Is heavy bleeding normal during early pregnancy: How Much Is Normal? What Causes It?
How Much Bleeding Is Normal In Early Pregnancy?
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Vaginal bleeding can happen at any stage of a pregnancy, from conception to delivery. With spotting, you may see just a few drops of blood in your underwear. Heavy bleeding is more noticeable. It will require a sanitary pad to protect your clothing.
Call your doctor whenever you experience bleeding of any kind. Call your doctor if you have vaginal bleeding or spotting. This is important even if an ultrasound test confirms your pregnancy is normal. An ultrasound is where a technician moves a wand around your stomach to see an image of the baby.
Non-serious reasons for bleeding early in your pregnancy can include:
- implantation (as the egg settles in your uterus the first 6-12 days)
More serious causes of vaginal bleeding during the early part of pregnancy can include:
- An ectopic pregnancy (a pregnancy that starts outside the uterus and will not survive).
- A miscarriage (losing the baby early in a pregnancy).
- A molar pregnancy (a fertilized egg that implants in the uterus that does not live).
In later pregnancy, the following medical conditions can cause vaginal bleeding:
- Placental abruption (the placenta detaches from the wall of the uterus during birth).
- Placenta previa (the placenta is lying too low in the uterus and nearly covers the cervix).
- Placenta accreta (when the placenta invades and doesn’t separate from the uterine wall).
- Preterm labor (labor that starts before completing 37 of 40 weeks of pregnancy).
Bleeding may be just one sign of preterm labor. It also can include vaginal discharge, pressure in your pelvis or abdomen (lower stomach), a dull backache, cramps, contractions, and your water breaking.
If you are bleeding early in your pregnancy, your doctor will want to know how long and how much. If you have cramps and pain early in the pregnancy, he or she will order tests. This will include an ultrasound, blood, and urine tests.
If continued bleeding is not serious, your doctor may treat it by recommending that you rest, relax, stay off your feet, and not have sex. Keep your body healthy. Take a prenatal vitamin with folic acid daily while pregnant. Take it earlier if you plan to get pregnant. Avoid smoking, drinking alcohol, and taking illegal drugs. Talk to your doctor before taking prescription medicine. Also, when you are pregnant, you should never douche (use vaginal cleansing products) or use tampons. Serious bleeding may need to be treated with a long-term bed rest, hospitalization, or surgery.
You cannot prevent a miscarriage after it has started. The exact cause is usually unknown. It’s rarely something the mother did wrong. Most women can have healthy pregnancies in the future. If you have lost more than 3 pregnancies, talk to your doctor.
I’m Pregnant! Why Am I Bleeding?
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Many moms-to-be experience bleeding while they are pregnant. In fact, the American Pregnancy Association says studies show that 20-30 percent of women experience some degree of bleeding during early pregnancy. But how do you know how much bleeding is normal and when it’s a cause for concern? It depends on how far along you are, and how severe the bleeding is.
First, know how to tell spotting from bleeding.
Spotting is very light bleeding. It is common in the first trimester. The blood will be light brown or pink, similar to what you see at the end of a period.
Bleeding is heavier. The blood is bright red and is more like the bleeding you experience when having your period.
If you’re thinking about it, call your doctor.
When to Call the Doctor
David McKenna, MD, a Maternal-Fetal Medicine specialist with Perinatal Partners, advises calling your doctor if you see any sign of bleeding during pregnancy and have not yet talked to your doctor about it. This is especially the case for women who are pregnant for the first time. “Explain what’s happening to your doctor. Talk about your next steps and if – and when – you should call back,” he says.
Why You May Bleed During Pregnancy
First Half of Pregnancy
Spotting during this time is common, especially after sex, a pelvic exam, or a transvaginal ultrasound. In these cases, the blood might be coming from the cervix. It becomes tender during pregnancy and could be a bit inflamed or irritated. This type of bleeding can also occur prior to a miscarriage or with an ectopic pregnancy, but most often it is not a cause for concern.
Heavier bleeding during the first trimester can also be a sign of a miscarriage or ectopic pregnancy. This bleeding doesn’t mean a miscarriage will occur, or that you have an ectopic pregnancy. About half of pregnant women who have bleeding do not miscarry. The most important thing you can do is to let you doctor know about any bleeding, so that you can evaluated for the cause.
Second Half of Pregnancy
During the late second and entire third trimester, causes of bleeding can include:
- Placenta previa. This occurs when the placenta is low in the uterus and partly or completely covers the cervix. Most women notice no pain with the bleeding. Placenta previa occurs in 1 in 200 pregnancies and requires immediate attention when there is bleeding. Placenta previa often resolves on its own, especially when it is found early during pregnancy. Other times it can lead to an early delivery by Cesarean section.
- Placental abruption. This occurs when the placenta detaches from the uterine wall before or during labor. It can cause serious complications if it is not found early. It often comes with painful contractions. Placental abruptions are rare, occurring in just 1 percent of pregnant women. Risk factors for placental abruptions include maternal smoking, drug use and high blood pressure.
- Preterm labor. Defined as labor starting prior to 37 weeks’ gestation, preterm labor might also include these signs: regular contractions, cramping, back pain and increased pelvic pressure. If you think you’re going into early labor, call your doctor right away.
Be Prepared for These Questions
If you experience bleeding during pregnancy, be ready to answer these questions when you call or visit your doctor:
- How far along are you?
- When did you first have a positive pregnancy test?
- Have you had an ultrasound, and if so, what did it show?
- When did the bleeding start?
- Were there any obvious causes? For example, have you recently had intercourse or a vaginal exam?
- How heavy has the bleeding been?
- Have you had any pain or other symptoms with the bleeding?
If you are asked to make an appointment, your doctor is likely to check your cervix with a speculum. You might have an ultrasound or other testing to help learn the cause of the bleeding.
Many factors can cause spotting and bleeding during pregnancy. Because of that, it’s best to talk with your doctor if you have any bleeding. The bottom line is, if you’re thinking about it, call your doctor.“That’s what we’re here for,” says Dr. McKenna.
It’s easy to get the care you need.
See a Premier Physician Network provider near you.
Source: David S. McKenna, MD; Perinatal Partners; American Pregnancy Association; The American Congress of Obstetricians and Gynecologists; Whattoexpect.com
Bleeding During Pregnancy | ACOG
Cervix: The lower, narrow end of the uterus at the top of the vagina.
Cesarean Birth: Birth of a fetus from the uterus through an incision (cut) made in the woman’s abdomen.
Complications: Diseases or conditions that happen as a result of another disease or condition. An example is pneumonia that occurs as a result of the flu. A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labor.
Ectopic Pregnancy: A pregnancy in a place other than the uterus, usually in one of the fallopian tubes.
Egg: The female reproductive cell made in and released from the ovaries. Also called the ovum.
Fallopian Tubes: Tubes through which an egg travels from the ovary to the uterus.
Fertilization: A multistep process that joins the egg and the sperm.
Hysterectomy: Surgery to remove the uterus.
Inflammation: Pain, swelling, redness, and irritation of tissues in the body.
Miscarriage: Loss of a pregnancy that is in the uterus.
Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.
Oxygen: An element that we breathe in to sustain life.
Pap Test: A test in which cells are taken from the cervix (or vagina) to look for signs of cancer.
Pelvic Exam: A physical examination of a woman’s pelvic organs.
Placenta: An organ that provides nutrients to and takes waste away from the fetus.
Placenta Accreta: A condition in which part or all of the placenta attaches abnormally to the uterus.
Placental Abruption: A condition in which the placenta has begun to separate from the uterus before the fetus is born.
Placenta Previa: A condition in which the placenta covers the opening of the uterus.
Preterm: Less than 37 weeks of pregnancy.
Sexual Intercourse: The act of the penis of the male entering the vagina of the female. Also called “having sex” or “making love.”
Trimester: A 3-month time in pregnancy. It can be first, second, or third.
Ultrasound Exam: A test in which sound waves are used to examine inner parts of the body. During pregnancy, ultrasound can be used to check the fetus.
Uterus: A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus. Also called the womb.
