If your pregnant and bleeding what does that mean
Vaginal bleeding - NHS
Bleeding during pregnancy is relatively common and does not always mean there's a problem – but it can be a dangerous sign.
Urgent advice: Call your midwife or GP immediately if:
- you have any bleeding from your vagina
Causes of bleeding in early pregnancy
Implantation bleeding
In early pregnancy, you might get some harmless light bleeding, called "spotting". This is when the developing embryo plants itself in the wall of your womb. This type of bleeding often happens around the time your period would have been due.
Cervical changes
Pregnancy can cause changes to the cervix, and this may sometimes cause bleeding – after sex, for example.
Miscarriage or ectopic pregnancy
During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy.
However, if you bleed at this stage of pregnancy it's likely you will go on to have normal and successful pregnancies.
Treating bleeding in early pregnancy
You may be offered a medicine called progesterone to stop bleeding in early pregnancy. This will only be recommended if you've had a scan to confirm you're pregnant and you've had a miscarriage before.
Your doctor may recommend you take the medicine twice a day until you're 16 weeks pregnant.
Miscarriage
If a pregnancy ends before the 24th week, it's called a miscarriage. Around 1 in 5 pregnancies ends this way.
Many early miscarriages (before 14 weeks) happen because there is something wrong with the baby. There can also be other causes of miscarriage, such as hormone or blood clotting problems.
Most miscarriages occur during the first 12 weeks (3 months) of pregnancy and, sadly, most cannot be prevented. Other symptoms of miscarriage include:
- cramping and pain in your lower abdomen
- a discharge or fluid from your vagina
- a discharge of tissue from your vagina
- no longer experiencing the symptoms of pregnancy, such as feeling sick
If you have bleeding or any of the symptoms above, contact your midwife or GP straightaway.
Ectopic pregnancy
An ectopic pregnancy is when a fertilised egg implants outside the womb – for example, in the fallopian tube.
It can cause bleeding and is dangerous because the fertilised egg cannot develop properly outside the womb. The egg has to be removed, which can be done through an operation or with medicines.
Symptoms of an ectopic pregnancy tend to develop in the 6th week of pregnancy but can happen later.
Other signs of ectopic pregnancy can include:
- tummy pain low down which may be on one side
- vaginal bleeding or a brown, watery discharge
- pain in the tip of your shoulder
- discomfort when peeing or pooing
Call 111 if you have symptoms of an ectopic pregnancy.
Causes of bleeding in later pregnancy
Cervical changes
These can lead to bleeding, particularly after sex.
Vaginal infections
Your midwife or doctor can discuss tests and treatment with you.
A 'show'
This is when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is getting ready for labour to start. It may happen a few days before contractions start or during labour itself.
Find out about the signs of labour and what happens in labour.
Placental abruption
This is a serious condition in which the placenta starts to come away from the womb wall. Placental abruption usually causes stomach pain, and this may occur even if there is no bleeding.
Low-lying placenta (placenta praevia)
This is when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low-lying placenta can be very heavy, and put you and your baby at risk.
You may be advised to go into hospital for emergency treatment, and a caesarean section will usually be recommended. The Royal College of Obstetricians and Gynaecologists has more information on placenta praevia.
Vasa praevia
This is a rare condition where the baby's blood vessels run through the membranes covering the cervix.
When your waters break, these vessels may be torn and cause vaginal bleeding. The baby can lose a life-threatening amount of blood.
Finding out the cause of bleeding in pregnancy
To work out what is causing the bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests to check your hormone levels.
Your doctor will also ask you about other symptoms, such as cramp, pain and dizziness. Sometimes it might not be possible to find out what caused the bleeding.
If your symptoms are not severe and your baby is not due for a while, you'll be monitored and, in some cases, kept in hospital for observation.
How long you need to stay in hospital depends on the cause of the bleeding and how many weeks pregnant you are.
Being in hospital allows staff to keep an eye on you and your baby, so they can act quickly if there are further problems.
Find the answers to common health problems in pregnancy
Video: What should I do if I start bleeding during early pregnancy?
In this video, a midwife tells you what to do if you start to bleed during early pregnancy.
