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by EBSCO Medical Review Board

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

Risk Factors

Things that raise the risk of bleeding depend on what is causing it to happen.

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.

Revision Information

  • Reviewer: EBSCO Medical Review BoardElizabeth Margaret Prusak, MD
  • Review Date: 03/2022
  • Update Date: 05/18/2022