Bleeding During Pregnancy: What’s Normal and What’s Not
Published on 05/05/20
Most expectant moms would agree that not having to deal with a regular menstrual cycle is one of the best fringe benefits of pregnancy. For nine whole months, there are no abdominal cramps, no major mood swings, no unpredicted early starts, no uncomfortably heavy flow, and no overpriced feminine hygiene products; in short, it’s a delightful respite from the norm.But even though you don’t have to bother with your period for the better part of a year, you still may experience light vaginal bleeding, or spotting, from time to time. Light bleeding during pregnancy is actually fairly common, particularly early on in the first trimester — up to 30% of moms-to-be experience some amount of light bleeding within their first 12 weeks of pregnancy.
While any type of vaginal bleeding when you’re expecting can trigger alarm bells, it isn’t always an indication that something’s wrong. Here’s what you should know about bleeding during pregnancy — what’s normal, what’s not, and why you should always give us a call anytime it happens. The team here at Rosh Maternal & Fetal Medicine is here to help.
Is it spotting or bleeding?
Light bleeding, or spotting, is very different from moderate or heavy vaginal bleeding. Before we dive into the possible causes of bleeding during pregnancy, it can be helpful to know the difference between the two.
As the name implies, spotting usually appears as a few small spots of blood. While its color may vary from light pink to bright red or even dark brown, spotting is light enough and brief enough that it doesn’t require you to wear a pad or liner. To put it another way, it’s similar to the kind of bleeding you may experience as your period begins or ends.
Moderate to heavy bleeding causes a much heavier flow that’s similar to what you normally experience in the middle of your period, when your flow is at its peak; it’s the kind of bleeding that does require you to a liner or pad.
If you start bleeding anytime during your pregnancy, it’s helpful to wear a sanitary napkin so you can keep track of the amount and type of bleeding you’re experiencing. Until you’ve been given the all-clear, it’s a good idea to avoid having sex or inserting anything into your vagina, including tampons.
Bleeding during early pregnancy
A day or two of light bleeding is common within two weeks of conception, before most women even know they’re pregnant. That’s when the fertilized egg burrows, or implants itself, into the lining of your uterus, causing perfectly normal light spotting known as implantation bleeding.
As the first trimester continues, changing hormone levels prompt the development of new blood vessels and an increased blood flow to your uterus, cervix, and vagina, all of which can lead to normal spotting or light bleeding following sexual intercourse, intense exercise, or a routine pelvic exam.
Some of the most common reasons for abnormal and potentially problematic vaginal bleeding during early pregnancy include:
Early first trimester bleeding is sometimes evidence of an ectopic pregnancy, which happens when an embryo implants itself somewhere other than the uterus (usually in a fallopian tube). Although this kind of bleeding can occur without other symptoms, it’s often accompanied by abdominal, pelvic, or even shoulder pain.
Because an ectopic pregnancy can be life-threatening, you should call your obstetrician anytime you experience bleeding or pain in your first trimester.
Bleeding during the first trimester — particularly when it’s accompanied by abdominal pain or cramping — can also be the first sign of a miscarriage, or early pregnancy loss. Approximately 10% of known pregnancies end in miscarriage, and about half of all women who experience unusual bleeding in early pregnancy eventually miscarry.
It’s important to keep in mind that most miscarriages can’t be prevented; they typically occur when an unhealthy pregnancy isn’t developing as it should.
Bleeding during late pregnancy
While it’s possible to experience harmless spotting during your second and third trimesters — especially following intercourse or a routine pelvic exam — late pregnancy bleeding of any kind is always cause for concern that warrants an immediate call to your obstetrician.
Heavy bleeding, in particular, can indicate a serious complication in late pregnancy, such as:
Worrisome late-pregnancy bleeding can be a sign that something’s wrong with the placenta or the vascular tissue that nourishes and maintains your baby while in utero.
Placental abruption, which occurs when the placenta detaches from the uterus, often causes heavy bleeding accompanied by cramping or back pain. Placenta previa, which occurs when the placenta partly or totally covers your cervix, typically causes bleeding without pain.
Spotting or bleeding that occurs anytime in your second or third trimester — but before you reach your 37th week of pregnancy — can also be a sign of preterm, or premature, labor.
Other signs of preterm labor include vaginal discharge changes, increased pelvic pressure, abdominal cramping, lower back pain, and contractions.
Complete-access obstetric care
Here at Rosh Maternal & Fetal Medicine, we’re committed to making sure all our expectant moms can reach us any time of day and any day of the week to report potential problems, discuss pressing concerns, or ask a simple question.
As such, you can always get in touch with one of our experienced obstetricians for prompt advice if you happen to experience spotting or bleeding during any trimester.
To learn more, call our Manhattan, New York City office today, or use the easy online tool to schedule a visit with one of our board-certified obstetricians.
Bleeding and spotting from the vagina during pregnancy
Bleeding and spotting from the vagina during pregnancy are common. Up to 1 out of 4 (up to 25%) of all pregnant women have some bleeding or spotting during their pregnancy.
Bleeding and spotting in pregnancy don’t always mean there’s a problem, but they can be a sign of miscarriage or other serious complications. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy.
Call your health care provider if you have any bleeding or spotting, even if it stops. It may not be caused by anything serious, but your provider needs to find out what’s causing it.
What’s the difference between bleeding and spotting?
Bleeding or spotting can happen anytime, from the time you get pregnant to right before you give birth. Spotting is light bleeding. It happens when you have a few drops of blood on your underwear. Spotting is so light that the blood wouldn’t cover a panty liner. Bleeding is when the blood flow is heavier, enough that you need a panty liner or pad to keep the blood from soaking your underwear and clothes.
What should you do if you have bleeding or spotting during pregnancy?
Call your health care provider if you have any kind of bleeding during pregnancy and do these things:
- Keep track of how heavy your bleeding is, if it gets heavier or lighter, and how many pads you are using.
- Check the color of the blood. Your provider may want to know. It can be different colors, like brown, dark or bright red.
- Don’t use a tampon, douche or have sex when you’re bleeding.
Call your health care provider right away at any time during pregnancy or go to the emergency room if you have:
- Heavy bleeding
- Bleeding with pain or cramping
- Dizziness and bleeding
- Pain in your belly or pelvis
What causes bleeding or spotting early in pregnancy?
It’s normal to have some spotting or bleeding early in pregnancy. Bleeding or spotting in the first trimester may not be a problem. It can be caused by:
- Having sex
- An infection
- Implantation. When a fertilized egg (embryo) attaches to the lining of the uterus (womb) and begins to grow.
- Hormone changes. Hormones are chemicals made by the body.
- Changes in your cervix. The cervix is opening to the uterus that sits at the top of the vagina.
- Certain types of testing during pregnancy like an amniocentesis or Chorionic villus sampling (CVS). These are tests that are done to check for genetic abnormalities in your baby. Genetic abnormalities are changes in the genes that are passed down to a baby from mom or dad. These genetic changes can cause health problems for a baby.
- Problems related to smoking. If you smoke, it’s best to stop before pregnancy or as soon as you know you’re pregnant.
Sometimes bleeding or spotting in the first trimester is a sign of a serious problem, like:
- Miscarriage. Almost all women who miscarry have bleeding or spotting before the miscarriage.
- Ectopic pregnancy. This is when a fertilized egg implants itself outside of the uterus and begins to grow. An ectopic pregnancy cannot result in the birth of a baby. It can cause serious, dangerous problems for the pregnant woman.
- Molar pregnancy. This is when a mass of tissue forms inside the womb, instead of a baby. Molar pregnancy is rare.
What causes bleeding or spotting later in pregnancy?
Bleeding or spotting later in pregnancy may be caused by:
- Having sex
- An internal exam by your health care provider
- Problems with the cervix, like an infection, growths, inflammation or cervical insufficiency. This is when a woman’s cervix opens too early. Inflammation of the cervix is when it may be painful, swollen, red or irritated.
Bleeding or spotting later in pregnancy may be a sign of a serious problem, like:
- Preterm labor. This is labor that happens too early, before 37 weeks of pregnancy.
- Placenta previa. This is when the placenta lies very low in the uterus and covers all or part of the cervix.
- Placenta accreta. This is when the placenta grows into the wall of the uterus too deeply.
- Placental abruption. This is when the placenta separates from the wall of the uterus before birth.
- Uterine rupture. This is when the uterus tears during labor. This happens very rarely. It can happen if you have a scar in the uterus from a prior cesarean birth (also called c-section) or another kind of surgery on the uterus. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.
How are bleeding and spotting treated?
Your treatment depends on what caused your bleeding. You may need a medical exam and tests.
