Bleeding for 2 weeks while pregnant
Bleeding in Early Pregnancy: When Should you Worry?
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Light bleeding or spotting during your first trimester is common.
Here’s what it could mean (and when to seek help).During pregnancy, your body changes. A lot. And in early pregnancy, you may deal with some pretty substantial hormonal shifts. Between mood swings, exhaustion and morning sickness, you might not feel your best. But there’s another symptom that can happen in early pregnancy that you might not be thinking about — bleeding or spotting.
“Bleeding in early pregnancy happens to 20 to 40% of women,” says Deidre Heber, DO, OB-GYN at Geisinger. “Most of the time, it’s nothing to worry about.”
Potential causes of first trimester bleeding
Bleeding during the first trimester can look different for everyone. The amount can range from light to heavy. For some, it can be intermittent. Others may have more constant bleeding or spotting. And it may or may not be painful.
Here are a few things that might be behind it.
Implantation bleeding
Early in pregnancy (sometimes before you know you’re pregnant), you may have some spotting when your period is due. This common occurrence is called implantation bleeding. “It happens between 6 and 12 days after conception as the fertilized egg implants into your uterus,” Dr. Heber says. This bleeding is typically light and may last for a few days.
Cervical changes
During pregnancy, there’s increased blood flow to your cervix. Having sex or getting a Pap smear, which cause contact with the cervix, can trigger light bleeding. Other cervical changes that can trigger bleeding include:
- Polyps
- Minor infections
- Cervical ectropion (when cells from the inside of the cervix move to the outside)
Hormones
In the early weeks of pregnancy, your body starts making the hormones you need to sustain a pregnancy. This change can cause your progestin levels to drop. That drop may lead to spotting or light bleeding.
Miscarriage
Since miscarriages are most common during the first trimester, worrying about bleeding is normal. Light bleeding or spotting doesn’t automatically mean you’re miscarrying. But if your bleeding is heavy, bright red or you’re passing clots and in pain, contact your healthcare provider. They can explain next steps.
Most women who miscarry go on to have healthy pregnancies. But having a miscarriage is a loss that families may need help handling. Don’t rush the grieving process, and find a support group or counselor if you feel you need it.
Ectopic pregnancy
An ectopic pregnancy happens when a fertilized egg implants outside the uterus, like in your fallopian tube. When that happens, it can lead to heavy bleeding, pain and other serious symptoms. “An ectopic pregnancy is an emergency,” says Dr. Heber. “If you have symptoms, contact your provider immediately.”
When to call the doctor about bleeding
Call 911 or go to the nearest emergency room if you have any of these symptoms:
- Severe pain or cramps low in the abdomen
- Severe bleeding, soaking greater than one heavy pad per hour, with or without pain
- Passage of blood clots or tissue
- Dizziness or fainting
- Chills
- Fever higher than 100. 4° F
If you’re pregnant and bleeding heavily, don’t use a tampon. Wear a pad instead. “Doctors need to know how much you’re bleeding to gauge the severity,” says Dr. Heber.
And if you’re passing tissue, consider bringing it in for testing.
Your doctor may use an ultrasound to determine the cause of your bleeding. Once they find the cause, they’ll work with you on a treatment plan.
Healthy parent, healthy baby
Building good habits now can help you have the healthiest pregnancy possible. Dr. Heber makes these suggestions to help you (and your baby) feel your best.
- Eat a nutritious, well-balanced diet
- Exercise regularly
- Avoid alcohol, recreational drugs and cigarettes
- Reduce caffeine intake to 1-2 cups a day
- Attend regular prenatal visits
- Take your prenatal vitamins
Next steps:
Meet Deidre Heber, DO
Learn about pregnancy care at Geisinger
Separating fact from fiction: 6 pregnancy myths
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How Much Bleeding Is Normal In Early Pregnancy?
Light amounts of vaginal bleeding early in your pregnancy can occur. In most cases, it’s not serious. It can happen in the first 20 weeks for different reasons. It can be the result of something serious or non-serious. Continued bleeding throughout the pregnancy is not common. Call your doctor immediately if you are bleeding heavily. Go to the emergency room if you have severe pain.
