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Vaginal bleeding in early pregnancy

Miscarriage - vaginal bleeding; Threatened abortion - vaginal bleeding

Description

Vaginal bleeding during pregnancy is any discharge of blood from the vagina. It can happen any time from conception (when the egg is fertilized) to the end of pregnancy.

Some women have vaginal bleeding during their first 20 weeks of pregnancy.

The Difference Between Spotting and Bleeding

Spotting is when you notice a few drops of blood every now and then on your underwear. It is not enough to cover a panty liner.

Bleeding is a heavier flow of blood. With bleeding, you will need a liner or pad to keep the blood from soaking your clothes.

Ask your health care provider more about the difference between spotting and bleeding at one of your first prenatal visits.

Should I Worry about Spotting?

Some spotting is normal very early in pregnancy. Still, it is a good idea to tell your provider about it.

If you have had an ultrasound that confirms you have a normal pregnancy, call your provider the day you first see the spotting.

If you have spotting and have not yet had an ultrasound, contact your provider right away. Spotting can be a sign of a pregnancy where the fertilized egg develops outside the uterus (ectopic pregnancy). An untreated ectopic pregnancy can be life-threatening for the woman.

What Causes Vaginal Bleeding?

Bleeding in the 1st trimester is not always a problem. It may be caused by:

More serious causes of first-trimester bleeding include:

What Will My Provider Need to Know?

Your provider may need to know these things to find the cause of your vaginal bleeding:

Treatment for Vaginal Bleeding

Most of the time, the treatment for bleeding is rest. It is important to see your provider and have testing done to find the cause of your bleeding. Your provider may advise you to:

Very heavy bleeding may require a hospital stay or surgical procedure.

What if I Discharge More than Blood?

If something other than blood comes out, call your provider right away. Put the discharge in a jar or a plastic bag and bring it with you to your appointment.

Your provider will check to see if you are still pregnant. You will be closely watched with blood tests to see if you are still pregnant.

If you are no longer pregnant, you may need more care from your provider, such as medicine or possibly surgery.

When to Call the Doctor

Call or go to your provider right away if you have:

If you cannot reach your provider, go to the emergency room.

If your bleeding has stopped, you still need to call your provider. Your provider will need to find out what caused your bleeding.

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.

Salhi BA, Nagrani S. Acute complications of pregnancy. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 178.

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Review Date: 10/5/2020  

Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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