Most of the time, treatment for bleeding or spotting is rest. Your provider may also suggest treatments like:
- Take time off from work and stay off your feet for a little while
- You may need medicine to help protect your baby from Rh disease. Rh disease is when your blood and baby’s blood are incompatible (can’t be together). This disease can cause serious problems — even death — for your baby.
- Don’t have sex, douche or use tampons
- If you have heavy bleeding, you may need a hospital stay or surgery
Last reviewed: April 2020
Bleeding and/or Pain In Early Pregnancy
- Reference Number: HEY-025/2018
- Departments: Gynaecology
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This leaflet has been produced to give you general information about your condition. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and your nurse/doctor, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team .
What is vaginal bleeding in early pregnancy?
Vaginal bleeding is common in early pregnancy and does not always mean there is a problem. However, bleeding can be a warning sign of a miscarriage.
What are the causes of early bleeding?
There are a number of causes of bleeding in early pregnancy which include:
Spotting or bleeding may occur shortly after conception, this is known as an implantation bleed. It is caused by the fertilised egg embedding itself in the lining of the womb. This bleeding is often mistaken for a period, and it may occur around the time your period is due.
Hormonal bleeding is when some women experience a light bleed at around four to eight weeks of pregnancy, or around the time their period would have been due. This can be very confusing for women who are pregnant and is the reason many women do not realise they are pregnant for a while. Again, it is totally normal. This usually settles around the 13th week of pregnancy as by this time the placenta is sufficiently developed to produce all of the hormones needed to sustain the pregnancy.
After the egg is fertilised, the fertilised egg then goes on to implant itself into the lining of the womb (uterus). Sometimes this results in a little bleeding that shows up on an early scan as a haematoma(collection of blood). This is not anything to worry about. When it happens the woman may notice a small amount of vaginal bleeding, but this is not necessarily the case.
The haematoma will gradually disappear and in most cases, the pregnancy remains safe.
Cervical Erosion (alternatively known as cervical ectropion) may be a source of spotting or bleeding. The blood supply to the womb and cervix is increased during pregnancy and the cervix may bleed harmlessly and painlessly. An erosion may cause bleeding following sexual intercourse; therefore this type of bleeding must always be reported to your doctor.
Can bleeding indicate a miscarriage?
Not all bleeding in pregnancy is harmless, and it can be the first sign of a miscarriage. As many as 1 in 5 pregnancies are thought to end in miscarriage. The cause of miscarriage is not always known, but researchers have shown that in some cases there is a problem with the developing pregnancy, which means it is unable to develop normally. For most women, miscarriage is a very sad and upsetting experience.
Experiences of miscarriage vary. In some cases there may be only very slight spotting, in other cases bleeding may stop and start or heavier bleeding with clots and cramping period type pains can occur. Sometimes there may be no bleeding at all.
For further information relating to miscarriage, please ask your nurse for further details.
What should I do if I experience bleeding during pregnancy?
If you experience bleeding, it is wise to have this checked out. If you have been seen in the Early Pregnancy Assessment Unit (EPAU) during your pregnancy, you may contact us directly, up to 15 weeks + 6 days of pregnancy. Your GP or midwife can also help you.
If you have been seen in the EPAU and you then experience more bleeding contact the EPAU. Depending on how much bleeding and for how long the nursing staff will decide if you need to be seen again. A rescan is not always necessary. Sometimes the nurse will advise that you monitor this bleeding at home. A rescan will only be performed if bleeding heavy with clots. If there is a significant change in your symptoms then the nurse will make an appointment to come to EPAU and be either rescanned or to be assessed by the doctor. If bleeding unmanageable then the nurse may advise to be assessed on ward 30 or the Emergency department depending on your symptoms.
What if I experience pain in early pregnancy?
If you experience pain that does not go away, or which you feel is becoming more sever, you should seek advice from your doctor, nurse or midwife. It is important that any serious causes of pain are excluded. For example there is a need to rule out an ectopic pregnancy (this is where the pregnancy develops outside the womb).
What kind of pain may I feel?
Some women experience abdominal (tummy) pain in early pregnancy. This may be low cramping pain, similar to that felt during a period, or a stitch like or stabbing pain on one or both sides of the tummy. Aches and pains may come and go or be present continuously.
What are the causes of abdominal and back pain?
Some of the aches and pains experienced during pregnancy are thought to be due to hormonal changes. Large amounts of the hormone progesterone are produced, which are needed to sustain pregnancy. In addition to this, progesterone acts on the muscles, ligaments and joints causing them to become slacker and more flexible. This hormonal effect is thought to be responsible for some of the stitch like pains that some women experience in the lower part of the tummy and in some cases this can be quite severe. The same hormones can be responsible for constipation during pregnancy; this can also cause abdominal pain.
The enlarging womb is made up of layers of muscles and is held in place in the pelvis by supporting ligaments. As the womb expands to accommodate the developing baby, it can pull on the ligaments and muscles, to cause these “growing pains”.
The backache that some women get in early pregnancy is also thought to be due to a hormonal effect, and the supporting muscles are softer.
Abdominal and/or backache can also be a sign of a urine infection. This may also cause burning or stinging when passing urine and the need to pass urine more frequently. You must inform your doctor of these symptoms, so that a urine test can be obtained and treatment given if needed.
Pain on its own does not mean that a miscarriage will occur. However if you experience bleeding as well as pain this could indicate a threatened miscarriage and you should always seek advice from your doctor, nurse or midwife.
Can I take pain relief medication during pregnancy?
If you find that you need to take pain relief medication to relieve any pain, it is safest to use something simple such as paracetamol. Drugs such as aspirin and ibuprofen should be avoided. If you find that you need a stronger pain relief medication, you must always check with your doctor, nurse or midwife first.
Scanning in early pregnancy
An ultrasound scan is used during pregnancy for a number of reasons. In the first three months of pregnancy it can be used to check the presence of the baby’s heartbeat, which can be reassuring if you have experienced a problem, such as vaginal bleeding or pain. A scan will also be used to check to see if the pregnancy is in the correct place and to accurately predict the estimated date of delivery (the date the baby is due) by measuring the end points (size) of the embryo or fetus.
Will I have an ultrasound scan?
Yes, if the nurse/doctor thinks it is appropriate for you to have a scan.
What is an ultrasound scan?
Ultrasound uses high frequency sound waves that are sent out from a transducer or probe. These sound waves are received back and converted into an image on a screen.
Is it safe to have a scan in early pregnancy?
Yes it is safe, there is so far no evidence to suggest that an ultrasound scan is unsafe.
What type of scan will I have?
A vaginal scan is the best method in early pregnancy (under 8 weeks) as it gives us a more accurate result at an earlier stage in pregnancy than an abdominal scan. It may be a little uncomfortable but it is safe to be done, you do not need a full bladder when having a vaginal scan. If you have concerns about a vaginal scan, please let the nurse, midwife doctor know.
What will the scan tell us?
A scan can only tell us how your pregnancy is at that particular time. Unfortunately it is no guarantee that your pregnancy will continue successfully. If your symptoms persist or become worse, you must contact EPAU, midwife or your GP.
In later pregnancy ultrasound scanning is used to look more closely at the anatomy and organs of the developing baby. This is usually done between 18 – 21 weeks.
What if the scan confirms a miscarriage?
If the scan confirms that you have miscarried, the choices of how we can manage this will be discussed with you.
Occasionally, the scan may pick up an unexpected finding such as a cyst on the ovary. If this is the case, the staff will explain the findings and any necessary follow up.
Common abbreviations used on scans
LMP – Last menstrual period.
FH – Fetal heart-rate.
EDD – Estimated date of delivery.
FM – Fetal movement.
USS – Ultrasound scan.
YS – Yolk sac.
CRL – Crown to rump length (a measurement of the embryo/fetus used in early pregnancy).
BPD – Bi-Parietal Diameter.
HC – Head circumference. Both of these measurements of the fetus are used in later pregnancy, after 12-14 weeks.
Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the:
Early Pregnancy Assessment Unit/Emergency Gynaecology Unit
Women and Children’s Hospital
Women and Children’s Hospital
Information on Gynaecology Services at Hull University Teaching Hospitals NHS Trust can be found at:
Information on Maternity Services at Hull University Teaching Hospitals NHS Trust can be found at:
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Bleeding in Early Pregnancy – American Family Physician
Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.
Information from Your Family Doctor
What causes bleeding during early pregnancy?