Media last reviewed: 20 March 2020
Media review due: 20 March 2023
Bleeding and spotting from the vagina during pregnancy
Bleeding and spotting from the vagina during pregnancy are common
If you bleed or spot during pregnancy, it doesn’t always mean there’s a problem but in some cases they may be signs of a problem for you or your baby’s health
If you have heavy bleeding, call your health care provider right away
Tell your provider about any bleeding or spotting you have during pregnancy
Bleeding and spotting from the vagina during pregnancy are common. Up to 1 out of 4 (up to 25%) of all pregnant women have some bleeding or spotting during their pregnancy.
Bleeding and spotting in pregnancy don’t always mean there’s a problem, but they can be a sign of miscarriage or other serious complications. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy.
Call your health care provider if you have any bleeding or spotting, even if it stops. It may not be caused by anything serious, but your provider needs to find out what’s causing it.
What’s the difference between bleeding and spotting?
Bleeding or spotting can happen anytime, from the time you get pregnant to right before you give birth. Spotting is light bleeding. It happens when you have a few drops of blood on your underwear. Spotting is so light that the blood wouldn’t cover a panty liner. Bleeding is when the blood flow is heavier, enough that you need a panty liner or pad to keep the blood from soaking your underwear and clothes.
What should you do if you have bleeding or spotting during pregnancy?
Call your health care provider if you have any kind of bleeding during pregnancy and do these things:
- Keep track of how heavy your bleeding is, if it gets heavier or lighter, and how many pads you are using.
- Check the color of the blood. Your provider may want to know. It can be different colors, like brown, dark or bright red.
- Don’t use a tampon, douche or have sex when you’re bleeding.
Call your health care provider right away at any time during pregnancy or go to the emergency room if you have:
- Heavy bleeding
- Bleeding with pain or cramping
- Dizziness and bleeding
- Pain in your belly or pelvis
What causes bleeding or spotting early in pregnancy?
It’s normal to have some spotting or bleeding early in pregnancy. Bleeding or spotting in the first trimester may not be a problem. It can be caused by:
- Having sex
- An infection
- Implantation. When a fertilized egg (embryo) attaches to the lining of the uterus (womb) and begins to grow.
- Hormone changes. Hormones are chemicals made by the body.
- Changes in your cervix. The cervix is opening to the uterus that sits at the top of the vagina.
- Certain types of testing during pregnancy like an amniocentesis or Chorionic villus sampling (CVS). These are tests that are done to check for genetic abnormalities in your baby. Genetic abnormalities are changes in the genes that are passed down to a baby from mom or dad. These genetic changes can cause health problems for a baby.
- Problems related to smoking. If you smoke, it’s best to stop before pregnancy or as soon as you know you’re pregnant.
Sometimes bleeding or spotting in the first trimester is a sign of a serious problem, like:
- Miscarriage. Almost all women who miscarry have bleeding or spotting before the miscarriage.
- Ectopic pregnancy. This is when a fertilized egg implants itself outside of the uterus and begins to grow. An ectopic pregnancy cannot result in the birth of a baby. It can cause serious, dangerous problems for the pregnant woman.
- Molar pregnancy. This is when a mass of tissue forms inside the womb, instead of a baby. Molar pregnancy is rare.
What causes bleeding or spotting later in pregnancy?
Bleeding or spotting later in pregnancy may be caused by:
- Labor
- Having sex
- An internal exam by your health care provider
- Problems with the cervix, like an infection, growths, inflammation or cervical insufficiency. This is when a woman’s cervix opens too early. Inflammation of the cervix is when it may be painful, swollen, red or irritated.
Bleeding or spotting later in pregnancy may be a sign of a serious problem, like:
- Preterm labor. This is labor that happens too early, before 37 weeks of pregnancy.
- Placenta previa. This is when the placenta lies very low in the uterus and covers all or part of the cervix.
- Placenta accreta. This is when the placenta grows into the wall of the uterus too deeply.
- Placental abruption. This is when the placenta separates from the wall of the uterus before birth.
- Uterine rupture. This is when the uterus tears during labor. This happens very rarely. It can happen if you have a scar in the uterus from a prior cesarean birth (also called c-section) or another kind of surgery on the uterus. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.
How are bleeding and spotting treated?
