Bleeding in Pregnancy – Causes of early and late Pregnancy Bleeding & What to do

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Bleeding is one of the common findings in pregnancy with about 20% of women experiencing it at the early part of pregnancy. Today our doctor will be talking to us briefly on Bleeding in pregnancy, the common causes of bleeding in pregnancy and also what you should do if you experience bleeding in pregnancy.

What is bleeding in pregnancy?

It is important to know that when we mention pregnancy bleeding or bleeding in pregnancy, we mean any vaginal bleeding in a woman that is pregnant. This can occur before the woman even confirms that she is pregnant as is seen in implantation bleeding or after pregnancy has been confirmed as is seen in other causes of pregnancy bleeding.

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Vaginal bleeding is a common finding or complaints during pregnancy especially in early pregnancy. Bleeding has been noticed to occur in about 20% of pregnant women. While some causes of pregnancy bleeding may require no medical treatment, others may be due to more serious problems and will require medical treatment.

What are the Causes of Bleeding in Pregnancy?

Pregnancy as we know it is divided into 3 stages called trimester comprising of 13weeks each. Each of these stages of pregnancy has different causes of vaginal bleeding as we will see below.

First Trimester Bleeding: Causes of Bleeding in First Trimester

About 20% of women have some form of bleeding during the first 13 weeks of pregnancy and some possible causes are; implantation bleeding, ectopic pregnancy, miscarriages, infection and cervical changes.

Implantation Bleeding:  This is otherwise called spotting. Please note that implantation bleeding is normal. It occurs when the fertilized ovum or egg gets implanted into the wall of womb or uterus. In many women, this is the first symptom of pregnancy they notice and maybe mistaken for normal menstrual bleeding. It occurs within the first 6 days to about 12days after you conceive. It is very light and may last for a few hours to days.
Miscarriage:  Miscarriage is another common cause of bleeding in pregnancy. There are different forms or types of miscarriage but in all but one form, all the babies are lost. Types of miscarriage includes – threatened miscarriage, incomplete miscarriage, complete miscarriage and missed abortion.

It is important to note that it is only in threatened miscarriage which has been briefly explained below that the baby is alive. In other types of miscarriage, the babies are lost.

Threatened Miscarriage:  It is also called threatened abortion. You have vaginal bleeding and abdominal cramps or pain but the cervix is closed and ultrasound shows that your baby is still alive.

Ectopic pregancy:  An ectopic pregnancy is any pregnancy in which the fertilized egg or embryo is implanted outside the uterus. It occurs only in about 2% of pregnancies and can be life-threatening. Commonest site of ectopic pregnancy is the fallopian tubes which may rupture and cause severe bleeding into the abdomen.

Apart from bleeding, other symptoms of ectopic pregnancy includes lower abdominal pain or severe camps. There maybe light headedness of even fainting attack.

Molar Pregnancy:  Also called Gestational Trophoblastic diseases GTD as it is a spectrum of different diseases. It is an abnormal form of pregnancy in which abnormal tissues are formed in the uterus. Molar pregnancy is characterized by passage of vesicles or bubble-like substances from the vagina as well as exaggerated symptoms of pregnancy such as nausea and vomiting with rapid enlargement of the uterus as well.

This is particularly dangerous as some of the disease that make up molar pregnancy are cancers. So it is very important to take note of this.

Infection: Vaginal infection or some infections of the cervix can cause vaginal bleeding in early pregnancy. Some examples of such infection that can cause bleeding in pregnancy are Herpes, Gonorrhea, Chlamydia etc.

Cervical Changes: Due to the hormonal changes in pregnancy, there is extra blood flow to the cervix and any little contact can cause vaginal bleeding in pregnancy example sexual intercourse and pap smear tests.

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Late Bleeding in Pregnancy – what are the Causes of Bleeding in late pregnancy?

It is important to note that every cause of bleeding in late pregnancy is a cause for concern. It may maybe an indication that either the life of the baby, mother or both are in serious danger.
The causes of bleeding in late pregnancy may include –

Placenta Previa: This is a condition in which the placenta partially or completely closes the birth canal. Medically it is said to occur when the placed is located at the lower uterine segment. Bleeding from placenta previa is painless.

Abruptio Placenta or Placental Abruption Abruptio Placenta occurs when the placenta separates or detaches from the wall of the uterus before the baby is delivered. This can put the lives of both the baby and the mother in a serious danger.

Other signs to look out for in abruptio placenta includes abdominal pain, back pain, clots from vagina and a tender uterus when examined by the doctor. The baby may have been lost at the time of assessment in which case no fetal heart activity is seen on ultrasound.

Vasa Previa:  Vasa previa in plain terms can be said to occur when the blood vessels of the baby cross the opening of the birth canal. The blood vessel can get torn and the baby will bleed severely. This is particularly very dangerous for the baby.

Other causes of bleeding in pregnancy may include;

  • Premature labour
  • Trauma to the abdomen
  • Injury to the cervix or Vagina

What to do if you experience Bleeding in pregnancy

  1. It is important to call your doctor if you notice any form of bleeding in pregnancy.
  2. Take note of the amount of blood you have lost by making use of a pad
  3. Take note of the colour of blood that is coming out of your vagina and if there is any other tissue that accompanies it
  4. Usually your doctor will do an ultrasound scan as part of the assessment to know the exact cause of the bleeding and the state of your baby.
  5. In severe case, you need to go to the hospital emergency as soon as possible or call the emergency number of your country. Some such severe symptoms includes;
  • Severe vaginal bleeding in pregnancy
  • Severe abdominal pain or cramps in the lower abdomen
  • Dizziness or fainting
  • Any discharge from your vagina that contains tissues

In the last couple of minutes, we have taken out time to discuss bleeding in pregnancy briefly. If you have any questions to ask on anything about pregnancy bleeding or bleeding in pregnancy please feel free to use the comment box below.

NOTE: It is important to note that the information we have provided here on bleeding in pregnancy is for educational purposes and does not replace the advice of your doctor.