Path to improved health
Vaginal bleeding can happen from conception to delivery. Spotting is a type of light bleeding. You may see just a few drops of blood in your underwear. Heavy bleeding is more noticeable. It will require a sanitary pad to protect your clothing.
Call your doctor whenever you experience bleeding of any kind. Call your doctor if you have vaginal bleeding or spotting. This is important even if an ultrasound test confirms your pregnancy is normal. An ultrasound is where a technician moves a wand around your stomach to see an image of the baby.
Non-serious reasons for bleeding early in your pregnancy can include:
- Implantation (as the egg settles into your uterus the first 6-12 days)
- Sex
- Infection
- Hormones.
More serious causes of vaginal bleeding during the early part of pregnancy can include:
- An ectopic pregnancy (a pregnancy that starts outside the uterus and will not survive but can be life threatening).
- A miscarriage (losing the baby early in a pregnancy).
- A molar pregnancy (a fertilized egg that implants in the uterus that does not live).
In later pregnancy, the following serious medical conditions can cause vaginal bleeding:
- Placental abruption (the placenta detaches from the wall of the uterus before birth).
- Placenta previa (the placenta is lying too low in the uterus and nearly covers the cervix).
- Placenta accreta (when the placenta invades the uterus and doesn’t separate from the uterine wall).
- Preterm labor (labor that starts before completing 37 of 40 weeks of pregnancy).
Bleeding may be just one sign of preterm labor. Preterm labor also can include vaginal discharge, pressure in your pelvis or abdomen (lower stomach), a dull backache, cramps, contractions, and your water breaking.
If you are bleeding early in your pregnancy, your doctor will want to know how long and how much. If you have cramps and pain early in the pregnancy, he or she will order tests. This may include an ultrasound, blood, and urine tests.
If continued bleeding is not serious, your doctor may treat it by recommending that you rest, relax, stay off your feet, and not have sex. Keep your body healthy. Take a prenatal vitamin with folic acid daily while pregnant. Take it earlier if you plan to get pregnant. Avoid smoking, drinking alcohol, and taking illegal drugs. Talk to your doctor before taking prescription medicine. When you are pregnant, you should never douche (use vaginal cleansing products) or use tampons. Serious bleeding may need to be treated with a long-term bed rest, hospitalization, or surgery.
You cannot prevent a miscarriage after it has started. The exact cause is usually unknown. It’s rarely something the mother did wrong. Most women can have healthy pregnancies in the future. If you have lost more than 3 pregnancies, talk to your doctor.
Things to consider
If you experience bleeding or spotting at any time during your pregnancy, your doctor will want to collect as much information as possible. That will include:
- How far along is your pregnancy?
- Have you had bleeding at any other time during your pregnancy?
- When did the bleeding start?
- Is the bleeding heavy or spotting?
- Does it start and stop?
- How much blood is there?
- What color is the blood (bright red or dark brown)?
- Does the blood have an odor?
- Do you have cramps or pain?
- Do you feel weak, tired, faint, or dizzy?
- Have you experienced vomiting, nausea, or diarrhea?
- Do you have a fever?
- Were you recently injured (such as a fall or car accident)?
- Have you engaged in any physical activity?
- Are you under extra stress?
- When did you last have sex? Did you bleed afterward?
- Do you have a bleeding disorder? Women with bleeding disorders are at risk of complications during and after pregnancy. This includes iron-deficiency anemia, bleeding during pregnancy, and serious bleeding after delivery (postpartum hemorrhage). Talk to your doctor before getting pregnant if you have a bleeding disorder. Also, bleeding disorders are genetic.
- What is your blood type? If your blood type is Rh negative, you will need treatment with a medicine called Rho(D) immune globulin. This prevents complications with future pregnancies.
