While bleeding or spotting during pregnancy isn't uncommon, it's certainly unexpected — and annoying. Find out more about the causes of bleeding during pregnancy, how to tell when it's serious and what to do if something happens to you.
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Bleeding of any kind during pregnancy is frightening, even for the most level-headed expectant mother. The good news is that spotting, or light bleeding in early pregnancy that is not as heavy as your menstrual period, occurs in almost a third of all expectant mothers and often poses no danger to mother or baby. For example, it is common for a small percentage pregnant women have spotting after intercourse, and others may have bleeding for reasons unrelated to pregnancy, such as infection or tears in the vaginal wall. "The vast majority of spotting is harmless," says Alyssa Stephenson-Famy, M.D., board-certified maternal-fetal medicine at the University of Washington, Seattle. But bleeding, no matter how minor, can portend a variety of complications, including miscarriage, ectopic pregnancy, and placenta previa, and as such should never be ignored. Here are the various reasons bleeding can occur during pregnancy, when to know if you should call your doctor, and tips on how to effectively communicate your symptoms to your doctor.
Causes of bleeding or spotting in the first 20 weeks
Doctors estimate that 25 to 40 percent of women experience vaginal bleeding during early pregnancy, and most pregnancy is normal, says Dr. Stephenson family. According to the American Pregnancy Association, there are a number of possible causes of harmless spotting, or bleeding, during the first half of pregnancy, including:
Implantation bleeding: The egg implants in the lining of the womb around 4 weeks after your pregnancy, when the fertilized egg attaches itself to the wall of your womb. If you notice a little bleeding about a week to 10 days after conception, implantation bleeding is probably the cause and nothing to worry about.
Sexual Intercourse: During the second and third trimesters, your cervix swells due to the increased blood supply to that area. As a result, heavy intercourse during pregnancy can lead to spotting.
Infections: Some women have cervical bleeding because of an infection, usually a sexually transmitted disease such as chlamydia. In this case, the underlying disease must be treated.
Internal examination by your obstetrician or midwife: After a pap smear or a gynecological examination, which is carried out in many practices between the 6th and 12th week of pregnancy, it is not uncommon for bleeding to occur. Spotting can occur within 24 hours of the visit and usually goes away within a day.
However, sometimes bleeding in the first half of your pregnancy can be a sign of a more serious condition, such as:
- Subchorionic hemorrhage, which bleeds around the placenta. Although it is possible to continue with a normal pregnancy after this type of bleeding occurs, prompt diagnosis and treatment is crucial. "While most subchorionic hemorrhages heal, they put the woman at increased risk for other complications, such as preterm labor," says Dr. Stephenson family.
- Chemical pregnancy, which occurs when an egg is fertilized but never fully implants in the uterus.
- Miscarriage (either imminent or imminent), d. H. the spontaneous loss of a pregnancy in the first 20 weeks. Often, the bleeding or spotting that occurs during a miscarriage is accompanied by other symptoms, such as cramping or abdominal pain.
- Ectopic pregnancy, which occurs when a fertilized egg implants somewhere other than the uterus, most commonly in a fallopian tube. An ectopic pregnancy, sometimes referred to as an ectopic pregnancy, cannot progress normally and can be life-threatening for the mother if undiagnosed.
- Molar pregnancy, a nonviable pregnancy characterized by abnormal growth of the placenta and usually an abnormal fetus
Causes of bleeding or spotting in the last 20 weeks
Although the risk of miscarriage (known as stillbirth after the first 20 weeks) decreases sharply after the first trimester, and many of the early complications are eliminated (like ectopic and molar pregnancies), bleeding in the second half of pregnancy should be taken very seriously, especially when it's ongoing, says Dr. Stephenson family. Causes of bleeding in the second half of pregnancy are:
- Sexual intercourse
- Cervical exams, especially late in the third trimester when they become more frequent
- Placenta previa, when the placenta partially or completely covers the cervix
- A placental abruption, where the placenta tears away from the uterine wall, can cause severe vaginal bleeding and is life-threatening for both mother and baby. According to the American Academy of Family Physicians, placental abruption is the leading cause of heavy bleeding in late pregnancy. The condition is rare, occurring in only about one percent of all pregnancies.
- Preterm labor, where vaginal bleeding is accompanied by cramps or contractions, diarrhea, pelvic pressure, or back pain before 37 weeks, could have serious consequences for the baby if left untreated. At 37 weeks, these symptoms could be a normal onset of labour.
How can you tell if spotting or bleeding is serious during pregnancy?
Vaginal bleeding during pregnancy is not uncommon, but it is not usually normal either. It can indicate many things depending on whether it is severe or mild, how long it lasts, what color it is, and at what point in the pregnancy it occurs. Signs that the bleeding is due to serious medical conditions such as miscarriage, placental problems, or preterm labor include heavy bleeding (similar to menstrual bleeding), bleeding associated with cramps and/or fever, or bleeding and loss of tissue. The color of the blood is also important: bright red blood is usually more worrisome than brownish blood.
When to Call Your Doctor If You Have Spotting or Bleeding During Pregnancy
No matter when it occurs, even if you have less than a dime of blood stain, call your doctor or midwife right away to make sure, as any vaginal bleeding during pregnancy can be a symptom of a larger problem. Be prepared to answer detailed questions about the amount of blood you've lost and a description of how you're feeling overall, advises Laura Riley, M.D., author of Pregnancy: The Ultimate Week-by-Week Pregnancy Guide. Your doctor will decide if there is any cause for concern. If that's the case, she may want to monitor the situation by asking you to stay off your feet for a few hours and calling you back, or asking you to come right away. She may also order an ultrasound to see what's going on with the fetus. dr Riley says you should insist on being seen if you have vaginal bleeding that makes you feel faint or soaking through a sanitary napkin. You should also be evaluated if the bleeding is persistent or accompanied by pain or fever.
Unfortunately, if the bleeding is due to a miscarriage, there is nothing that can be done.
If the bleeding is a sign of preterm labor, your doctor will take steps to prevent it and may recommend bed rest or medication.
If the bleeding is due to placenta previa — a condition in which the placenta covers the mouth of the uterus — your doctor may put you on modified bed rest. She will likely avoid doing an internal vaginal exam and will likely recommend that you have a cesarean when your baby is ready to be born. A planned cesarean is usually performed at 38 or 39 weeks, but women with placenta previa often bleed in the third trimester. In this case, the caesarean section can be performed earlier.