Vaginal bleeding during pregnancy is any discharge of blood through the vagina from the time of conception to the end of pregnancy.
Between 20% and 30% of women experience some vaginal bleeding during their first 20 weeks of pregnancy. Up to 10% of women have vaginal bleeding in their third trimester. While it is often a normal part of the process of gestation, it may indicate complications. You should always report vaginal bleeding to your health care provider right away.
What Could It Be?:
First-trimester bleeding isn’t always a problem. It may be caused by:
* Implantation of the fertilized egg in the uterus.
* Hormonal changes.
* Undetermined factors that cause no harm to the mother or baby.
More serious causes of first-trimester bleeding may include:
* Miscarriage. Almost all women who miscarry will have vaginal bleeding prior to the loss of the pregnancy.
* Ectopic pregnancy. When the fertilized egg develops outside of the uterus, usually in the fallopian tube, it may cause cramping and bleeding.
* Molar pregnancy. Also known as a hydatidiform mole or trophoblastic disease, molar pregnancy is a condition in which the pregnancy does not form properly.
Mid- or late-term bleeding may be caused by:
* Trauma to the sensitized cervix, such as sexual intercourse or an internal exam.
* Diseases of the vagina or cervix, including infections.
* Unknown causes that pose no threat to the mother or baby.
* Uterine fibroids or cervical polyps.
More serious causes of late-term bleeding may include:
* Placenta previa. The placenta has implanted in the lower portion of the uterus and covers the cervix and its opening.
* Placenta abruptio. The placenta becomes detached, either partially or fully, from the uterine wall.
* Late miscarriage.
* Preterm labor. Dilatation of the cervix associated with uterine contractions that occurs between 20 and 37 weeks of pregnancy is called preterm labor.
What Should I Do?:
Immediately contact your health care provider any time you experience vaginal bleeding. You will be asked very specific questions during your visit. Try to be as precise as possible since the differences in bleeding with or without symptoms may signal different complications. If the bleeding is heavy or if you have bleeding with pain or cramping, and you can't reach your health care provider, go to the emergency room.
Questions your health care provider may ask include:
* How far along is the pregnancy?
* Has bleeding occurred before or during this pregnancy? Has it been constant since the beginning of the pregnancy?
* When did the bleeding begin? Is it intermittent or constant?
* How much bleeding is present?
* What is the color of the blood?
* Is there an odor to the blood?
* Is cramping present? Is there other abdominal pain, weakness, or increased fatigue?
* Is there fainting, dizziness, nausea, vomiting, or diarrhea? Is there a fever?
* Are there changes in urination or bowel movements?
* Has there been an injury, such as a fall?
* Have there been changes in physical activity?
* Has there been additional stress?
* When did you last have sexual intercourse? Did the bleeding occur during or after sexual intercourse?
* Does rest reduce or stop the bleeding?
Your health care provider will most likely perform a pelvic exam, with careful inspection of the cervix.
Other diagnostic tests may include:
* Blood tests
* Ultrasound
* Pap smear
* Cervical cultures or tests for infections
Between 20% and 30% of women experience some vaginal bleeding during their first 20 weeks of pregnancy. Up to 10% of women have vaginal bleeding in their third trimester. While it is often a normal part of the process of gestation, it may indicate complications. You should always report vaginal bleeding to your health care provider right away.
What Could It Be?:
First-trimester bleeding isn’t always a problem. It may be caused by:
* Implantation of the fertilized egg in the uterus.
* Hormonal changes.
* Undetermined factors that cause no harm to the mother or baby.
More serious causes of first-trimester bleeding may include:
* Miscarriage. Almost all women who miscarry will have vaginal bleeding prior to the loss of the pregnancy.
* Ectopic pregnancy. When the fertilized egg develops outside of the uterus, usually in the fallopian tube, it may cause cramping and bleeding.
* Molar pregnancy. Also known as a hydatidiform mole or trophoblastic disease, molar pregnancy is a condition in which the pregnancy does not form properly.
Mid- or late-term bleeding may be caused by:
* Trauma to the sensitized cervix, such as sexual intercourse or an internal exam.
* Diseases of the vagina or cervix, including infections.
* Unknown causes that pose no threat to the mother or baby.
* Uterine fibroids or cervical polyps.
More serious causes of late-term bleeding may include:
* Placenta previa. The placenta has implanted in the lower portion of the uterus and covers the cervix and its opening.
* Placenta abruptio. The placenta becomes detached, either partially or fully, from the uterine wall.
* Late miscarriage.
* Preterm labor. Dilatation of the cervix associated with uterine contractions that occurs between 20 and 37 weeks of pregnancy is called preterm labor.
What Should I Do?:
Immediately contact your health care provider any time you experience vaginal bleeding. You will be asked very specific questions during your visit. Try to be as precise as possible since the differences in bleeding with or without symptoms may signal different complications. If the bleeding is heavy or if you have bleeding with pain or cramping, and you can't reach your health care provider, go to the emergency room.
Questions your health care provider may ask include:
* How far along is the pregnancy?
* Has bleeding occurred before or during this pregnancy? Has it been constant since the beginning of the pregnancy?
* When did the bleeding begin? Is it intermittent or constant?
* How much bleeding is present?
* What is the color of the blood?
* Is there an odor to the blood?
* Is cramping present? Is there other abdominal pain, weakness, or increased fatigue?
* Is there fainting, dizziness, nausea, vomiting, or diarrhea? Is there a fever?
* Are there changes in urination or bowel movements?
* Has there been an injury, such as a fall?
* Have there been changes in physical activity?
* Has there been additional stress?
* When did you last have sexual intercourse? Did the bleeding occur during or after sexual intercourse?
* Does rest reduce or stop the bleeding?
Your health care provider will most likely perform a pelvic exam, with careful inspection of the cervix.
Other diagnostic tests may include:
* Blood tests
* Ultrasound
* Pap smear
* Cervical cultures or tests for infections
