Bleeding two months pregnant

Vaginal bleeding in pregnancy: MedlinePlus Medical Encyclopedia

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

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.

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 (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

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.

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.

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 specialist for the duration of the pregnancy.

Pregnancy - vaginal bleeding; Maternal blood loss - vaginal

Ultrasound in pregnancy
Female reproductive anatomy
Anatomy of a normal placenta
Placenta previa
Vaginal bleeding during pregnancy

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 in 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.

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.

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

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

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.

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 spots. 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?

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?

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?

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

Experience 38 years

Consultations 1816

Articles 46

Specialist with extensive practical experience. He has a certificate of a mammologist, a certificate of professional certification. Participates in foreign business trips and individual training programs (Los Angeles).

1982 - 1986 NPO MONIIAG - obstetrician-gynecologist
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1989 - 1992 departmental polyclinic st. Moscow - Kurskaya - obstetrician-gynecologist
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