Early pregnancy bleeding is fairly common and occurs in 20 – 30% of pregnancies. Vaginal bleeding in early pregnancy can be worrying, so it's only natural that if it happens to you, you're concerned about your baby, especially if you've had trouble getting pregnant and maintaining a pregnancy. It doesn't always mean that there's a problem, however, it can be a warning sign of a miscarriage or recurrent pregnancy loss. Here are the top five facts you should know about early pregnancy bleeding:
Reasons for Light Bleeding in Early Pregnancy
Some of the most common reasons for light bleeding in early pregnancy are:
A cause of light bleeding is the fertilised egg implanting in your uterus (womb). Implantation bleeding can occur anywhere from 6-12 days after possible conception. Every woman will experience implantation bleeding differently—some will lightly spot for a few hours, while others may have some light spotting for a couple of days.
Some type of infection in the pelvic cavity or urinary tract may cause bleeding.
Bleeding may be caused by your cervix softening, forming a raw area. This is called cervical erosion or ectropion. This could lead to bleeding after intercourse. If this happens, you should discontinue intercourse until you have been seen by your doctor. This is to prevent any further irritation—having normal sexual intercourse does not cause a miscarriage!
Conditions Associated with Vaginal Bleeding
Some of the main conditions associated with vaginal bleeding in early pregnancy are:
Threatened miscarriage. You will have an entirely normal pregnancy and birth 50% of the time. Alternatively, you may progress to have a spontaneous abortion or miscarriage. If you have an ultrasound at the time of your evaluation, which shows a fetus with a heartbeat in the uterus, there is a 75%-90% chance of having a normal pregnancy.
Ectopic or tubal pregnancy – this is a potentially serious condition where the pregnancy is outside the uterus. This has been discussed in detail in a previous blog.
Molar pregnancy. This is a rare condition where the placenta is abnormal.
What To Do If You Have Early Pregnancy Bleeding
If you're bleeding, always wear a pad or panty liner so that you can monitor how much you're bleeding and what type of bleeding you're experiencing. Remember to keep track of the number of pads used and if the bleeding is increasing or decreasing.
Never wear a tampon or introduce anything else into the vaginal area such as douche, or have sexual intercourse, if you are currently experiencing bleeding.
Contact your health care provider immediately, especially if the bleeding is accompanied by severe cramping.
Tests That Evaluate Early Pregnancy Bleeding
A urine or a blood test to confirm pregnancy.
Blood test to confirm blood type. If you have a Rh (rhesus) negative blood group, then you may be given an injection of anti-D immunoglobulin to protect future pregnancies.
A vaginal ultrasound examination to confirm pregnancy. If a normal appearing pregnancy with a normal beating heart is seen by ultrasound inside the uterus and you are younger than 40 years, the pregnancy has a less than 3% chance of being a miscarriage. If you are older than 40 years, then there is an 8% chance of a miscarriage. If there is not a definite pregnancy seen within the uterus, then the likelihood of a miscarriage is really unknown but could be up to 50%. A repeat scan may be necessary after 7 to 10 days if the pregnancy is very small or has not been seen.
How to Prevent Early Pregnancy Bleeding
Avoid bleeding in pregnancy by controlling your risk factors, especially the use of tobacco and cocaine. If you have high blood pressure, work closely with your health care professional to keep it under control.
If you're doing research on early pregnancy bleeding, you may come across a number of different terms used to describe miscarriage. Here are the definitions of some of these terms:
Threatened miscarriage – bleeding or cramping in a continuing pregnancy.
Incomplete miscarriage – a miscarriage has started but there is still some pregnancy tissue left inside the womb.
Complete miscarriage – when all the pregnancy tissue has been passed and the womb is empty.
Delayed miscarriage / missed miscarriage / silent miscarriage – the pregnancy has stopped developing but is still inside the womb. This will be diagnosed via scan.
Dr. Karande is Board Certified in the specialty of Obstetrics and Gynecology as well as the subspecialty of Reproductive Endocrinology and Infertility. He is a Fellow of the American College of Obstetricians and Gynecologists and Member of the American Society for Reproductive Medicine.