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Vaginal bleeding in pregnancy has many causes. Some are serious and some are not. Bleeding can occur early or later in pregnancy. Slight bleeding often stops on its own. Sometimes, bleeding may pose a risk to you or your fetus. You should call you’re the Arbor ObGyn office or seek medical advice any time that bleeding occurs.

Many women have vaginal spotting or bleeding in the first 12 weeks of pregnancy. A pelvic exam and an ultrasound are typically used to evaluate first trimester bleeding. Ultrasound can help verify the predicted age of the pregnancy.  Some pregnancies are too early/small to be seen with ultrasound. Often, a follow-up ultrasound one week later is used to confirm a viable pregnancy.

A blood test may be done to measure human chorionic gonadotropin (hCG, pregnancy hormone). This substance is made by your body during pregnancy. You may have more than one test because hCG levels increase throughout pregnancy. Your blood type also will be checked to see if you need treatment for Rh sensitization (RhoGAM). Ultrasound may be used to find the cause of the bleeding. Sometimes the cause is not found.

Spotting may occur after a vaginal ultrasound or a pelvic exam. Bleeding of the cervix may also occur during sex, or from an infection of the cervix. If you experience bleeding, do not have sex again until consultation with the doctor. You may also want to decrease heavy physical activity and exercise, although most women can continue work and their usual day-to-day activities.

Keeping a record of spotting, bleeding, cramping, and other symptoms can be helpful for your doctor.

Miscarriage can be caused by a problem with the pregnancy. Bleeding does not always mean that miscarriage will happen. The following signs and symptoms may indicate a miscarriage:  (1) Vaginal bleeding, (2) Cramping pain felt low in the abdomen–often more strong than menstrual cramps, (3) Tissue passing from the vagina.

Miscarriage can occur any time in the first half of pregnancy. Most often it occurs in the first 13 weeks. It happens in about 15–20% of pregnancies. Many women who have vaginal bleeding have little or no cramping. Sometimes the bleeding stops and pregnancy goes on. Other times the bleeding and cramping may become stronger, leading to miscarriage.

If you think you have passed fetal tissue, take it to the doctor’s office. The doctor may send it to a lab to be examined.

If some tissue stays in the uterus, bleeding often continues. Your doctor may then recommend one or more treatment options. Medication may be used to help you pass the tissue. The tissue may be removed by dilation and curettage (D&C). It also may be removed by a suctioning device. This is called suction curettage. Sometimes more than one option is needed.

Most miscarriages cannot be prevented. They are often the body’s way of dealing with a pregnancy that was not normal. There is no proof that exercise or sex causes them. Also, there is no proof that stress or work causes them. Having a miscarriage does not mean you cannot have more children. Less than 5% of women will experience two consecutive miscarriages, and only 1% experience three or more. It does not always mean something is wrong with your health. If you have two in a row, your doctor may suggest tests to look for a cause.

An ectopic pregnancy occurs when the fertilized egg does not implant in the uterus. Instead, it implants somewhere else, often in one of the fallopian tubes. An ectopic pregnancy causes pain and bleeding early in pregnancy.

A major risk with this type of pregnancy occurs if the fallopian tube ruptures. A rupture needs prompt treatment. There may be internal bleeding. Blood loss may cause weakness, fainting, pain, shock, or death.

Ectopic pregnancies are much less common than miscarriages. They occur in about 1 in 60 pregnancies. Women are at a higher risk if they have had: an infection in the fallopian tubes (such as pelvic inflammatory disease), a previous ectopic pregnancy, or tubal surgery.

Some information above provided by the American College of Obstetricians & Gynecologists

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