

Molar pregnancy (also called gestational trophoblastic disease). This is a very rare condition in which abnormal tissue grows inside the uterus instead of a baby. In rare cases, the tissue is cancerous and can spread to other parts of the body.

Other symptoms of molar pregnancy are severe nausea and vomiting, and rapid enlargement of the uterus.

Additional causes of bleeding in early pregnancy include:

• Cervical changes. During pregnancy, extra blood flows to the cervix. Intercourse or a Pap test, which cause contact with the cervix, can trigger bleeding. This type of bleeding isn’t cause for concern.
• Infection. Any infection of the cervix, vagina, or a sexually transmitted infection (such as chlamydia, gonorrhea, or herpes) can cause bleeding in the first trimester.

Abnormal bleeding in late pregnancy may be more serious because it can signal a problem with the mother or baby. Call your doctor as soon as possible if you experience any bleeding in your second or third trimester.

Possible causes of bleeding in late pregnancy include:

Placenta previa. This condition occurs when the placenta sits low in the uterus and partially or completely covers the opening of the birth canal. Placenta previa is very rare in the late third trimester, occurring in only one in 200 pregnancies. A bleeding placenta previa, which can be painless, is an emergency requiring immediate medical attention.

Placental abruption. In about 1% of pregnancies, the placenta detaches from the wall of the uterus before or during labor and blood pools between the placenta and uterus. Placental abruption can be very dangerous to both the mother and baby.

Other signs and symptoms of placental abruption are abdominal pain, clots from the vagina, tender uterus, and back pain.

Uterine rupture. In rare cases, a scar from a previous C-section can tear open during pregnancy. Uterine rupture can be life-threatening, and requires an emergency C-section.

Other symptoms of uterine rupture are pain and tenderness in the abdomen.

Vasa previa. In this very rare condition, the developing baby’s blood vessels in the umbilical cord or placenta cross the opening to the birth canal. Vasa previa can be very dangerous to the baby because the blood vessels can tear open, causing the baby to bleed severely and lose oxygen.

Other signs of vasa previa include abnormal fetal heart rate and excessive bleeding.

Premature labor. Vaginal bleeding late in pregnancy may just be a sign that your body is getting ready to deliver. A few days or weeks before labor begins, the mucus plug that covers the opening of the uterus will pass out of the vagina, and it will usually have small amounts of blood in it (this is known as “bloody show”). If bleeding and symptoms of labor begin before the 37th week of pregnancy, contact your doctor right away because you might be in preterm labor.

Other symptoms of preterm labor include contractions, vaginal discharge, abdominal pressure, and ache in the lower back.

Additional causes of bleeding in late pregnancy are:

• Injury to the cervix or vagina
• Polyps
• Cancer

Because vaginal bleeding in any trimester can be a sign of a problem, call your doctor. Wear a pad so that you can keep track of how much you’re bleeding, and record the type of blood (for example, pink, brown, or red; smooth or full of clots). Bring any tissue that passes through the vagina to your doctor for testing. Don’t use a tampon or have sex while you are still bleeding.

Your doctor might recommend that you rest as much as you can and avoid exercise and travel.

You should expect to receive an ultrasound to identify what the underlying cause of your bleeding may be. Vaginal and abdominal ultrasounds are often performed together as part of a full evaluation.

Go to the emergency room or call 911 right away if you have any of the following symptoms, which could be signs of a miscarriage or other serious problem:

• Severe pain or intense cramps low in the abdomen
• Severe bleeding, with or without pain
• Discharge from the vagina that contains tissue
•  Dizziness or fainting
• A fever of more than 100. 4 or more degrees Fahrenheit and/or chills

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Blood clots and pregnancy | March of Dimes

Anyone can develop a blood clot but pregnant women are at higher risk during pregnancy and after giving birth.

Blood clots can cause other health problems in pregnancy but there are ways to prevent and protect you and your baby.

It is important to know the signs of a blood clot and factors that may increase your risk for a blood clot.

Tell your health care provider if you or someone in your family has had problems with blood clots.

A blood clot (also called a thrombosis) is a mass or clump of blood that forms when blood changes from a liquid to a solid. The body normally makes blood clots to stop the bleeding after a scrape or cut. But sometimes blood clots can partly or completely block the flow of blood in a blood vessel, like a vein or artery.