Vaginal bleeding is usually blood without clots or tissue. If you see something other than blood, call your doctor immediately. Try to collect the discharge in a container and bring it with you when you see your doctor. It may mean you have miscarried. If that is the case, your doctor will provide additional care. If not all the tissue from the miscarriage has passed, your doctor may need to perform a procedure. This procedure is called a dilation and curettage (D and C). It involves opening (dilating) the cervix. Your doctor will gently suction out the remaining tissue from the miscarriage.
Questions to ask your doctor
- Can certain foods (such as spicy foods) cause bleeding?
- Is it best to avoid having sex throughout your entire pregnancy?
- Is spotting during later pregnancy normal?
- Is my life at risk?
- I feel sad. Is there someone I could talk to about my feelings? Is there a support group?
Resources
U.S. National Library of Medicine, Vaginal bleeding in early pregnancy
March of Dimes, Bleeding and Spotting From the Vagina During Pregnancy
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
The question is asked by Anya, - a question-answer from the specialists of the clinic "Mother and Child"
10/23/2014
Hello! I have a second pregnancy (my son is 1 year 2 months), the term is 13-14 weeks. At the 11th week, heavy bleeding began (until that time, nothing bothered) and I was admitted to the hospital with a diagnosis of “beginning miscarriage.” Heavy bleeding lasted from 13.00 to 16.00, then it bled a little all the next day, and on the third day the discharge began to darken and disappeared. The next morning after admission, I had an ultrasound scan (06/04/05), which showed: The uterus in anteflexio, with clear, even contours, rounded, enlarged due to pregnancy and according to its duration. Meometrium of normal structure and echogenicity, without nodules and retrochorial hematomas, in which one live embryo is visualized. The placenta is formed on the right side with the transition to the anterior wall of the uterus, up to 1.2 m thick. The amount of water is normal. The internal os of the uterus is completely closed. The results of the analyzes: Cl. blood test: Er - 4, 15; Hb - 124; Ht - 35, 8; L-9, four; P - 6; C - 73; L - 18; M-3; E-0; ESR - 22. General analysis of urine: Specified weight -1010, PH - Neutral; Protein, Glucose, erythrocytes - neg; L - 1-2-1; epithelium singly. Biochem. blood test: Common. Protein - 65.0; Urea - 3, 2; Creatinine - 76; Bilirubin - 12-0-12; Alat - 23; AsAt - 59; Glucose - 3, 4. Gr. Blood A (II) Rh - factor positive. RW, HIV, HBs Ag - negative, DHA - 1. 88. Treatment was prescribed: No-shpa 2, 0-3 times / m, papaverine 2 times, utrozhestan 1 t - 2 times, Vite 1-3 times, dicynone 2, 0 - 2 times / m, valerian 1 - 3 times, dexamethasone ½ tab. H night, magneB6 2-3 times, Materna 1. a day. While I was in the hospital, I bled a little bit a couple of times, and every day there were periodically pulling pains and tingling in the lower abdomen. She was discharged after 2 weeks, the medications were the same (except for decinone). The next day after discharge, dark brown discharge appeared again, on the same day I did a new ultrasound (06/20/05) results: Pregnancy 14 weeks, One live embryo is determined in the uterine cavity, the size of the fetus is proportional and corresponds to a period of 12 weeks. Rhythmic heartbeat 10 beats/min. Motor activity is determined by malformations not identified. Chorion along the anterior wall of the uterus On the degree of maturity. The thickness of the placenta is 16 mm. The tone of the myometrium is slightly increased along the anterior wall. The cervix is not shortened. The cervical canal is closed. I have a few questions: How might such a threat affect a child's development? What additional tests should be taken to clarify the cause of the threat? How long to take the prescribed medication in this amount? Could the short period between pregnancies be the cause of the threat? Thank you for your advice
Clinic "Mother and Child" Kuntsevo:
01/27/2021
The presence of short-term bleeding during pregnancy with normal blood tests and ultrasound data (adequate fetal development, absence of detachment of the placenta) does not have a negative effect on the fetus. In such cases, it is necessary to exclude inflammation of the vagina, a decidual polyp of the cervical canal, when spotting does not occur from the uterus, but is external in nature and is not associated with problems of the fetal egg. Nevertheless, in your case, it is better to follow a sparing regimen, take antispasmodics (no-shpu, magnesium B6, soothing herbs, continue taking utrogestan until 16 weeks of pregnancy, dexamethasone. With normal health and ultrasound data after 16 weeks, gradually cancel utrogestan, antispasmodics, magnesium B6).