About one in every four pregnant women will have vaginal bleeding in the first few months. Mild cramping and light spotting can be normal in early pregnancy. But vaginal bleeding may be a sign of something more serious. Some of the most common causes are:
Threatened miscarriage. This is when there is bleeding from the uterus but the pregnancy is still healthy. Sometimes a blood clot forms in the uterus and increases the risk of miscarriage. But most women with threatened miscarriage will have a healthy baby.
Ectopic pregnancy. This is when the pregnancy grows outside the uterus, usually in the fallopian tubes. Symptoms include heavy bleeding, dizziness, sharp pain in the stomach or shoulder, and cramps. Ectopic pregnancy is a medical emergency and can be life threatening.
Early pregnancy loss (also called miscarriage). This is the unexpected loss of a pregnancy before 14 weeks. Most miscarriages happen because the pregnancy is not developing normally.
Other causes of bleeding in early pregnancy include infections, hemorrhoids (HEM-uh-roids, or swollen veins in your rectum or anus), cervical cancer, and rare pregnancy-related cancers.
What should I do if I am bleeding?
Call your doctor right away. If you have heavy bleeding or severe pain, go to the emergency room.
Your doctor can do tests to see why you are bleeding. You may need a pelvic exam, an ultrasound, blood tests, or urine tests. Sometimes an ultrasound is all that’s needed to make sure your pregnancy is healthy. If it is still early in the pregnancy, you may need more tests to find the cause of the bleeding.
How is it treated?
It depends on the cause of the bleeding. No treatment is needed for a threatened miscarriage. Ectopic pregnancies need to be treated with medicine or surgery. After a miscarriage, the tissue may pass on its own. If not, you may need medicine or a procedure called aspiration to remove the tissue. Women with Rh-negative blood types may need a shot to help prevent problems in future pregnancies.
What can I do to prevent early pregnancy loss?
There is no way to prevent an early pregnancy loss after it has been diagnosed. There is often no way of knowing exactly why it happens. If you have an early pregnancy loss it is important to remember that you did not do anything to cause it. Most women who have had an early pregnancy loss can have healthy pregnancies in the future. If you have had two or more early pregnancy losses, talk to your doctor about whether you need other tests or treatment.
Keeping your body healthy is the best way to have a healthy pregnancy and baby. Talk to your doctor about any health problems before getting pregnant. Taking a prenatal vitamin with folic acid before you get pregnant can lower the risk of brain and spinal cord problems in your baby. Talk to your doctor before taking any over-the-counter or prescription medicines. Using cigarettes, drugs, alcohol, and large amounts of caffeine may increase your risk of early pregnancy loss.
90,000 Bleeding in the first half of pregnancy – Information
Pregnancy is a complex physiological process that can be accompanied by various complications, including those that cause uterine or vaginal bleeding. As a rule, the most dangerous from this point of view are the first and last trimester of pregnancy, more precisely, the very first and last weeks of it.
Strange as it may seem, but not any bleeding at the beginning of pregnancy indicates a pathology that requires immediate medical intervention.
Moreover, it can be said that in the very early stages of pregnancy, minor bleeding is considered a common symptom that is not a cause for concern and does not pose a danger to the normal course of pregnancy.
The first weeks of pregnancy are the time of global restructuring of the woman’s body, hormonal and physiological.
What are the reasons for the discharge of blood from the genital tract of a pregnant woman?
First of all, during the fixation of the ovum in the wall of the uterus, small fragments of its mucous membrane can be rejected, which causes the appearance of small bloody discharge from the vagina.This vaginal discharge can be brown, brownish, or intensely red. Most often, the discharge is not abundant and does not last longer than a few days. Sometimes they are accompanied by minor spasms, sometimes they go away completely painlessly for a pregnant woman.
It is this kind of bleeding that sometimes becomes the first indicators of the onset of pregnancy. We repeat that this does not happen when the pregnancy has already been established, but during the implantation of the ovum, that is, when the “real” uterine pregnancy has not yet begun.
Most often, in time, such spotting coincides with the time of the onset of the next menstruation, which leads to the rather widespread opinion that with the onset of pregnancy, menstruation does not stop for everyone.
However, after the pregnancy is established, any bleeding should alert the pregnant woman and force her to immediately appear to the obstetrician-gynecologist conducting the pregnancy.
A fairly common reason for the discharge of blood from the genital tract in pregnant women in early pregnancy is cervical erosion.This also happens for a completely understandable reason: due to the increased blood flow to the uterus during pregnancy, the mucous membrane of the cervix can begin to bleed, turning into a kind of inflammatory ulcer.
In case of cervical erosion in pregnant women, blood from the genital tract appears after sexual intercourse or for no apparent reason at all, such bleeding is not accompanied by pain, is insignificant and quickly stops spontaneously.
In addition to erosion, the cause of bleeding in pregnant women in the first trimester of pregnancy can be polyps of the cervical canal and decidual polyps – harmless tumors that grow in the uterus or cervix.At the same time, bleeding is also insignificant and is not accompanied by pain.
Depending on the specific situation, the doctor may remove the polyp or wait for the polyp to fall off on its own, as is most often the case. Removal of a bleeding polyp does not harm the course of pregnancy, since curettage of the uterine cavity is not required when removing it. In parallel with the removal of the polyp, treatment is required, aimed at replenishing blood loss and maintaining pregnancy.
However, there are other cases when bleeding in the first trimester of pregnancy serves as a signal that “not everything is calm in the Danish kingdom.”
In particular, such severe complications of the first trimester of pregnancy as spontaneous miscarriage and ectopic pregnancy can begin with vaginal bleeding.
In addition, the release of blood from the genital tract of a pregnant woman may indicate the development of any severe pathology of the cervix, up to oncological neoplasms.
Other causes of bleeding include varicose veins of the vulva, vaginal infections.
Let us remind you again: in order not to miss the first signs of these complications, any bleeding in a pregnant woman should be a reason to see a doctor.
Spontaneous miscarriage is an extremely serious complication of pregnancy that occurs early in pregnancy and usually begins with bleeding. Bleeding indicative of an incipient miscarriage may be minor and painless. However, it does not stop after a short time, but continues to grow both in intensity and in the accompanying unpleasant sensations.
Spontaneous miscarriage occurs in several stages: threatening miscarriage, miscarriage that has begun, abortion in progress, incomplete and complete spontaneous miscarriage. These stages differ just by the intensity of bleeding and the presence of pain.
With a threatening miscarriage, bloody discharge from the genital tract of a pregnant woman is extremely meager, pain is usually absent or is manifested by aching sensations in the lower abdomen. At the same time, the uterus has not yet been changed, and with active and timely treatment, the pregnancy can be saved.
An incipient miscarriage is characterized by slow bleeding, cramping pain. The cervix at this stage of the miscarriage may already be slightly shortened, and the external pharynx is slightly open. At the same time, the woman’s condition remains satisfactory and, with proper treatment, it is possible to maintain pregnancy. If this moment is missed, then it is almost impossible to maintain the pregnancy, and, in addition, severe bleeding during an abortion on the go causes the need for urgent hospitalization, in which curettage of the uterine cavity is performed, with compensation for blood loss, depending on its volume and the condition of the woman.
Bloody discharge with incomplete miscarriage is significant, usually dark red in color, clots can be seen in them. Bleeding is accompanied by cramping pains in the lower abdomen. Emergency care consists in scraping the uterine cavity, removing the remnants of the ovum; compensation of blood loss, depending on its volume and the condition of the woman.
If there is a complete miscarriage, then there is no bleeding, since the ovum is completely excreted from the uterus. The only thing that the doctor should do in this case is to scrape the uterine cavity so that no parts of the ovum remain there.
Spontaneous miscarriages, sadly, are a fairly common cause of uterine bleeding during pregnancy.
Another cause of bleeding in pregnant women can be an ectopic pregnancy, that is, a situation in which the ovum is fixed not in the body of the uterus, but in the tubes or in the cervix. An ectopic pregnancy that is not noticed in time can lead to a rupture of the cervix and even death.
Therefore, at the very first signs of malaise (bleeding from the genitals, combined with subjective signs of pregnancy: toxicosis, engorgement of the mammary glands, etc.)you must immediately consult a doctor. However, we note that bleeding, indicating an ectopic pregnancy, occurs when a woman does not yet know about pregnancy at all. So this situation can be attributed very conditionally to bleeding during pregnancy.
