There are several reasons that pregnant women might consult their doctor during pregnancy, but one of the most common symptoms that worry pregnant women is that of vaginal bleeding in early pregnancy. Vaginal bleeding during pregnancy can be scary. However, it is not always a sign of trouble. Bleeding in the first trimester (weeks one through 12) might occur, and most women who experience bleeding during pregnancy go on to deliver healthy babies. It important to take vaginal bleeding during pregnancy seriously. Sometimes bleeding during pregnancy indicates an impending miscarriage or a condition that needs prompt treatment.
Vaginal bleeding in the first trimester
Vaginal bleeding or spotting is a common concern that many pregnant women face. Approximately 20% of women report they experience spotting during their first 12 weeks of pregnancy. Bleeding that occurs early on in pregnancy is usually lighter in flow than a menstrual period. Also, the colour often varies from pink to red to brown. The amount of bleeding might vary. Light bleeding, or spotting, during pregnancy is common, especially during the first trimester. Usually, this is no cause for alarm. It is considered spotting when you notice a few drops of blood occasionally in your underwear, or if you wipe yourself with tissue and see a little blood on the paper. There should not be enough blood to cover a panty liner.
Bleeding is a heavier flow of blood. With bleeding, you will need a liner or pad to keep the blood from soaking your clothes. Whether you are bleeding or spotting, it is best to contact your healthcare provider and describe what you are experiencing.
What are some causes of vaginal bleeding in early pregnancy?
Implantation bleeding is a common cause of spotting early on in pregnancy. Implantation bleeding (which occurs about 10 to 14 days after conception when the fertilized egg implants in the lining of the uterus) can cause vaginal spotting for a number of days. This can be light bleeding or resemble a menstrual period. This spotting occurs before a woman even knows she is pregnant, and is often mistaken as a pending period. Bleeding that occurs after the day a woman expects her period is typically too late to be considered implantation bleeding, and is more likely related to early pregnancy in general.
Another common cause of spotting is a cervical polyp (a harmless growth on the cervix) which is more likely to bleed during pregnancy due to higher estrogen levels. This may occur because there is an increased number of blood vessels in the tissue around the cervix during pregnancy. As a result, contact with this area (through sexual intercourse or a gynecological exam, for example) can cause bleeding.
Even without the presence of a cervical polyp, there are a few things that may cause some spotting in the couple days after:
• Sexual intercourse
• Gynecological exam, such as a vaginal ultrasound
• Heavy lifting/excessive exercise
Other causes of bleeding in early pregnancy include the following:
• Ectopic pregnancy (in which the fertilized egg implants and grows outside of the uterus, such as in a fallopian tube)
• Miscarriage (the spontaneous loss of pregnancy before the 20th week)
• Molar pregnancy (a rare occurrence in which an abnormal fertilized egg develops into abnormal tissue instead of a baby)
• Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix.
When to see your doctor?
It is important to report any vaginal bleeding during pregnancy to your healthcare provider. Be prepared to describe how much blood you passed, what it looked like, and whether it included any clots or tissue. Your obstetrician or midwife will then discuss further management with you. In some cases you might need immediate referral to hospital, but in most cases hospitalization is not required. Clinical evaluation to include an ultrasound scan of the developing fetus is often warranted to help in making a diagnosis.
Management
This will often depend on the cause of the vaginal bleeding. To help manage your spotting or bleeding during your pregnancy, and to increase the probability of continuing with a healthy pregnancy, your healthcare provider may encourage you to do a number of simple things such as stop working for a short period of time.
Conclusion
Vaginal bleeding or spotting in the first half of a pregnancy is very common, and can be very scary to the pregnant woman. It is important to stress that the majority of women who experience spotting during pregnancy go on to have a healthy pregnancy. However, do not let this fact keep you from contacting your healthcare provider. It is important to discuss spotting/bleeding with your doctor so that you can be fully evaluated. One potentially life-threatening cause of bleeding in early pregnancy is that of ectopic pregnancy – and this requires urgent management by an experienced obstetrician/gynaecologist. Remember if you have any concerns about bleeding in early pregnancy discuss them with your healthcare provider.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-seven years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