Anyone can develop a blood clot, but you are at higher risk for a blood clot during pregnancy and up to 3 months after giving birth to your baby.  Most women with blood clotting conditions have healthy pregnancies. But these conditions may cause problems for some pregnant women. In severe cases, they can cause death for both mom and baby. But testing and treatment can help protect and save both you and your baby.

If you’re pregnant or trying to get pregnant and have had problems with blood clots in the past, tell your health care provider at a preconception checkup (before pregnancy) or at your first prenatal care checkup.

If you or someone in your family like your parent, brother or sister has had problems with blood clots, talk to your provider.  Blood clots may run in your family.  You may also talk to your provider about getting a blood test to see if you have a thrombophilia. This is a health condition that increases your chances of making abnormal blood clots. Some pregnant women with thrombophilias need treatment with medicines called blood thinners. They stop clots from getting bigger and prevent new clots from forming.

Why are pregnant women at greater risk for blood clots?

Pregnant women are 5 times more likely to experience a blood clot compared to women who are not pregnant.  This may be because:

• When you’re pregnant, your blood clots more easily to lessen blood loss during labor and delivery.
• In pregnant women, the blood may flow less to the legs later in pregnancy because the growing baby presses upon blood vessels around your pelvis. 
• When you’re pregnant you may experience less movement or immobility (not moving a lot) like when you’re on bed rest or recovering from giving birth.

What are other reasons people may be at risk for having blood clots?

Certain things make you more likely than others to have a blood clot. These are called risk factors. Having a risk factor doesn’t mean for sure that you’ll have a blood clot. But it may increase your chances. Talk to your provider about what you can do to help reduce your risk.

Risk factors for blood clots include:

• Having certain health conditions, like a thrombophilia, high blood pressure, diabetes or being overweight or obese. A family history of blood clotting problems also increases your chances of blood clots.
• Taking certain medicines, like birth control pills or estrogen hormones. These medicines can increase the risk of clotting. If you’ve had problems with blood clots or thrombophilias or have a family history of these conditions, birth control pills may not be safe for you to use. Talk to your provider about other birth control options.
• Smoking. Smoking damages the lining of blood vessels, which can cause blood clots to form.
• Having surgery, like a cesarean section (also called c-section). A c-section is a surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. The American College of Obstetricians and Gynecologists (ACOG) recommends that doctors help prevent blood clots in women during a c-section. This may include using compression devices that put pressure on your legs to help keep your blood flowing during the c-section.
• Being dehydrated. This means you don’t have enough water in your body. Dehydration causes blood vessels to narrow and your blood to thicken, which makes you more likely to have blood clots.
• Not moving around much. This may be because you’re on bed rest during pregnancy or recovering from surgery or an accident. Being still for long periods of time can lead to poor blood flow, which makes you more likely to have blood clots. Even sitting for long periods of time, like when traveling by car or plane for 4 hours or more, can increase your chances of having a blood clot.
• Having a baby. You’re more likely to have a blood clot in the first 6 weeks after birth than women who haven’t given birth recently.

What problems can blood clots cause during pregnancy?

If you have a blood clot or a kind of thrombophilia called antiphospholipid syndrome (also called APS), you may be more likely to have complications that can affect your health and your baby’s health, including:

Blood clots in the placenta. The placenta grows in your uterus (womb) and supplies the baby with food and oxygen through the umbilical cord. A blood clot in the placenta can stop blood flow to your baby and harm your baby.

Heart attack. This usually happens when a blood clot blocks blood and oxygen flow to the heart. Without blood and oxygen, the heart can’t pump blood well, and the affected heart muscle can die. A heart attack can lead to lasting heart damage or death.

Intauterine growth restriction (also called IUGR). This is when your baby grows poorly in the womb.

Miscarriage.  A miscarriage is when a baby dies in the womb before 20 weeks of pregnancy.

Placental insufficiency. This is when the placenta doesn’t work as well as it should so your baby gets less food and oxygen.

Preeclampsia. This condition that usually happens after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has both protein in her urine and high blood pressure.

Premature birth. This is when your baby is born before 37 weeks of pregnancy.