Based on the examination, analyzes and ultrasound diagnostics, the doctor will immediately determine whether there is inflammation that could cause bleeding, how the pregnancy proceeds, whether there is a threat of miscarriage.
With competent and timely treatment, many complications can be avoided, our doctors always strive to preserve pregnancy, even in its earliest stages.
90,000 The gynecologist “CM-Clinic” told whether there can be periods during pregnancy
The appearance of bloody discharge in the expectant mother – is it a reason to see a doctor or is it normal for early pregnancy? Understanding.
Tatyana Vladimirovna Grigorieva, obstetrician-gynecologist at SM-Clinic (@smclinic), told the readers of Letidora about what the menstrual cycle is like, as well as about menstruation during pregnancy.
Tatiana Vladimirovna Grigorieva, obstetrician-gynecologist “CM-Clinic”
Can menstruation ensure that pregnancy has not occurred
First, let’s remember what the menstrual cycle is. This is the alternation of the menstruation itself (lasts 3-7 days), the follicular phase, ovulation and the luteal phase. During menstruation, the mucous membranes of the uterus are rejected. The process is accompanied by bleeding (this happens at the end of the ovulatory cycle).If there was no ovulation, then the bleeding is called menstrual.
It is extremely rare for two eggs to ripen in one cycle (but this happens!): One is fertilized, and the second is rejected by the body and causes the onset of menstruation.
Menstruation cannot be normal during pregnancy.
However, do we always understand the nature of bleeding from the vagina without a medical diagnosis? If, during the alleged menstruation, a woman noticed bloody discharge, but their nature is different from the usual menstruation (the discharge is scanty, ends quickly, has a brown or bright scarlet color) and you remember that unprotected intercourse took place – this is a reason to do pregnancy test and consult a doctor.
What menstruation can talk about during pregnancy
After the fertilization of the egg and the onset of pregnancy, menstruation does not occur throughout the entire gestation process.
It should be remembered that the appearance of any bleeding from the vagina with a confirmed pregnancy (positive urine pregnancy test, ultrasound data, hCG indicators) indicates possible pathologies. For example, when there is a threat of miscarriage and termination of pregnancy (started spontaneous abortion), placenta previa (low, marginal, complete).
Lean spotting during the first days of pregnancy may be nothing more than implantation bleeding. The implantation of a fertilized egg (blastocyst) into the endometrium occurs 7-10 days after conception, that is, in fact, approximately on the days when menstruation should come in case of late ovulation.
The introduction of the blastocyst is accompanied by the destruction of capillaries, and, therefore, a small amount of blood is excreted. But, unlike true menstrual bleeding, implantation does not last long: in most cases, a day, or even less.
What is the effect of progesterone on the mucous membranes of the uterus
Progesterone is the most important hormone throughout pregnancy. He participates in the preparation of the endometrium for the implantation of a fertilized egg, fetal development, and prevents premature birth. The reason for the occurrence of bleeding from the vagina, including on days in which menstruation was previously observed in a woman, may be a lack of this hormone.
Hormonal bleeding, if left unattended, can lead to spontaneous abortion.
However, in most cases, with timely treatment, it is possible to remove the deficit state and minimize the risks.
Could the appearance of spotting indicate an ectopic pregnancy
An ectopic pregnancy is when a fertilized egg deviates from its intended path and attaches in the wrong place – outside the uterine cavity. The appearance of bloody discharge from the genital tract is not uncommon with an ectopic pregnancy.
Unlike menstrual bleeding, they are thicker and darker in color.
It should be remembered that early signs of ectopic (ectopic) pregnancy are very similar to signs of normal pregnancy (delayed menstruation, swelling of the mammary glands, positive urine pregnancy test).
Any suspicion of an ectopic pregnancy is an indication for emergency hospitalization, as this is a life-threatening condition.
When is there still menstrual flow and what does it mean
In most other cases, bleeding during early pregnancy (in the first trimester) is an alarming symptom.
For example, it may indicate that the placenta is located in the lower part of the uterus and overlaps its internal pharynx (this can be interpreted as a threat of termination of pregnancy).
In the second and third trimester, the appearance of bloody discharge may indicate a rupture of the uterus (for example, it can occur if there is a scar on the uterus after a previous birth), premature detachment of a normally located placenta, and other problems.
Bleeding during pregnancy is a sure sign for the expectant mother that an urgent need to consult a doctor.
It is important to remember that periods during pregnancy are not normal. In case of any bloody discharge, in this case, the help of a specialist is needed.
How often menstruation occurs during pregnancy
15–20% of pregnancies end in spontaneous abortion early. However, it is important to understand that although bloody discharge from the vagina against the background of a live intrauterine pregnancy is designated by doctors as a “threat of miscarriage”, but in a large number of cases, despite a formidable diagnosis, such a pregnancy is successfully carried on.
If interruption does occur, in most cases (overwhelmingly) we are talking about genetic abnormalities of the fetus, incompatible with life. Other reasons include early infectious diseases, hormonal disruptions, physical overload, and so on.
Do I need to see a doctor if the appearance of bleeding during pregnancy is noted only after intercourse
The appearance of bloody discharge from the genital tract after intercourse may indicate erosion of the cervix, the presence of polyps of the cervical canal.Allocations in this case are usually scanty and pass quickly.
However, only a doctor can find out if this is so or if there is a threat of miscarriage.
A until the diagnosis is made, the couple is advised to observe sexual rest.
The fact is that during intimate caresses in a woman’s body, oxytocin is released – a hormone that stimulates uterine contractions.
Published on the letidor.ru portal
90,063 90,000 Discharge during pregnancy
Pregnancy is a new stage in the life of every woman, which brings previously unknown sensations and sometimes worries about her health or the health of her baby. One of the most frequently asked questions that a gynecologist encounters in his practice is normal vaginal discharge.
During pregnancy, normal discharge is light, white, may be slightly yellowish, without an unpleasant odor. The amount of discharge often increases. It is very common for pregnant women to develop white, cheesy discharge, which is caused by the Candida fungus known as thrush.During pregnancy, hormonal changes occur, which also affect the microflora of the vagina. If yellow or greenish discharge with an unpleasant odor appears, itching, burning, it is imperative to consult a gynecologist. This discharge can be caused by an infection in the vagina or sexually transmitted infections.
It is imperative to inform the gynecologist if spotting appears during pregnancy. About 20% of expectant mothers in early pregnancy have spotting spotting.They can be of different shades, from light pink to dark brown. They can be seen in small numbers on toilet paper and are painless. Usually, such discharge is not associated with a poor outcome of pregnancy and it proceeds normally until the very birth. But still, spotting can be associated with complications of pregnancy, especially if they appear in the II or III trimester.
If bright red discharge appears, in large quantities, lasts longer than one day and is accompanied by pain in the lower abdomen, an urgent need to contact a gynecologist.Bleeding may indicate a risk of termination of pregnancy. With bleeding in early pregnancy, it is necessary to exclude an ectopic pregnancy, which often threatens a woman’s life and requires urgent medical attention. Bleeding in the II and III trimester of pregnancy threatens not only the life of the mother, but also the baby. The most common causes of bleeding at these periods are such urgent conditions as placenta previa, placental abruption, uterine rupture.
In case of bleeding, it is very important to seek help from a gynecologist as soon as possible, since only the doctor will be able to correctly assess the condition of the pregnant woman and the baby, as well as develop the necessary action plan.
The iVF Riga Stem Cell Center holds free lectures for expectant mothers every month. A lecture on preparation for childbirth and stem cells is delivered by a certified midwife and a specialist at a stem cell center. You can find out about upcoming lectures on the website, as well as on our Facebook page.
Can pregnant women continue their periods?
The appearance of bloody discharge from the vagina after conception can disturb any woman.Some girls confuse them with menstruation, especially if they coincide with her expected dates. However, it should be remembered that there can be no menses during pregnancy. Therefore, for any bloody discharge, you should quickly contact a gynecologist in Krasnodar.
Causes of bleeding
Most often, women experience spotting during the first trimester. If they are represented by only small spots on the panties, this may indicate that the placenta has been implanted into the uterus.Sometimes a woman can also observe mild bleeding after intercourse, which is explained by the transformations of uterine cells that occur during pregnancy.
However, there are more serious causes of bleeding in the first trimester of pregnancy, among which are:
- Subchorionic hemorrhage that occurs between the uterus and the placenta.
- Ectopic pregnancy.