Your treatment depends on what caused your bleeding. You may need a medical exam and tests.
Most of the time, treatment for bleeding or spotting is rest. Your provider may also suggest treatments like:
- Take time off from work and stay off your feet for a little while
- You may need medicine to help protect your baby from Rh disease. Rh disease is when your blood and baby’s blood are incompatible (can’t be together). This disease can cause serious problems — even death — for your baby.
- Don’t have sex, douche or use tampons
- If you have heavy bleeding, you may need a hospital stay or surgery
Last reviewed April 2020
Bleeding during pregnancy. What is Bleeding During Pregnancy?
IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
Bleeding during pregnancy is a sign that can occur regardless of the period of embryogenesis and indicates ongoing changes in the woman's body. It can be observed with spontaneous miscarriage, ectopic pregnancy, Rh conflict, placenta previa and other conditions. This manifestation can develop against the background of general well-being or be accompanied by painful sensations in the lower abdomen, lower back, and sacrum. Diagnosis of bleeding during pregnancy is carried out on the basis of data from a gynecological examination, an ultrasound assessment of the condition of the patient and the fetus. The treatment of this pathological symptom is determined by its cause and is prescribed exclusively by a specialist.
- Causes of bleeding during pregnancy
- Classification and symptoms of bleeding during pregnancy
- Diagnosis and treatment of bleeding during pregnancy
- Prognosis and prevention of bleeding during pregnancy
- Prices for treatment
General
Bleeding during pregnancy is an obstetric symptom, indicating the possible development of a number of disorders, the cause of which can be both physiological changes in the body of a woman after conception, and pathological conditions. Only an obstetrician-gynecologist can finally find out the etiology of such a manifestation after a complete examination. Bleeding during pregnancy occurs in about one in five patients. In 50%, they indicate pathological changes and end in spontaneous miscarriage. In half of the patients, the symptom is physiological in nature. Bleeding occurs more often in the first and third trimester of embryogenesis.
The danger of bleeding during pregnancy lies in the fact that a variety of factors can provoke them, including those that pose a threat to the mother and fetus. In some situations, there are no other pathological signs. Any bleeding during pregnancy should be a reason for immediate medical attention. Only a specialist is able to assess the danger to the health of a woman and the fetus, as well as decide on further tactics. Timely assistance provided even with an abnormal course of pregnancy allows you to continue its management and save the life of the child.
Bleeding during pregnancy
Causes of bleeding during pregnancy
Bleeding during pregnancy can occur at any time of embryogenesis, develops both against the background of physiological changes in the woman's body, and as a result of the formation of a certain obstetric pathology. In the early stages, half of the women have a slight separation of blood due to the implantation of the fetal egg in the uterine cavity. Such bleeding during pregnancy is often regarded by the patient as menstrual, so she does not seek medical help, which in the future may make it difficult to determine the timing of embryogenesis. A similar symptom is possible with insufficient production of progesterone in the early stages of gestation.
The most common cause of abnormal bleeding during pregnancy in the first trimester is spontaneous miscarriage. This symptom appears both with a just-started and with a complete abortion. Approximately 6 weeks after conception, the symptom occurs when the fetal egg is attached ectopically. Also, bleeding during pregnancy at this time may indicate an Rhesus conflict, fetal fading. Similar manifestations are characteristic of women suffering from varicose veins that feed the uterus. In this case, bleeding during pregnancy is due to increased blood supply to the tissues.
Bleeding during pregnancy in the second trimester is diagnosed much less frequently, in about 5-10% of all cases of gestation. As a rule, the symptom is caused by pathological changes and in most cases indicates spontaneous late abortion or isthmic-cervical insufficiency. Sometimes the separation of blood from the genital tract is observed during intrauterine death of the fetus. Bleeding during pregnancy in the third trimester also always speaks of the development of gestation pathology. The most common cause is placenta previa. In this case, the embryonic organ completely or partially covers the uterine os, while due to the high load on the lower segment, placental micro-ruptures occur, which causes a similar sign.