Pathological and physiological causes of bleeding during early pregnancy
The gestation period is a complex process that does not always go well. Every second woman has various complications. Most often, women go to the doctor with complaints of spotting. Why does bleeding occur during early pregnancy, how dangerous is it?
Causes of bleeding in pregnancy
Blood in the first trimester of pregnancy in the vaginal secretion is observed in 30% of expectant mothers. Bleeding can be weak, spotting, plentiful.
Most often, blood during early pregnancy is observed during implantation of the fetal egg. When the egg is attached, the vessels are often damaged, which leads to the appearance of blood secretions. They are similar to menstruation, last 1-2 days. This process is considered natural, does not indicate any pathologies.
Any bloody discharge during early pregnancy is a reason for an urgent appeal to a gynecologist. Even if there is no additional discomfort. At a remote consultation, our doctor will collect an anamnesis, draw up a clinical picture in order to identify the cause of bleeding. And he will select effective methods to eliminate the problem.
Blood during pregnancy - other common causes
In addition to the main ones, there are some other reasons why pathology can develop.
No. | Cause |
one | Excessive exercise, deep penetration during intercourse. If the cervix is damaged, slight red discharge occurs, which disappears within two hours. |
2 | Progesterone deficiency. With a low level of the hormone, the body starts the process of menstruation. Bloody discharge during pregnancy appears when the uterine mucosa is exfoliated. The situation may adversely affect the implantation of the fetal egg. |
3 | Miscarriage - occurs in 2-8% of pregnant women. It is characterized by pain in the lower abdomen, which is rapidly increasing, bloody discharge at the beginning of pregnancy. The causes of the pathological condition can be different - infectious diseases, fetal malformations that are incompatible with life, dehydration, abdominal trauma, taking certain drugs. |
four | Ectopic pregnancy. Dangerous condition, urgent hospitalization is required. |
5 | A failed miscarriage. Blood discharge during pregnancy, abdominal pain are the main manifestations of intrauterine development of the fetus. |
6 | Infections. To avoid dangerous complications, it is necessary to treat diseases. Parents of both sexes should be tested. |
7 | Full or partial hydatidiform mole. Pathology of the chorion, in which the size of the villi increases, bubble expansions form. The risk group includes women with ovarian dysfunction, inflammatory diseases of the reproductive system, and a history of cystic mole. Bleeding is profuse and constant, characteristic blisters are present. The symptoms of early toxicosis are very pronounced, the size of the uterus, the hCG indicators do not correspond to the gestational age. |
eight | Cervical cancer. Pregnant women are rarely diagnosed. The risk group includes women with a large number of abortions and childbirth, often changing sexual partners. |
9 | Subchorionic hematoma. Hemorrhage around the placenta most often resolves on its own. But it increases the risk of preterm birth and other complications. |
ten | Cervical erosion. Detected in 50% of women. For pregnant women, the disease is not dangerous, but constant medical supervision is needed. |
Bleeding in the first trimester can be caused by causes that appear at any gestational age. These are fibroids, polyps in the uterus and cervical canal, cardiovascular pathologies that are associated with a weakening of the endothelium.
Physiological or pathological bleeding during gestation - differences
Clinical manifestations of bleeding in pregnant women depend on the causes. Physiological discharge of blood from the genital tract in the early stages of gestation proceeds without deterioration in well-being. With bleeding caused by erosion, fibroids and polyps, there are also no additional discomfort. In this case, only a few drops of blood are released, it bleeds for a short time.
Abundant bleeding, similar to menstruation, against the background of a general satisfactory condition, occurs with a deficiency of progesterone.