- Gestational trophoblastic disease. It is an extremely rare condition that can simulate pregnancy through the development of a tumor containing abnormal fetal tissue.
- A sharp decrease in the level of hormones. A decrease in the amount of estrogen in the body of the expectant mother can occur due to stress, a viral disease or an inflammatory process. It leads to endocrine disorders, which are expressed by the appearance of bloody discharge on those days when a woman should have had her period.This condition can last 3-4 months, it significantly increases the likelihood of miscarriage.
Bloody discharge, which is observed in early pregnancy, can be distinguished from menstruation in a number of ways. First, they often have a light pink or brown hue and are not particularly abundant. During menstruation, women usually have a faint discharge at first, which then intensifies and acquires a rich red color. By the end of menstruation, the intensity of bleeding decreases, and the shade of the discharge becomes less bright.
Bleeding can occur at a later date. If they happen after the 20th week, this is most often due to such reasons as:
- Examination of the cervix by a gynecologist. Rarely enough, this procedure causes mild and short-term bleeding.
- Placenta previa. This is the name of the condition when it blocks the exit from the uterine cavity.
- Sexual contact. During pregnancy, the tissues of the vagina and cervix acquire increased sensitivity, so they can easily be injured during an active sex life.
- Premature or normal labor. Compression of the uterus and expansion of the cervix, which helps the fetus move downward, can also cause bleeding.
- Uterine rupture. It can happen during childbirth and requires emergency medical attention. This is a very rare pathology, but the risk of its occurrence does exist.
- Placental abruption. This is the name of the condition when it begins to detach from the walls of the uterus before the onset of labor.
If bleeding occurs during pregnancy, a woman should contact our gynecological clinic in Krasnodar.But there are cases when it needs to be done urgently. These are situations in which bleeding from the vagina is accompanied by pain and cramps, fainting or dizziness. You should also be alert to heavy bleeding with clots.
The appearance of bleeding from the vagina during pregnancy does not always mean that you may lose your baby. Therefore, with such symptoms, you do not need to panic and get upset. Many women who have mild bleeding then have normal pregnancies and healthy babies.However, in about a third of the fair sex, such bleeding becomes more intense over time and ultimately leads to unpleasant consequences.
90 000 Miscarriage, how to avoid – Planning and management of pregnancy in gynecology of the Litfond polyclinic after miscarriage
Miscarriage is always associated with serious consequences for the entire body of a woman and for her reproductive organs in particular, it also affects the family situation, disrupts the woman’s work schedule.An unfavorable outcome of pregnancy requires a lot of mental and physical costs on the part of the parents. Therefore, contacting doctors to find out the causes of the problem is the very first and correct step on the way to having a child.
Any competent gynecologist will tell you that the problem of miscarriage can be solved. With proper preparation for pregnancy and its management, the next time you will have a successful pregnancy. Most girls after a miscarriage go to extremes: they try to get pregnant again as soon as possible.And if this succeeds, then the miscarriage is very often repeated. And you need to give the body a rest for 2-3 months, then identify and eliminate the cause. And only then try.
Causes of miscarriage
Many are convinced that a miscarriage is due to a fall, bruise, or some other physical shock. Any woman who has had a miscarriage can remember that shortly before that she either fell or lifted something heavy. And I am sure that I lost my unborn child precisely because of this. However, those women whose pregnancy was normal also fall and lift.This is not why most sudden miscarriages occur. The reason is in the violations of the pregnancy itself. About half of miscarriages are due to abnormal genetic development of the fetus, which can be hereditary or accidental. Compassionate nature, following in all the principles of natural selection, destroys the defective and unviable fruit. But you should not be afraid of this. The fact that there is a defect in one embryo does not at all mean that all the others will be the same.
In the other half of miscarriages, the woman’s body is almost always to blame.They are caused by various known and unknown factors, such as: acute infectious diseases in the first trimester of pregnancy, poor environment or difficult working conditions, excessive psychological or physical stress, abnormal development of the uterus, radiation, alcohol, smoking and certain types of drugs.
The causes of miscarriage in the early and later periods may differ, although they may be the same. The most important thing is to find out and eliminate or compensate for your own cause of miscarriage.Having found the cause, the gynecologist will tell you how to avoid another loss.
The statistics of miscarriages also includes “frozen pregnancy”. Sometimes it happens that the embryo dies and lingers in the uterine cavity. Most often, this fact is detected by ultrasound. The dead fetus can begin to decompose, and this, thereby, will lead to poisoning of the mother’s body.
Doctors resort to surgical curettage, which is associated with the risk of inflammation and complications.With such a miscarriage, the next pregnancy is planned after the full recovery of the body – not earlier than a year. During this year, you will have to find out the cause of the missed pregnancy and carry out treatment.
Miscarriage up to 6 weeks
The main causes of miscarriage on this line are malformations of the embryo itself. Statistics say that 70-90% of embryos had chromosomal abnormalities: they are accidental and will not occur in other pregnancies. You may be sick, taking medication, or under the influence of other harmful factors.Fate has saved you from a child with developmental defects.
The human body is perfect and finds a way to correct the situation with a miscarriage. Today is a tragedy for you. The preservation and birth of a sick, unviable child would be a real tragedy. So do not cry and understand: everything is for the better, you cannot help grief with tears … And after three months try again – it will almost certainly be successful.
It should also be noted that the fact of a miscarriage does not mean that you have lost something.So for a period of 7-8 weeks, the absence of an embryo in the ovum is found – “anembryonia”. It is believed that in 80-90% of cases, miscarriages are undiagnosed undeveloped pregnancies.
Miscarriage between 6 and 12 weeks
A miscarriage in this period is also considered early. The most common causes are:
Endocrine disorders, when the ovaries synthesize insufficient hormones to keep the fetus in the womb, or the amount of male sex hormones is increased, is one of the most common causes of miscarriage and miscarriage.
Imbalance of hormones in a woman’s body is likely to lead to early termination of pregnancy. With a lack of the main hormone progesterone, produced by the ovaries, this happens most often. Another hormonal problem is an increase in the tone of the uterus, which provokes the expulsion of the fetus.
Progesterone prepares the uterine mucosa for implantation, and is a hormone for maintaining pregnancy in the first months. If conception occurs, the embryo cannot properly anchor in the uterus.As a result, the ovum is rejected. But pregnancy can be saved with progesterone drugs if the problem is detected early.
Also, the cause of early miscarriage can be an excess of male sex hormones that suppress the production of estrogen and progesterone. Often, androgens, which affect the formation and development of pregnancy, are the cause of repeated miscarriages; also hormones of the thyroid and adrenal glands. Consequently, changes in the function of these glands can lead to miscarriage.
Untreated genital infections
This problem must be solved before conception. Often the cause of miscarriage is sexually transmitted infections: syphilis, trichomoniasis, toxoplasmosis, chlamydia, cytomegalovirus and herpes infections. Their effect on the fetus and the course of pregnancy is different for each woman and depends on the timing of infection, the activity of the microorganism, the degree of immune defense and the presence of other unfavorable factors. Depending on the situation, they can lead to the formation of fetal malformations, intrauterine infection, feto-placental insufficiency, early miscarriage or premature birth.Infection of the fetus and damage to the fetal membrane leads to miscarriage. To avoid this, infections should be treated before pregnancy. The use of therapy is also possible during pregnancy as prescribed by a doctor.
Viral infections and other diseases
Any diseases accompanied by intoxication and fever higher than 38 to C can lead to miscarriage. Rubella, influenza and viral hepatitis occupy a leading position in this list. At a period of 4-10 weeks for pregnancy, ordinary angina can also become tragic; pneumonia carries a more serious risk.Pyelonephritis and appendicitis can cause early labor. When planning a pregnancy, it is imperative to undergo a medical examination in order to identify and treat foci of infections.
Extremely dangerous during pregnancy rubella – it leads to severe fetal malformations, therefore, its infection during pregnancy is an indication for medical abortion.
Any disease during pregnancy can lead to the non-viability of the embryo. And the body, by miscarriage, insures you against unwanted offspring.With such a miscarriage, the next pregnancy has every chance to go well.
Immune causes of miscarriage
Sometimes in the blood of a pregnant woman, antibodies are formed that are hostile to the fetus. This cause can be predicted and eliminated in advance. Most often, a conflict arises when the embryo inherits the positive Rh factor of the father, and the negative Rh factor of the mother’s body rejects the tissues of the embryo that are foreign to it. Constant control of the antibody titer and the introduction of anti-rhesus immunoglobulins allows you to maintain and maintain pregnancy.In case of an immune conflict, progesterone preparations are also used to prevent miscarriage, which in this case has an immunomodulatory effect.
