Vaginal Bleeding During Pregnancy

Vaginal bleeding during pregnancy is concerning but is not always cause for alarm. Vaginal bleeding or spotting during the first trimester of pregnancy is common but should be carefully evaluated. Causes for vaginal bleeding during early pregnancy include:

• Miscarriage: pregnancy loss within the first 20 weeks of gestation. This difficult, emotional loss is often linked to abnormal fetal development

• Implantation: Some women experience bleeding approximately 2 weeks after conception when the fertilized egg implants in the uterine lining. The bleeding or spotting is light and quickly resolves

• Cervical causes: Infection, inflammation, or growths on the cervix can all lead to cervical bleeding. Some women experience bleeding during sex.

• Abnormal pregnancies: Ectopic pregnancy occurs when the fertilized egg implants in the fallopian tubes, abdomen, ovary, or cervix, instead of inside the uterus. Molar pregnancy is a benign tumor that forms in the uterus and contains either no embryo or an abnormal embryo. Both of these non-viable pregnancy types can produce abnormal bleeding

Bleeding after the first trimester of pregnancy may indicate a miscarriage or the following conditions:

• Placental problems: Placenta previa is a condition that occurs when the placenta is positioned low in the uterus, partially or fully covering the cervix. Placental abruption is due to the placenta detaching from the uterine wall. Both conditions can produce serious bleeding and may require bed rest, hospitalization or emergency C-section

• Incompetent Cervix: Due to weak cervical tissue, an incompetent or insufficient cervix softens and dilates too early in the pregnancy and, untreated, can lead to pregnancy loss. Light bleeding is a common symptom of the condition and requires careful ultrasound monitoring. Medication or cervical cerclage, a surgical procedure that involves suturing the cervix, are treatment options

• Sign of Labor: A small amount of blood and mucus can signal the start of labor. This event is common in late pregnancy. Bleeding that occurs before 37 weeks gestation may be associated with preterm labor.

All bleeding during pregnancy should be reported to your obstetrician so that a cause can be determined and appropriate treatment implemented, if necessary.