Bleeding with spontaneous interruption is accompanied by constant or periodic pain in the lumbar region, abdomen. Disturbed by nausea, bouts of dizziness, slightly increased body temperature. Bleeding can be weak or intense, and clots are often observed in the discharge.
When a fertilized egg is fixed outside the uterus, internal bleeding often occurs, and discharge from the genital tract may appear much later. Characteristic manifestations - acute pain in the abdomen radiates to the anal region, right or left side, blood pressure decreases, cold sweat appears, fainting is possible. Significant blood loss leads to the development of a state of shock with a high probability of death.
Learn more about implantation bleeding
Why does it bleed at the initial stages of gestation? Most often, the appearance of spotting during pregnancy is associated with the implantation of the embryo. They occur 6-12 days after conception and are often one of the first signs of conception.
Usually, the appearance of spotting at the beginning of pregnancy coincides with the time of the onset of menstruation, if the cycle is regular. But discharge in pregnant women is not as abundant as menstrual bleeding. Duration - from several hours to three, with the first pregnancy up to 5 days.
How does implantation bleeding manifest?
- weak, pulling pain in the lower abdomen;
- headache, dizziness;
- sudden change of mood;
- bouts of nausea;
- increased sensitivity, swelling of the mammary glands;
- fatigue, drowsiness.
Important! When the embryo is implanted, little blood is released, usually these are small specks. The discharge may be pink, brown, orange, and there should be no clots.
Possible causes of early bleeding by week
The first months of pregnancy are the most difficult and dangerous. It is in the early stages that various pathologies and complications often appear.
Why blood may appear in the early stages during pregnancy:
- At the 4th week of pregnancy, discharge with an admixture of blood may appear - this is implantation bleeding. Heavy bleeding is a dangerous sign, most often indicates a miscarriage. Spontaneous abortion can be caused by exercise, fever, infections, drugs or alcohol. Such bleeding is profuse, painful, blood clots are present.
- The appearance of sanious discharge at the 5th week of pregnancy may be a sign of a missed pregnancy. The reasons are overwork, Rh conflict, bad habits, bacterial and viral diseases of the reproductive system, genetic disorders in the embryo. Symptoms - causeless fever, severe pain in the lower back and lower abdomen, the disappearance of signs of toxicosis.
- Blood in the discharge at the 6th week of pregnancy appears with an ectopic attachment of the fetal egg, fetal fading, Rhesus conflict. Discharge with blood at 6 weeks of pregnancy is a reason for an urgent visit to the gynecologist.
- At the 7th week of pregnancy, discharge with blood is not the norm. May indicate a miscarriage, missed or ectopic pregnancy.
- From the 8th week of pregnancy, one of the most dangerous periods of pregnancy begins. The formation of the placenta begins, the hormonal background changes. Bloody discharge appears with the threat of miscarriage or spontaneous abortion. Pregnancy is often not saved.
Pay attention! In the second trimester, bleeding occurs only in 5-10% of women. Most often this is due to late spontaneous abortion, isthmic-cervical insufficiency. The appearance of blood in the third trimester mainly occurs with presentation, placental abruption.
Early bleeding after IVF
The appearance of blood discharge during pregnancy on the 8-10th day after IVF is not considered a pathology, provided that the woman feels normal. After the introduction of the embryo into the uterine cavity, minor damage to the small uterine vessels often occurs. Brown, dark cream, pale pink, odorless discharge most often indicates a successful transplant, pregnancy.
If spotting after IVF is observed for 1-2 days, slight pulling pains in the lower abdomen are disturbing, this may be due to a progesterone deficiency. After the examination, the doctor will adjust the hormonal maintenance therapy.
Pink discharge on the 16th day after the transfer is a dangerous symptom. It may be a sign of detachment of the fetal egg, the threat of termination of pregnancy.
According to studies, uterine bleeding in the first trimester is a common occurrence in pregnancy after IVF. Discharge does not affect the incidence of adverse reproductive outcomes. The number of embryo rejections in women with and without uterine bleeding is approximately the same. Consult with our doctors by phone for more details.