Pulmonary embolism (also called PE). An embolism is a blood clot that moves from where it formed to another place in the body. When the clot moves to a lung, it’s a PE. PE can cause low oxygen levels in your blood and damage your body organs. It’s an emergency and a leading cause of death during pregnancy. Signs and symptoms of PE may include:

• Trouble breathing
• Fast or irregular heartbeat
• Chest pain
• Fainting
• Coughing up blood

Stillbirth. This is when a baby dies in the womb before birth but after 20 weeks of pregnancy.

Stroke. This happens when a blood clot blocks a blood vessel that brings blood to the brain, or when a blood vessel in the brain bursts open. Pregnancy and childbirth cause strokes in about 8 in 100,000 women. Stroke can cause lasting damage to the body or death.

Thrombosis. This happens when a blood clot forms in a blood vessel and blocks blood flow. It most often happens in the deep veins of the legs but can be in other places of the body:

• Cerebral vein thrombosis (also called CVT). This happens when a blood clot forms in a vein in the brain. CVT can lead to stroke. Signs and symptoms include headache, vision problems and seizures.   
• Deep vein thrombosis (also called DVT). This happens when a blood clot forms in a vein deep in the body, usually in the lower leg or thigh. DVT can be diagnosed with ultrasound or other imaging tests. Signs and symptoms may include warmth and tenderness over the vein and pain, swelling or skin redness in the affected area.

Venous thromboembolism (also called VTE). This happens when a blood clot breaks off and travels through blood to vital organs, like the brain, lungs or heart. This condition includes DVT and PE. VTEs that block blood vessels in the brain or heart can cause stroke or heart attack.

How are these conditions treated?

Your provider may use tests like ultrasound or magnetic resonance imaging (also called MRI) to find out if you have a blot clot or clotting conditions. Ultrasound uses sound waves and a computer screen to make a picture of a baby in the womb. MRI uses magnets and computers to make a clear picture of the inside of the body. These tests are painless and safe for you and your baby.

If you’re pregnant and have a clotting condition, you may need to go for prenatal care checkups more often than women who don’t have these blood clot conditions. At these visits, your provider checks your blood pressure and can use other tests, like blood tests, to monitor your health.

Your provider also checks your baby’s health in the womb using tests like:

• Ultrasound to check your baby’s growth and development. She may use a special kind of ultrasound called Doppler to check your baby’s blood flow in the umbilical artery, a blood vessel in the umbilical cord. The umbilical cord connects your baby to the placenta. It carries food and oxygen from the placenta to the baby.
• Fetal heart rate monitoring (also called a nonstress test or NST). This test checks your baby’s heart rate in the womb and sees how the heart rate changes when your baby moves. Your provider uses this test to make sure your baby’s getting enough oxygen.

During pregnancy your provider may give you a blood thinner called heparin (low-molecular weight heparin or unfractionated heparin). If you have APS, your provider may instruct you to take heparin along with low-dose aspirin. Your provider also may refer you to a hematologist. This is a doctor who treats blood conditions.

After you give birth, your provider may continue to treat you with heparin. Or she may treat you with a blood thinner called warfarin. Warfarin is safe to take after pregnancy, even if you’re breastfeeding. Warfarin is not safe to take during pregnancy because it may cause birth defects.

Don’t take combined hormonal methods of birth control during the first 21-42 days after delivery. The risk of DVT is highest in the first 21 days. 

How can I safely keep up with my prenatal care appointments during the COVID-19 pandemic?

During the coronavirus disease 2019 pandemic (COVID-19) your prenatal care visits may change. Ask your provider how he will monitor your health and do the tests you need while keeping you and your baby safe from COVID-19.

Providers are taking steps to prevent the spreading of COVID-19 by using telehealth or telemedicine. Telehealth or telemedicine are health visits where you talk to your provider by phone or by videocall, instead of going to his office.  You will need either a phone, tablet or computer for a telehealth visit and in some cases you may need access to the internet. Let your provider know if you are unable to have telehealth visits due to lack equipment or any other reason. Ask any questions you may have about keeping up with your ultrasounds and other tests while avoiding getting COVID-19.

What can I do to reduce my risk of blood clots?

