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Vaginal bleeding in pregnancy

Pregnancy - vaginal bleeding; Maternal blood loss - vaginal

Vaginal bleeding in pregnancy is any discharge of blood from the vagina during pregnancy.

Considerations

Up to 1 in 4 women have vaginal bleeding at some time during their pregnancy. Bleeding is more common in the first 3 months (first trimester), especially with twins.

Causes

A small amount of light spotting or bleeding may be noted 10 to 14 days after conception. This spotting results from the fertilized egg attaching itself to the lining of the uterus. Assuming it is light and does not last very long, this finding is most often nothing to be concerned about.

During the first 3 months, vaginal bleeding may be a sign of a miscarriage or ectopic pregnancy. Contact the health care provider right away.

During months 4 to 9, bleeding may be a sign of:

  • The placenta separating from the inner wall of the uterus before the baby is born (abruptio placentae)
  • Miscarriage
  • The placenta covering all or part of the opening to the cervix (placenta previa)
  • Vasa previa (the baby's blood vessels exposed across or near the internal opening of the uterus)

Other possible causes of vaginal bleeding during pregnancy:

Home Care

Avoid sexual intercourse until your provider tells you that it is safe to start having intercourse again.

Consume only fluids if the bleeding and cramping are severe.

You may need to cut down your activity or be put on bed rest at home. Your provider will talk to you about the specific kinds of activity changes you may need to make.

Medicine is not needed in most cases. DO NOT take any medicine without talking with your provider.

Also, talk to your provider about what to look for, such as the amount of bleeding and color of the blood.

When to Contact a Medical Professional

Contact your provider if:

  • You have any vaginal bleeding during pregnancy. Treat this as a potential emergency.
  • You have vaginal bleeding and have placenta previa (get to the hospital right away).
  • You have cramps or labor pains.

What to Expect at Your Office Visit

Your provider will take a medical history and perform a physical exam.

You will probably have a pelvic exam, or ultrasound as well.

Tests that may be done include:

You may be referred to a high risk pregnancy specialist (maternal fetal medicine specialist or perinatologist) for the duration of the pregnancy.

Open References

References

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 18.

Henn MC, Lall MD. Complications of pregnancy. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 173.

Turocy J, Williams Z. Early and recurrent pregnancy loss: etiology, diagnosis, treatment. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 16.

  • Ultrasound in pregnancy

    Ultrasound in pregnancy - illustration

    The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing numbers of conditions including meningomyelocele, congenital heart disease, kidney abnormalities, hydrocephalus, anencephaly, club feet, and other deformities. Ultrasound does not produce ionizing radiation and is considered a very safe procedure for both the mother and the fetus.

    Ultrasound in pregnancy

    illustration

  • Female reproductive anatomy

    Female reproductive anatomy - illustration

    Internal structures of the female reproductive anatomy include the uterus, ovaries, and cervix. External structures include the labium minora and majora, the vagina and the clitoris.

    Female reproductive anatomy

    illustration

  • Anatomy of a normal placenta

    Anatomy of a normal placenta - illustration

    The placenta provides the fetus with oxygen and nutrients and takes away waste such as carbon dioxide via the umbilical cord.

    Anatomy of a normal placenta

    illustration

  • Placenta previa

    Placenta previa - illustration

    Placenta previa is a condition of pregnancy when the placenta implants in the lower part of the uterus, partly or completely obstructing the cervical outlet to the vagina (birth canal).

    Placenta previa

    illustration

  • Vaginal bleeding during pregnancy

    Vaginal bleeding during pregnancy - illustration

    There are many possible causes of bleeding during pregnancy. Bleeding should always be evaluated by a health care provider.

    Vaginal bleeding during pregnancy

    illustration

    • Ultrasound in pregnancy

      Ultrasound in pregnancy - illustration

      The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing numbers of conditions including meningomyelocele, congenital heart disease, kidney abnormalities, hydrocephalus, anencephaly, club feet, and other deformities. Ultrasound does not produce ionizing radiation and is considered a very safe procedure for both the mother and the fetus.

      Ultrasound in pregnancy

      illustration

    • Female reproductive anatomy

      Female reproductive anatomy - illustration

      Internal structures of the female reproductive anatomy include the uterus, ovaries, and cervix. External structures include the labium minora and majora, the vagina and the clitoris.

      Female reproductive anatomy

      illustration

    • Anatomy of a normal placenta

      Anatomy of a normal placenta - illustration

      The placenta provides the fetus with oxygen and nutrients and takes away waste such as carbon dioxide via the umbilical cord.

      Anatomy of a normal placenta

      illustration

    • Placenta previa

      Placenta previa - illustration

      Placenta previa is a condition of pregnancy when the placenta implants in the lower part of the uterus, partly or completely obstructing the cervical outlet to the vagina (birth canal).

      Placenta previa

      illustration

    • Vaginal bleeding during pregnancy

      Vaginal bleeding during pregnancy - illustration

      There are many possible causes of bleeding during pregnancy. Bleeding should always be evaluated by a health care provider.

      Vaginal bleeding during pregnancy

      illustration

    Talking to your MD

     

    Self Care

     

    Tests for Vaginal bleeding in pregnancy

     
     

    Review Date: 3/31/2024

    Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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