Diagnostics
If blood has gone from the genitals of a pregnant woman, the doctor conducts an external and gynecological examination.
Analyzes and examinations:
- general and biochemical blood test;
- general urine analysis;
- tests for hCG, other hormones;
- Ultrasound of the pelvic organs;
- CTG is performed to assess the vital activity of the fetus.
Treatment
Methods of treatment depend on the results of the examination.
Bloody discharge in the first trimester - causes and therapeutic measures:
The reasons | Treatment |
Miscarriage | Cleansing the uterus. |
Ectopic pregnancy | Diagnostic laparoscopy, removal of residual fetal tissues, antibiotic therapy. |
Risk of miscarriage | Hospitalization, bed rest, prescribing drugs to maintain pregnancy, sedatives and tocolytics to reduce uterine tone. |
bubble skid | Curettage of the uterine cavity. |
Cervical cancer | Operational intervention. |
Polyp injury, cervical erosion | Expectant management, if the condition does not worsen, removal and cauterization is carried out after childbirth. |
progesterone deficiency | hormone therapy. |
Damage to the uterus | Complete bed rest. |
Infectious pathologies | Depending on the type of pathogen - antibiotics, antiviral or antifungal drugs. |
Complications and consequences
It is impossible to ignore bloody impurities in vaginal discharge during pregnancy. Without proper and timely assistance, the following complications may occur:
- miscarriage;
- intrauterine fetal death;
- the development of an infectious process, sepsis due to the remainder of dead tissues in the uterine cavity;
- profuse blood loss can lead to death.
Important! Urgent medical attention is needed in case of heavy bleeding, discharge of bright scarlet blood, presence of blood clots in the discharge. In life-threatening and fetal conditions, severe pain in the abdomen, lower back, convulsions, profuse cold sweat, and loss of consciousness are disturbing.
Methods of prevention
If there is blood in the first trimester, it is important to remain calm. Stress and anxiety will only exacerbate the situation. But any health problem is easier to prevent than to treat.
How to avoid bleeding during childbearing - recommendations from a gynecologist:
- eat right and balanced, give up junk and junk food, eat more fresh vegetables and fruits;
- observe the drinking regime;
- in the absence of contraindications, moderate physical activity is indicated - yoga, swimming, special gymnastics for pregnant women;
- more time to walk in the fresh air;
- avoid stress, overwork, observe the daily routine, get enough sleep;
- give up bad habits, do not be in smoky rooms;
- timely visit a gynecologist;
- according to the doctor's prescription, take vitamin complexes for pregnant women;
- do not self-medicate.
The prognosis for bleeding during gestation depends on the causes and timely visit to the doctor. Properly provided medical care can save the life of the fetus and the woman.
FAQ
Why is there blood from the genital tract during gestation?
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The causes of bleeding in early pregnancy are different. Most often, spotting appears when the fetal egg is fixed, progesterone deficiency, with erosion of the cervix and polyps. Dangerous causes - ectopic, molar, miscarriage, miscarriage.
What to do if there is bleeding during pregnancy?
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Much depends on the amount of blood released, general well-being. If the bleeding is not strong, not for long, the general condition is normal, it is enough to lie down and rest. Write down the date of the attack, inform the doctor at the next visit. But if even slight spotting during early pregnancy lasts more than 72 hours, is accompanied by cramping or acute pain, fever, you should immediately visit a gynecologist or call an ambulance.
How can you recognize a miscarriage?
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With the threat of interruption, spotting is scanty, pain in the lower abdomen is absent or may be dull, aching. The condition is considered reversible, with timely treatment, pregnancy can be saved. If a miscarriage has begun, bleeding intensifies, cramping pain appears. The general condition is satisfactory. Urgent hospitalization is required, the probability of maintaining pregnancy is decided on an individual basis.
Expert opinion:
Bleeding during pregnancy is a dangerous symptom. Sometimes spotting can be caused by physiological reasons. But often such a symptom appears in life-threatening conditions for the woman and the fetus.
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Article author
Menshikova Maria Viktorovna obstetrician-gynecologist
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