Less commonly, bleeding during pregnancy in the third trimester is due to premature detachment of a normally located placenta. In this situation, there is a high threat to the life of the fetus. The danger also lies in the fact that initially internal bleeding develops during pregnancy or the formation of a hematoma, and only then the blood flows out. The rarest, but most dangerous for the life of the mother and child, the cause of the development of this symptom is uterine rupture. Such a complication is diagnosed in the presence of a scar on the myometrium and tissue overstretching, provoked by polyhydramnios, large fetuses or multiple pregnancies. It is extremely rare that bleeding during pregnancy occurs due to a violation of the integrity of the membranes or umbilical cord vessels.
Also, bleeding during pregnancy can be triggered by causes that appear at any stage of embryogenesis. Such reasons include benign neoplasms - fibroids, polyposis growths in the cervical canal and uterine cavity. Often bleeding during pregnancy occurs in women with cervical erosion. Sometimes a sign occurs due to increased blood circulation in the pelvic organs. The risk of developing a symptom is also present with violent sexual intercourse, significant physical exertion, concomitant cardiovascular diseases associated with a weakening of the endothelium.
Classification and symptoms of bleeding during pregnancy
Depending on the origin of bleeding, two groups can be distinguished:
- Physiological bleeding during pregnancy - occurs due to the restructuring of the body, does not pose a threat to the health and life of the fetus or mother.
- Pathological bleeding during pregnancy - indicate its abnormal course, may be accompanied by a risk to the life and health of the woman and baby, require immediate medical attention.
The clinic of bleeding during pregnancy directly depends on the cause of this symptom. Isolation of blood from the genital tract in the early stages of embryogenesis, provoked by physiological changes, proceeds against the background of general well-being. Bleeding during pregnancy, which has developed due to the presence of polyps, erosion, fibroids in most cases also does not cause disturbances in well-being. In this case, there is a slight release of biological fluid - just a few drops, the symptom is of a short-term nature. More abundant, similar to menstrual, will be bleeding during pregnancy associated with a deficiency of progesterone.
In the case of bleeding during pregnancy associated with its spontaneous interruption, the patient is worried about constant or cramping pain in the lumbosacral region, abdomen. Additionally, nausea, dizziness, malaise, and a slight increase in body temperature may occur. Bleeding during pregnancy in this case can be of varying intensity, often in the discharge there are pieces of tissue. With an ectopic attachment of the fetal egg, as well as with a rupture of the uterus, there is a serious threat to the life of a woman. In such a situation, internal bleeding initially develops during pregnancy, and only then do pathological discharges from the external genital tract appear. There is acute pain in the abdomen with irradiation to the anal region, the lateral parts of the body. With significant blood loss, a state of shock occurs with a threat of death.
Bleeding during pregnancy in the later stages is also not always accompanied by a detailed clinical picture. In the case of placenta previa, this is the only symptom that should cause alertness in a woman and become a reason for contacting an obstetrician-gynecologist. As for the premature detachment of a correctly attached placenta, in this case, bleeding during pregnancy develops against the background of uterine hypertonicity, there is pain in the abdomen, deterioration in general well-being. During cardiac monitoring of the fetus, there is a violation of the heart rate, motor activity.
Diagnosis and treatment of bleeding during pregnancy
To identify the cause of bleeding during pregnancy, a gynecological examination of a woman is performed. With changes in physiological origin, no deviations from the norm can be detected. With pathological bleeding during pregnancy against the background of spontaneous abortion, an opening of the cervix is observed. An increase in the tone of the myometrium may indicate the onset of placental abruption. Of the laboratory diagnostic methods, an analysis is used to determine the concentration of hCG (human chorionic gonadotropin). With ectopic pregnancy and bleeding, this figure will be reduced. Instrumental diagnosis of bleeding during pregnancy is to conduct an ultrasound scan. Using this method, it is possible to assess the state of the myometrium and the embryo, the level of blood flow in the vessels, the exact localization of the placenta and (possibly) its incipient detachment. Using CTG, the diagnostician can make a conclusion about the vital activity of the fetus.
Treatment of bleeding during pregnancy also depends on the cause of the symptom. If there are no pathological changes or the manifestation is provoked by damage to the polyp, medical attention is not required. In rare cases, the doctor recommends its removal. Expectant tactics are also used in case of cervical erosion. Her cauterization is carried out after childbirth. Bleeding during pregnancy against the background of the threat of miscarriage and placenta previa requires immediate hospitalization in an obstetric hospital, followed by the appointment of drug treatment. To reduce uterine tone, sedatives, tocolytics are used. Pregnancy management in this case requires careful monitoring by a specialist.
