Definition
Vaginal bleeding is common in the first 20 weeks of pregnancy. It is often nothing to worry about.
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Causes
During pregnancy, common causes of vaginal bleeding are:
- The egg attaches to the wall of the womb
- Blood between the membrane that surrounds the fertilized egg and the wall of the womb
- An egg attaches to the wall of the womb but does not grow
During pregnancy, common causes of vaginal bleeding are:
- Implantation bleeding—bleeding that happens after conception when the fertilized egg attaches to the wall of the womb
- Placental abruption—Blood between the membrane that surrounds the fertilized egg and the wall of the womb
- Miscarriage
- Blighted ovum—A fertilized egg that attaches to the wall of the womb but does not grow into an embryo
- Ectopic pregnancy—a fertilized egg that grows outside the womb
- Molar pregnancy (gestational trophoblastic disease)—the growth of abnormal tissue, instead of an embryo, inside the womb
- Threatened miscarriage
- Infection of the cervix, vulva, or vagina
- Urinary tract infection
- Trauma
- Cervical cancer or polyps
Symptoms
Signs of early pregnancy bleeding may be blood that appears in underwear. The blood may also be noticed when a person pees or passes stool (poop). The amount of blood and the way the blood looks will depend on the cause.
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. A pelvic exam may also be done.
Blood tests may be done to check hormone levels.
The doctor may want to view the belly and vagina. This can be done with an ultrasound.
Treatment
Treatment depends on what is causing the bleeding. Bleeding due to egg and womb attachment should clear in a few days. Bleeding due to pregnancy problems will need to be watched. Bed rest and medicine may also be needed. If bleeding is due to cancer or growths, treatment may include surgery.
Prevention
Some causes of bleeding cannot be prevented. Getting early and regular pregnancy care can help find and treat some problems before they happen.
Avoiding smoking, drugs, and alcohol can also help reduce the risk of bleeding.
RESOURCES
The American Congress of Obstetricians and Gynecologists http://www.acog.org
American Pregnancy Association http://www.americanpregnancy.org
CANADIAN RESOURCES
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
Women's Health Matters http://www.womenshealthmatters.ca
References
Bleeding during pregnancy. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/bleedingduringpreg.html. Accessed February 10, 2022.
Breeze C. Early pregnancy bleeding. Aust Fam Physician. 2016 May;45(5):283-286.
Early pregnancy bleeding. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/early-pregnancy-bleeding. Accessed February 10, 2022.
Pregnancy complications. Women's Health—US Department of Health and Human Services website. Available at: http://www.womenshealth.gov/pregnancy/you-are-pregnant/pregnancy-complications.html. Accessed February 10, 2022.
Pontius E, Vieth JT. Complications in early pregnancy. Emerg Med Clin North Am. 2019;37(2):219-237.