• Know  the signs and symptoms of a blood clot.  On an affected limb like a leg or arm, you may notice swelling, pain or tenderness that was not caused by an injury, warm skin when you touch it or redness and discoloration. Contact your provider if you experience any of these symptoms.
• Talk to your provider about your risk. If you or a family member like a parent, brother or sister have had blood clots before, tell your provider. 
• Move or stretch on long trips. If you sit for more than 4 hours on a trip, try to move your legs often. If you can walk around, you may do so. If you can’t, you may try seated leg stretches like extending your legs straight out and moving your ankles to move your toes toward and away from you. You may also pull your knee to your chest and hold it there with your hands for 15 seconds. 
• Follow other travel tips for reducing risk of blood clots. These include drinking lots of fluids like water, wearing loose-fitted clothing or wearing special stockings that compress your legs below the knee. Talk to your provider before trying these stockings.
• Follow your provider’s instructions during pregnancy and after giving birth.  Your provider may give you medications like blood thinners or ask you to come in for additional prenatal care checkups.   

Last reviewed September 2022

More information

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The question is asked by Anya, – a question-answer from the specialists of the clinic “Mother and Child”

10/23/2014

Hello! I have a second pregnancy (my son is 1 year 2 months), the term is 13-14 weeks. At the 11th week, heavy bleeding began (until that time nothing bothered me) and I was admitted to the hospital with a diagnosis of “beginning miscarriage.” Heavy bleeding lasted from 13.00 to 16.00, then it bled a little all the next day, and on the third day the discharge began to darken and disappeared. The next morning after admission, I had an ultrasound scan (06/04/05), which showed:
The uterus in anteflexio, with clear, even contours, rounded, enlarged due to pregnancy and according to its duration. Meometrium of normal structure and echogenicity, without nodules and retrochorial hematomas, in which one live embryo is visualized. The placenta is formed on the right side with the transition to the anterior wall of the uterus, up to 1.2 m thick. The amount of water is normal. The internal os of the uterus is completely closed.
The results of the analyzes: Cl. blood test: Er – 4, 15; Hb – 124; Ht – 35, 8; L-9, 4; P – 6; C – 73; L – 18; M-3; E-0; ESR – 22. General analysis of urine: Specified weight -1010, PH – Neutral; Protein, Glucose, erythrocytes – neg; L – 1-2-1; epithelium singly. Biochem. blood test: Common. Protein – 65.0; Urea – 3, 2; Creatinine – 76; Bilirubin – 12-0-12; Alat – 23; AsAt – 59; Glucose – 3, 4.
Gr. Blood A (II) Rh – factor positive. RW, HIV, HBs Ag – negative, DHA – 1.88.
Treatment was prescribed: No-shpa 2, 0-3 times / m, papaverine 2 times, utrozhestan 1 t – 2 times, Vite 1-3 times, dicynone 2, 0 – 2 times / m, valerian 1 – 3 times, dexamethasone ½ tab. H night, magneB6 2-3 times, Materna 1. a day.
While I was in the hospital, I bled a little bit a couple of times, and every day there were periodically pulling pains and tingling in the lower abdomen. She was discharged after 2 weeks, the medications were the same (except for decinone). The next day after discharge, dark brown discharge appeared again, on the same day I did a new ultrasound (06/20/05) results: Pregnancy 14 weeks, One live embryo is determined in the uterine cavity, the size of the fetus is proportional and corresponds to a period of 12 weeks. Rhythmic heartbeat 10 beats/min. Motor activity is determined by malformations not identified. Chorion along the anterior wall of the uterus On the degree of maturity. The thickness of the placenta is 16 mm. The tone of the myometrium is slightly increased along the anterior wall. The cervix is ​​not shortened. The cervical canal is closed.
I have a few questions: How might such a threat affect a child’s development? What additional tests should be taken to clarify the cause of the threat? How long to take the prescribed medication in this amount? Could the short period between pregnancies be the cause of the threat?
Thank you for your advice

Clinic “Mother and Child” Kuntsevo:

01/27/2021

The presence of short-term bleeding during pregnancy with normal blood tests and ultrasound data (adequate fetal development, absence of detachment of the placenta) does not have a negative effect on the fetus. In such cases, it is necessary to exclude inflammation of the vagina, a decidual polyp of the cervical canal, when spotting does not occur from the uterus, but is external in nature and is not associated with problems of the fetal egg. Nevertheless, in your case, it is better to follow a sparing regimen, take antispasmodics (no-shpu, magnesium B6, soothing herbs, continue taking utrogestan until 16 weeks of pregnancy, dexamethasone. With normal health and ultrasound data after 16 weeks, gradually cancel utrogestan, antispasmodics, magnesium B6).