Reduced immunity of a pregnant woman also refers to immune causes. The body is simply not able to grow a new life in itself. You need to take care of yourself and recover before your next conception.
Anatomical causes of miscarriage
The anatomical causes of miscarriage are the most intractable.Malformations of the uterus are a serious cause of miscarriage. Sometimes you just have to accept it.
Miscarriage between 12 and 22 weeks
This miscarriage is considered late. Its causes coincide with the causes of early miscarriages (anatomical, immune, infectious, endocrine).
At this time, miscarriage also occurs due to isthmic-cervical insufficiency – a weak cervix cannot hold the fetus and opens. For this reason, a miscarriage can occur in the 2-3 trimester.Isthmico-cervical insufficiency is observed in 15.0-42.7% of women suffering from miscarriage. Careful observation of the pregnant woman allows you to identify the problem in time and make a surgical correction of the cervix before the onset of childbirth.
In isthmic-cervical insufficiency, there is only one method of treatment – a mechanical narrowing of the cervical canal. To do this, the neck is either sewn up, or a special ring is put on it. However, the latter method is less effective because the ring can easily slide off the neck, then it will no longer restrain the process of its opening.
After suturing, if necessary, it is possible to use antibiotics and drugs that normalize the vaginal microflora. The vagina is cleaned and the sutures are monitored daily for 5 days. Sutures are removed at 37-38 weeks and with premature onset of labor.
Isthmico-cervical insufficiency may be primary (for no apparent reason), may be the result of abortion or hormonal disorders (increased levels of androgens – male sex hormones or their precursors).
Miscarriage after 22 weeks
Such a loss is hard to forget. Obstetricians talk about premature birth after the 28th week of pregnancy. Traditionally, a child born after this period is considered viable. But medicine knows many cases when it was possible to save the lives of earlier children.
We recommend that you carefully examine for miscarriage, check the above factors. In addition to them, the cause of miscarriage can be antiphospholipid syndrome, while the woman’s body perceives the child as something alien and rejects him.This disease, like the others listed, is amenable to correction, i.e. you have a very real chance of carrying a child.
Miscarriages due to hemostasis disorders
All of the above reasons account for only 30-40%. Up to 70% of miscarriages are caused by disorders in the blood coagulation system (hemostasis).
Disorders of the blood coagulation system, leading to the loss of pregnancy, can be divided into thrombophilic (increased coagulability) and hemorrhagic (tendency to bleeding).Both of these extremes are dangerous for the fetus. Various disorders leading to the formation of small blood clots lead to the fact that the fetus loses sufficient blood supply, development is impaired and the fetus is rejected.
The main hemorrhagic changes can manifest themselves even in childhood in the form of increased bleeding during cuts, tooth extraction, and the beginning of menstruation. But sometimes they declare themselves only during pregnancy and are the cause of miscarriage. Early bleeding and chorionic detachment are difficult to stop.
You may not guess, but incomprehensible headaches, weakness, fatigue, temporary loss of smell or hearing may be symptoms of disorders in the blood coagulation system.
When planning a pregnancy, you need to undergo a genetic examination and, if necessary, start treatment.
It is advisable to be examined for hidden defects of hemostasis, even for those who consider themselves healthy. This will help predict the occurrence of complications and prevent loss.Early therapy can prevent miscarriage in 98% of cases. If defects in hemostasis were found already during pregnancy, it can be difficult to maintain it.
What to do after a miscarriage?
Identify the cause! The ideal option is to be examined for future parents: it is much wiser to postpone conception and spend two or three months to identify the reasons than to risk getting pregnant again, spend two months waiting, and then lose everything again and still go to the doctors.
Until you understand the reason, it will not evaporate.In most cases, the answers lie on the surface. Take care of your health and your future baby.
Sign up for a consultation with an obstetrician-gynecologist by phone +7 (495) 150-60-01
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90,000 Influence of a woman’s sexual life on pregnancy
Pregnancy is a magical time in the life of every woman. In the body, every moment there are tangible changes that completely change the attitude of the expectant mother to life and those around her.With the onset of pregnancy, the strongest hormonal changes occur in a woman’s body. The restructuring of the body often contributes to an increase in sexual desire, provokes in a woman a desire for affection and tenderness, this is an absolutely normal phenomenon, because during this period the uterus expands and grows, the clitoris also increases, and the blood flow to the pelvic organs also increases. Accordingly, the desire of women for intercourse during pregnancy increases. Sex during pregnancy can be very productive: many women note that orgasm while carrying a child becomes brighter and stronger, and for some it even occurs for the first time, but sex can also lead to disastrous consequences such as threatening miscarriage.We decided to deal with this problem and understand the cause and effect relationship between sexual intercourse (orgasm) and pregnancy.
In the admission department of KMKB # 4 for 6 months. In 2016, a study was conducted to find out the causal relationship between the threat of termination of pregnancy and sexual intercourse.
The aim of our study was to assess the effect of intercourse on the course of pregnancy.
Due to the widespread prevalence of the diagnosis: threatened miscarriage, spontaneous abortion, this problem deserves special attention today.The reasons for the threat of miscarriage can be very diverse. According to statistics, up to 20% of pregnancies end in miscarriage.
There are the following reasons for early termination of pregnancy:
1. Genetic defects in the embryo that are incompatible with life. According to statistics, about 70% of this very reason poses a threat of miscarriage. Genetic disorders are not hereditary, but arise as a result of certain mutations in the germ cells of men and women due to the action of exogenous factors (viruses, alcohol, drugs).It is not possible to prevent miscarriage associated with genetic mutations; it is possible only in advance, before pregnancy, to reduce the risk of genetic defects in the fetus by eliminating mutagenic factors.
2. Hormonal disorders in women associated with insufficient production of the hormone progesterone, which is necessary for the onset, maintenance and progression of pregnancy. It is possible to prevent a miscarriage associated with a lack of progesterone if the causative factor is identified in a timely manner and eliminated.Also, a high level of androgens in the body of a pregnant woman can contribute to the threat of miscarriage, because these hormones suppress the secretion of the female hormones progesterone and estrogen, which are essential for pregnancy. An imbalance of adrenal and thyroid hormones in a pregnant woman’s body also contributes to the threat of miscarriage.
3. Rh-conflict arising as a result of rejection by the body of a Rh-negative woman, the body of a Rh-positive fetus. With such a problem, progesterone is often prescribed to prevent miscarriage.
4. Infectious diseases in women caused by nonspecific and specific infections. Nonspecific diseases include influenza, hepatitis, pneumonia, pyelonephritis, appendicitis, etc. Specific infections include gonorrhea, chlamydia, trichomoniasis, toxoplasmosis, herpes, and cytomegalovirus infections. Given the high risk of miscarriage due to infectious reasons, it is recommended to be examined before pregnancy and, if necessary, to undergo the necessary course of therapy so that the subsequent pregnancy proceeds without complications.
5. Previous abortions can cause miscarriage, since abortion is a manipulation that is stressful for a woman’s body and disrupts the functioning of her genitals.
6. Taking medications and herbs can cause a risk of miscarriage.
7. Psycho-emotional disorders.
8. Leading an unhealthy lifestyle, which consists in taking drugs, alcoholic beverages, including smoking and taking caffeine-containing beverages.
Physically heavy loads, falls, blows to the abdomen also contribute to the threat of miscarriage.
The causal factors of the threat of miscarriage in late pregnancy, in addition to the above, may also be:
blood clotting disorders,
pathology of the placenta – abruption or presentation,
preeclampsia and eclampsia – increased blood pressure, impaired renal function, accompanied by loss of protein in the urine and the appearance of edema,
the presence of isthmic-cervical insufficiency, which occurs after previous traumatic childbirth, abortion, operations on the cervix.
Considering the huge number of reasons that contribute to the threat of miscarriage, both in the early and late stages of pregnancy, we decided to analyze one of the reasons for miscarriage is sexual intercourse. During intercourse, the hormone oxytocin is produced and we will consider in our study the effect of this hormone on the female reproductive system.
