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Vaginal bleeding in pregnancy

Show Alternative Names
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:

  • Cervical polyp or growth
  • Early labor (bloody show)
  • Ectopic pregnancy
  • Infection of the cervix
  • Trauma to the cervix from intercourse (small amount of bleeding) or recent pelvic exam

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:

  • Blood tests
  • Pregnancy ultrasound
  • Ultrasound of the pelvis

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

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.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Ultrasound in pregnancy

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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.

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

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Placenta previa - Illustration Thumbnail

Placenta previa

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).

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Vaginal bleeding during pregnancy - Illustration Thumbnail

Vaginal bleeding during pregnancy

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

Illustration

Ultrasound in pregnancy - Illustration Thumbnail

Ultrasound in pregnancy

The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing numbers of conditions in the fetus 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.

Illustration

Female reproductive anatomy - Illustration Thumbnail

Female reproductive anatomy

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.

Illustration

Anatomy of a normal placenta - Illustration Thumbnail

Anatomy of a normal placenta

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

Illustration

Placenta previa - Illustration Thumbnail

Placenta previa

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).

Illustration

Vaginal bleeding during pregnancy - Illustration Thumbnail

Vaginal bleeding during pregnancy

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

Illustration


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