Bleeding during early pregnancy. Causes, symptoms of spotting in the first trimester

Bleeding during early pregnancy occurs with spontaneous miscarriage, Rhesus conflict, ectopic pregnancy. A condition occurs regardless of the timing of pregnancy. The gestation period is a complex process that does not always go well. Every second woman has various complications. Most often, women go to the doctor with complaints of spotting. Why does bleeding appear during early pregnancy, how dangerous is it?

General information

Bleeding during pregnancy is considered an obstetric symptom, indicating disorders in the woman’s body. Causes can be physiological changes or pathologies. Bleeding is observed in every fifth pregnant woman. In 50% of cases, they indicate the presence of pathology and end in spontaneous abortion. In the remaining 50% of women, this symptom is physiological. Most often, bleeding occurs in the 1st and 3rd trimesters.

Reasons

Blood in the first trimester of pregnancy in the vaginal secretion is observed in 30% of expectant mothers. Bleeding can be weak, spotting, plentiful.

Most often, blood during pregnancy in the early stages is observed during implantation of the fetal egg. When the egg is attached, the vessels are often damaged, which leads to the appearance of blood secretions. They are similar to menstruation, last 1-2 days. This process is considered natural, does not indicate any pathologies.

Blood during pregnancy can appear with the following pathologies:

1. Excessive exercise, deep penetration during intercourse . If the cervix is ​​damaged, slight red discharge occurs, which disappears within two hours.
2. Progesterone deficiency . With a low level of the hormone, the body starts the process of menstruation. Bloody discharge during pregnancy appears when the uterine mucosa is exfoliated. The situation may adversely affect the implantation of the fetal egg.
3. Miscarriage . Occurs in 2-8% of pregnant women. It is characterized by pain in the lower abdomen, which is rapidly increasing, bloody discharge at the beginning of pregnancy. The causes of the pathological condition can be different – infectious diseases, fetal malformations that are incompatible with life, dehydration, abdominal trauma, taking certain drugs.
4. Ectopic pregnancy . Dangerous condition, urgent hospitalization is required.
5. Miscarriage . Blood discharge during pregnancy, abdominal pain are the main manifestations of intrauterine development of the fetus.
6. Infections . To avoid dangerous complications, it is necessary to treat diseases. Parents of both sexes should be tested.
7. Complete or partial hydatidiform mole . Pathology of the chorion, in which the size of the villi increases, bubble expansions form. The risk group includes women with ovarian dysfunction, inflammatory diseases of the reproductive system, and a history of cystic mole. Bleeding is profuse and constant, characteristic blisters are present. The symptoms of early toxicosis are very pronounced, the size of the uterus, the hCG indicators do not correspond to the gestational age.
8. Cervical cancer . Pregnant women are rarely diagnosed. The risk group includes women with a large number of abortions and childbirth, often changing sexual partners.
9. Subchorionic hematoma . Hemorrhage around the placenta most often resolves on its own. But it increases the risk of preterm birth and other complications.
10. Cervical erosion . Detected in 50% of women. For pregnant women, the disease is not dangerous, but constant medical supervision is needed.
11. Bleeding in the first trimester can be caused by causes that appear at any gestational age. These are fibroids, polyps in the uterus and cervical canal, cardiovascular pathologies that are associated with a weakening of the endothelium.

Any bloody discharge during early pregnancy is a reason for an urgent visit to a gynecologist. Even if there is no additional discomfort. At a remote consultation, our doctor will collect an anamnesis, draw up a clinical picture in order to identify the cause of bleeding. And he will select effective methods to eliminate the problem.

Varieties

The clinical picture of the pathological condition depends on the causes. So, when physiological changes occur against the background of general well-being. Depending on the origin of bleeding are divided into:

Depending on the type, bleeding is divided into internal – indicate placental abruption, external – from the vagina, mixed – both internal and external bleeding appear.

Physiological or pathological bleeding during gestation – differences

Clinical manifestations of bleeding in pregnant women depend on the causes. Physiological discharge of blood from the genital tract in the early stages of gestation proceeds without deterioration in well-being. With bleeding caused by erosion, fibroids and polyps, there are also no additional discomfort. In this case, only a few drops of blood are released, it bleeds for a short time.

