Bleeding During Pregnancy – Is There Cause For Alarm

Pregnancy is a very exciting time and an incredible journey. Pregnancy is a time that is filled with questions about your health and your baby’s health. Especially with your first pregnancy, your day is filled with questions as to what is normal and what is not normal. One of the main concerns during pregnancy is bleeding.

Bleeding, especially during the first trimester is very common and is not necessarily cause for alarm. But bleeding during all phases of pregnancy may be dangerous. It is important that you are aware of potential problems and see your physician if you are having problems, in order to make sure that you and your baby are healthy.

Bleeding In The First Trimester

  • Bleeding During Implantation – It can be normal to have some spotting during the first week to 12 days after conceiving. The fertilized egg attaches itself to the lining of the uterus. This light bleeding is actually mistaken for a light period by some women and they don’t even realize they are pregnant.
  • Miscarriage – The first 12 weeks is the most common time for a woman to have a miscarriage. A miscarriage, or spontaneous abortion, is a pregnancy that ends before the fetus can survive. Approximately 50% of women who bleed during the first trimester, miscarry. This does not mean that if you are having some spotting, you will lose the baby, especially if you do not have other symptoms. Other symptoms can include pain in the lower abdomen and the passing of tissue through the vagina.
  • Ectopic pregnancy – This is when the embryo which is fertilized, implants outside of the uterus. This is normally in the fallopian tube. As the embryo grows, the tube bursts which can be life threatening to the mother. Only about 2% of women have ectopic pregnancies.
  • Molar pregnancy – This is extremely rare, it is also called gestational trophoblastic disease. Abnormal tissue grows inside the uterus instead of a baby. Symptoms of molar pregnancy can include nausea and vomiting and rapid enlargement of the uterus, along with the bleeding.
  • Additional causes – Extra blood flow to the cervix makes it easier to bleed during intercourse or a Pap test. Any infection of the cervix, vagina, or any sexually transmitted infection can cause bleeding at this time. This bleeding is not cause for concern.

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Bleeding In The Second And Third Trimester

Any bleeding during these two trimesters is different from the first three months and is definitely abnormal. Bleeding after the 28th week of pregnancy is an emergency. This bleeding can range from slight to brisk and may or may not be in conjunction with abdominal pain. Hemorrhaging is the most common cause of death in pregnant women in the United States.

  • Second Trimester CautionsPlacenta Previa – This is when the placenta is low in the uterus and partially or completely covers the opening of the birth canal. This is rare in the third trimester though. Bleeding, which can or cannot be accompanied by pain is an emergency, get help immediately.
  • Uterine rupture – This can be life threatening and requires an immediate C-section. In rare cases, this can be caused by a scar from a previous C-section. Bleeding, pain, and tenderness in the abdomen are signs of this.
  • Placenta abruption – This is when the placenta comes loose from the uterine wall. This can happen before or during labor. This can be highly dangerous to both the baby and the mother. Abdominal pain, back pain, a tender uterus, and passing clots from the vagina are signs and symptoms of this.
  • Vasa Previa – This is actually a very rare condition. The baby’s blood vessels that are in the umbilical cord or placenta cross over the birth canal opening. This condition is very dangerous for the baby, because it can cause the blood vessels to tear open. Signs of this can include excessive bleeding and abnormal fetal heart rate from the loss of blood and oxygen.
  • Premature labor – Vaginal bleeding during the latter part of pregnancy can also be early labor and your body is getting ready to deliver. The mucus plug that covers the opening of the uterus will pass out of the vagina, accompanied by small amounts of blood. If this happens prior to 37 weeks of pregnancy, notify your physician because it can be that you are in preterm labor.
  • Other causes of bleeding in late pregnancy can include an injury to the vagina or cervix, cancer or polyps.

What To Do If Bleeding Occurs

Vaginal bleeding at any time during your pregnancy can indicate a problem, so call your physician. Before going to see your physician some of the things you might do is to wear a pad so that the physician can see just how much you are bleeding. If you pass any tissue, take it with you to the appointment. Do not have sex while bleeding or use a tampon.

When you see your physician expect to have an ultrasound to help diagnosis the underlying cause of the bleeding. It is not uncommon to have a vaginal and an abdominal ultrasound as part of this evaluation.

If you are having severe pain or cramps in the lower abdomen, severe bleeding, discharge from the vagina that contains tissue, dizziness or fainting or a fever of more than 100.5 degrees Fahrenheit, go to the emergency room or call 911 immediately. These can be signs of a miscarriage or other serious problems.

Being pregnant is definitely an incredible journey and being aware of potential problems can make your journey safer for you and your baby. Bleeding may or may not indicate a 
problem. Always contact your physician with any questions and concerns to promote peace of mind about you and your baby’s health.

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