Oxytocin has a stimulating effect on the smooth muscles of the uterus, increases contractile activity and, to a lesser extent, the tone of the myometrium.In low concentrations, oxytocin increases the frequency and amplitude of uterine contractions, in high concentrations it helps to increase the tone of the uterus, to increase and intensify its contractions (up to tetanic contractions or the development of tonic contracture of the uterus). Oxytocin induces feelings of satisfaction, reduced anxiety, and a sense of calmness around your partner. Many studies have proven the link between oxytocin in human relationships, increasing confidence and reducing fear. This suggested that oxytocin may affect the areas of the brain responsible for behavior, fear, and anxiety.
To dispel the doubts of expectant mothers, literary data testify: an orgasm is useful for an unborn child. So, during orgasm, the walls of the uterus contract, and this leads to increased blood flow, and blood circulation in the placenta also increases. Thus, the fetus is provided with a large amount of nutrients and oxygen, metabolism is enhanced. In addition, the hormones of pleasure – endorphins and enkephalins, which are produced in the body at the peak of pleasure – also have a positive effect on both the mother and the baby.Another factor in favor of orgasm during pregnancy is that the contraction of the muscles of the uterus during orgasm becomes the training moment of labor.
However, excessive sexual activity may not always be beneficial. Orgasm can adversely affect if there is a threat of termination of pregnancy – in this case, you will have to be as careful as possible and it is better not to have sexual intercourse before stopping the threat. You should also give up sex 2-3 weeks before the expected date of birth – during this period, orgasm can cause contractions.But if the due date has already approached, and the baby still does not want to appear to mom and dad in the eyes, orgasm can do a good service and become a pleasant start of the labor process due to the contraction of the uterus with the help of oxytocin, which is produced during orgasm, as well as the effect of ejaculate on cervix, because there are prostaglandins in the ejaculate that help prepare for childbirth.
One of the main factors of sexual activity during pregnancy is the control of sexually transmitted infections.
In the admission department of the KGBUZ “KMKB No. 4” we analyzed the appeals of 200 patients admitted for emergency indications with complaints of acute pain in the lower abdomen, spotting from the genital tract, we note that this group was identified by interviewing during the history taking. By questioning the patients, it was found that in 80% (160) women, complaints appeared against the background of complete well-being, in all patients, early pregnancy up to 12 weeks. 10% (20) of women complained of complaints after active physical activity, as well as in all patients early pregnancy up to 12 weeks.6% (12 people) of women had complaints after experiencing stress. 4% (8) of women noted pulling pains in the lower abdomen, bloody discharge from the genital tract, after intercourse there is an increase in pain and bloody discharge with these complaints, the patients were admitted to the hospital. All patients were asked the question: did they have intercourse during this pregnancy – 90% answered “Yes”, 10% answered “No”. The patients were asked the following question, were there any pains or spotting after intercourse? 98% answered that there was no, 2% that there were minor pulling pains in the lower abdomen.Of the two hundred patients, 150 were hospitalized in a hospital, 50 were referred to a day hospital.
Conclusion: An active sex life does not negatively affect the course of pregnancy, and even in some aspects has a positive effect on the course of pregnancy and fetal development, but in the presence of medical contraindications, sexual activity is categorically contraindicated in the presence of signs of threatened abortion.
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Kurbanismailov R.B., Kuchugura O.A.
KGBUZ “KMKB No. 4”, admission department
Hospitalization in the department of pathology of pregnant women (high-risk pregnancy)
Eclampsia, premature birth and much more are reasons for immediate hospitalization and follow-up under medical supervision, pregnant women.Pregnancy is a joyful expectation of the upcoming happiness of motherhood, but it should be borne in mind that for various reasons, complications may arise that require enhanced medical monitoring of the vital signs of the mother and fetus. And you need to know that the timely intervention of specialists minimizes the potential health risks of pregnant women and their future children. That is why a specialized department of pathology of pregnant women, designed for 12 beds, was opened in the Kaplan medical center.A multidisciplinary staff, which is doctors, nurses, social workers, nutritionists, psychologists, is at the disposal of expectant mothers around the clock to provide both medical and psychological assistance, making the stay in the department as comfortable as possible.
Most common reasons for hospitalization:
Premature labor : Contractions begin before 37 weeks, when the fetal life systems are not fully formed to function independently outside the mother’s body.Signs: cramps in the lower abdomen, similar to those in the menstrual cycle, pressure or pain in the groin and pelvic areas, dull, aching pain in the lower back, stomach cramps, diarrhea, increased amount and discoloration of vaginal discharge, bleeding …
Hospitalized in case of premature birth by a doctor’s decision. Treatment: infusion, administration of steroids for fetal lethargy (in case of preterm labor), medication to stop contractions.
Pregnant women, upon admission to the department, take blood tests, urine tests and cervical smears for infections, and are under round-the-clock monitoring of the department’s specialists.
Leakage of amniotic fluid
Outpouring of amniotic fluid is one of the main signs of the onset of labor. They protect the fetus from infections, perform a nutritional function, and reduce pressure on the walls of the uterus. The integrity of the membranes can be compromised and water begins to leak long before the expected date of birth. The main reason is infection (amniotic fluid, vaginal, cervical). With the discharge of water in the early stages (up to 37 weeks), there is a high risk of termination of pregnancy.Therefore, urgent obstetric care is needed to make a decision – either the onset of labor is stimulated, or a cesarean section, or hospitalization under the close supervision of doctors for the condition of the fetus, taking medications (antibiotics) to reduce the risk of preterm labor.
Preeclampsia and eclampsia
Preeclampsia (a severe complication of the health of pregnant women) develops in the second half of pregnancy and is manifested by arterial hypertension in combination with liver, kidney damage, neurological and hematological disorders.The first signs of the disease are rapidly increasing swelling (especially of the face and hands) and increased blood pressure, headache, liver and kidney dysfunction, blurred vision, etc. other serious complications. With a full-term pregnancy, delivery (cesarean section) is performed, at an earlier stage, they are hospitalized. In any case, at the first of the above signs, an urgent need to consult a doctor.
Eclampsia – the most severe form of preeclampsia with seizures, loss of consciousness, development of post-eclampsia coma. The danger of eclampsia lies in the high likelihood of severe complications in a pregnant woman: cerebral hemorrhage, pulmonary edema, premature placental abruption, renal and hepatic failure, as well as fetal death, therefore, with eclampsia, the early delivery of the pregnant woman is indicated.
Bleeding during pregnancy
Bleeding during early pregnancy occurs in about 20% of women.This indicates a spontaneous miscarriage, ectopic pregnancy, Rh-conflict, placenta previa, etc. Bleeding develops both against the background of physiological changes in the woman’s body, and as a result of the formation of a certain obstetric pathology. In the early stages, half of women experience a slight separation of blood due to implantation of the ovum in the uterine cavity, as well as with a lack of progesterone in the body. The most common cause of abnormal bleeding during pregnancy in the first trimester is spontaneous miscarriage.
Bleeding during pregnancy in the second trimester is diagnosed much less often and speaks of the development of the pathology of gestation. The most common cause is placenta previa. It completely or partially overlaps the uterine pharynx, while, due to the high load on the lower segment, micro-ruptures of the placenta occur, which causes a similar symptom.
Less commonly, bleeding during pregnancy in the third trimester is due to premature detachment of the normally located placenta. In this situation, there is a high threat to the life of the fetus.The danger also lies in the fact that internal bleeding during pregnancy or the formation of a hematoma initially develops, and only then the blood is poured out. The rarest, but most dangerous for the life of the mother and child, the cause of the development of this symptom is a ruptured uterus.
Therefore, in the event of a change in the nature of cervical discharge, it is necessary to come to the maternity ward for a diagnosis. It is important to emphasize that even if the bleeding stops, sometimes it is recommended to undergo diagnostics in order to clarify the picture of the course of pregnancy and to prevent complications.
Urinary tract infections
During pregnancy, the risk of a genitourinary infection increases, mainly due to the growth of the uterus and hormonal changes in the body. A urinary tract infection during pregnancy requires treatment and monitoring to avoid complications for the health of the mother and the fetus. Signs of infection: a burning sensation on time and an increase in the frequency of urination, fever, back pain, a feeling of incomplete emptying of the bladder. The severity of the disease lies in the complication of kidney function and the spread of infection in the blood, and in particularly severe cases, it can lead to premature birth or death of the fetus.
Hospitalization will be carried out in case of detection of bacteria resistant to oral antibiotics in urine, suspicion of ascending infection to the upper urinary tract, high temperature.