Abundant bleeding, similar to menstruation, against the background of a general satisfactory condition, occurs with a deficiency of progesterone.

Bleeding with spontaneous interruption is accompanied by constant or periodic pain in the lumbar region, abdomen. Disturbed by nausea, bouts of dizziness, slightly increased body temperature. Bleeding can be weak or intense, and clots are often observed in the discharge.

When a fertilized egg is fixed outside the uterus, internal bleeding often occurs, and discharge from the genital tract may appear much later. Characteristic manifestations – acute pain in the abdomen radiates to the anal region, right or left side, blood pressure decreases, cold sweat appears, fainting is possible. Significant blood loss leads to the development of a state of shock with a high probability of death.

Implantation bleeding

Why does it bleed at the initial stages of gestation? Most often, the appearance of spotting during pregnancy is associated with the implantation of the embryo. They occur 6-12 days after conception and are often one of the first signs of conception.

Usually, the appearance of spotting at the beginning of pregnancy coincides with the time of the onset of menstruation, if the cycle is regular. But discharge in pregnant women is not as abundant as menstrual bleeding. Duration – from several hours to three, with the first pregnancy up to 5 days.

Photo: What is typical for implantation bleeding

How does implantation bleeding manifest?

• weak, pulling pain in the lower abdomen;
• headache, dizziness;
• sudden change of mood;
• bouts of nausea;
• increased sensitivity, swelling of the mammary glands;
• fatigue, drowsiness.

Important! When an embryo is implanted, little blood is released, usually these are small spots. The discharge may be pink, brown, orange, and there should be no clots.

Early dates

The first months of pregnancy are the most difficult and dangerous. It is in the early stages that various pathologies and complications often appear.

Why blood may appear in the early stages during pregnancy:

1. At the 4th week of pregnancy, discharge with an admixture of blood may appear – this is implantation bleeding. Heavy bleeding is a dangerous sign, most often indicates a miscarriage. Spontaneous abortion can be caused by exercise, fever, infections, drugs or alcohol. Such bleeding is profuse, painful, blood clots are present.
2. The appearance of sanious discharge at the 5th week of pregnancy may be a sign of a missed pregnancy. The reasons are overwork, Rh conflict, bad habits, bacterial and viral diseases of the reproductive system, genetic disorders in the embryo. Symptoms – causeless fever, severe pain in the lower back and lower abdomen, the disappearance of signs of toxicosis.
3. Blood in the discharge at the 6th week of pregnancy appears with an ectopic attachment of the fetal egg, fetal fading, Rhesus conflict. Discharge with blood at 6 weeks of pregnancy is a reason for an urgent visit to the gynecologist.
4. At the 7th week of pregnancy, discharge with blood is not the norm. May indicate a miscarriage, missed or ectopic pregnancy.
5. From the 8th week of pregnancy, one of the most dangerous periods of pregnancy begins. The formation of the placenta begins, the hormonal background changes. Bloody discharge appears with the threat of miscarriage or spontaneous abortion. Pregnancy is often not saved.

Pay attention! Second trimester bleeding occurs in only 5-10% of women. Most often this is due to late spontaneous abortion, isthmic-cervical insufficiency. The appearance of blood in the third trimester mainly occurs with presentation, placental abruption.

ECO

The appearance of blood discharge during pregnancy on the 8-10th day after IVF is not considered a pathology, provided that the woman feels normal. After the introduction of the embryo into the uterine cavity, minor damage to the small uterine vessels often occurs. Brown, dark cream, pale pink, odorless discharge most often indicates a successful transplant, pregnancy.

If spotting after IVF is observed for 1-2 days, slight pulling pains in the lower abdomen are disturbing, this may be due to a progesterone deficiency. After the examination, the doctor will adjust the hormonal maintenance therapy.

Pink discharge on the 16th day after the transfer is a dangerous symptom. It may be a sign of detachment of the fetal egg, the threat of termination of pregnancy.

According to studies, uterine bleeding in the first trimester is a common occurrence in pregnancy after IVF. Discharge does not affect the incidence of adverse reproductive outcomes. The number of embryo rejections in women with and without uterine bleeding is approximately the same. Consult with our doctors by phone for more details.

Consult a gynecologist

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Diagnostics

If blood has gone from the genitals of a pregnant woman, the doctor conducts an external and gynecological examination.

Analyzes and examinations:

• general and biochemical blood test;
• general urine analysis;
• tests for hCG, other hormones;
• Ultrasound of the pelvic organs;
• CTG is performed to assess the vital activity of the fetus.

Read also
Is it possible to get pregnant after an abortion

Treatment

Methods of treatment depend on the results of the examination.

Bloody discharge in the first trimester – causes and therapeutic measures:

• In case of miscarriage, they resort to cleaning the uterus.
• An ectopic pregnancy is treated by diagnostic laparoscopy, the remnants of fetal tissues are removed, and antibiotic therapy is carried out.
• With the threat of miscarriage, hospitalization, bed rest, the appointment of drugs to maintain pregnancy, sedatives and tocolytics to reduce uterine tone are indicated.
• Bubble drift is eliminated by curettage of the uterine cavity.
• Surgery is necessary for cervical cancer.
• Damage to the polyp, erosion of the cervix requires expectant management, if the condition does not worsen, removal and cauterization is performed after childbirth.
• Hormone therapy is prescribed for a shortage of progesterone.

Damage to the cervix of the uterus requires bed rest, and infectious pathologies are treated depending on the pathogen. In this case, antibiotics, antiviral, antifungal drugs can be prescribed.

Complications and consequences

It is impossible to ignore bloody impurities in vaginal discharge during pregnancy. Without proper and timely assistance, the following complications may occur:

• miscarriage;
• intrauterine fetal death;
• the development of an infectious process, sepsis due to the remainder of dead tissues in the uterine cavity;
• profuse blood loss can lead to death.

Important! Urgent medical attention is needed in case of heavy bleeding, discharge of bright scarlet blood, presence of blood clots in the discharge. In life-threatening and fetal conditions, severe pain in the abdomen, lower back, convulsions, profuse cold sweat, and loss of consciousness are disturbing.

Methods of prevention

If there is blood in the first trimester, it is important to remain calm. Stress and anxiety will only exacerbate the situation. But any health problem is easier to prevent than to treat.

How to avoid bleeding during childbearing – recommendations from a gynecologist:

• eat right and balanced, give up junk and junk food, eat more fresh vegetables and fruits;
• observe the drinking regime;
• in the absence of contraindications, moderate physical activity is indicated – yoga, swimming, special gymnastics for pregnant women;
• more time to walk in the fresh air;
• avoid stress, overwork, observe the daily routine, get enough sleep;
• give up bad habits, do not be in smoky rooms;
• timely visit a gynecologist;
• according to the doctor’s prescription, take vitamin complexes for pregnant women;
• do not self-medicate.

The prognosis for bleeding during gestation depends on the causes and timely visit to the doctor. Properly provided medical care can save the life of the fetus and the woman.

FAQ

Why is there blood from the genital tract during gestation?

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The causes of bleeding in early pregnancy are different. Most often, spotting appears when the fetal egg is fixed, progesterone deficiency, with erosion of the cervix and polyps. Dangerous causes – ectopic, molar, miscarriage, miscarriage.

What to do if there is bleeding during pregnancy?

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Much depends on the amount of blood released, general well-being. If the bleeding is not strong, not for long, the general condition is normal, it is enough to lie down and rest. Write down the date of the attack, inform the doctor at the next visit. But if even slight spotting during early pregnancy lasts more than 72 hours, is accompanied by cramping or acute pain, fever, you should immediately visit a gynecologist or call an ambulance.

How can you recognize a miscarriage?

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With the threat of interruption, spotting is scanty, pain in the lower abdomen is absent or may be dull, aching. The condition is considered reversible, with timely treatment, pregnancy can be saved. If a miscarriage has begun, bleeding intensifies, cramping pain appears. The general condition is satisfactory. Urgent hospitalization is required, the probability of maintaining pregnancy is decided on an individual basis.

Expert opinion

Bleeding during early pregnancy is a dangerous symptom. Sometimes spotting can be caused by physiological reasons. But often such a symptom appears in life-threatening conditions for the woman and the fetus. To clarify the diagnosis, ultrasound examinations are performed, the degree of blood loss is determined.

We publish only verified information

Article author

Menshikova Maria Viktorovna

obstetrician-gynecologist

Experience 38 years

Consultations 1816

Art.