Bleeding during pregnancy caused by ectopic attachment of the ovum, scar rupture, or completed spontaneous abortion requires hospitalization and surgical treatment. After removal of the remnants of fetal tissues or emergency delivery, antibiotic therapy is prescribed. In this case, stopping bleeding during pregnancy is carried out in different ways, depending on its intensity, often ligation of the uterine arteries is performed. With premature detachment of the placenta, an emergency caesarean section is indicated.
Prognosis and prevention of bleeding during pregnancy
Bleeding during pregnancy is usually accompanied by a favorable prognosis. Timely medical care can save the life of the fetus and the woman. Lethal outcome is extremely rare. Prevention of bleeding during pregnancy consists in the early detection of benign neoplasms and their treatment even before conception. To prevent the development of a pathological symptom, you should register as soon as possible, take all the necessary tests, and if any violations occur, immediately seek advice from an obstetrician-gynecologist. Prevention of bleeding during pregnancy also consists in avoiding stress, physical exertion, violent sexual contacts.
You can share your medical history, what helped you in the treatment of bleeding during pregnancy.
Sources
- In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
What is implantation bleeding? - IVF center Generation NEXT
How our body functions and what changes occur in it every month is always interesting. Especially during the period when we are pregnant or hope to become pregnant. Almost certainly never do we monitor our condition so carefully and closely as during the period when we hope to become pregnant. From feeling tired to feeling slightly nauseous, the smallest signs are examined and tested for their significance. In this article, we will look at some of the most common implant bleeding problems. This problem is frightening and confusing if the desired pregnancy has already occurred.
Thus, we will try to figure out what are the symptoms and signs of implantation bleeding, how to recognize the earliest signs of implantation and pregnancy? Such self-control in people undergoing assisted fertility treatment can be much stronger, which is understandable. In this context, we will consider whether any other symptoms of implantation should be expected during pregnancy, and if so, how.
About 30-40% of women experience a slight loss of blood after the embryo is implanted in the uterus. This phenomenon is known as implantation bleeding. Since this happens at the beginning of the cycle, it may even be the first sign of realizing that you are pregnant. Bleeding usually occurs in the first weeks of pregnancy, as the uterus is an organ rich in blood vessels that can easily "damage". When the embryo sticks to the inner wall of the uterus, the small veins and arteries that normally connect to the endometrium rupture, and this can cause bleeding. If this occurs, usually 6-10 days after fertilization, then it usually coincides with the theoretical date of menstruation, and therefore can be confused with its onset. There is no set pattern, and implantation bleeding may occur in one or all of a particular individual's pregnancies.
The first question for many people is how to recognize that this is implantation bleeding and not just the start of a cycle, in other words, how do these types of bleeding differ? The most common reason for confusion here is that bleeding occurs 10-14 days after conception, around the time that menstruation would have occurred if conception had not occurred. However, vaginal bleeding can occur anytime during the first 8 weeks of pregnancy. Blood loss may last 1-3 days, and the amount of discharge is usually less than during menstruation, although the color may be darker. It may look like a light spot or light continuous bleeding, and blood may or may not be mixed with mucus. The color may vary depending on how long it took to leave the body. Fresh bleeding looks red, it may look pink or orange if mixed with other vaginal discharge, and old blood may look brown due to oxidation.
Usually, the bleeding that occurs as a result of the implantation of the embryo in the uterus is manifested by a spot or light bleeding. Usually it is not strong and does not have clots, as in a normal cycle. If you suspect you may be pregnant and are bleeding heavily with clots, you should see your doctor as this could signal problems or even the onset of a premature miscarriage. On the other hand, if you have no other reason to suspect that you are pregnant, this type of bleeding is more likely to just be the start of your cycle.
Since implantation bleeding only occurs in about a third of pregnancies, you are likely to be among the majority who do not experience it. However, your vigilance for the signs and symptoms of successful implantation is probably still massively high! So what are other early signs that you might be pregnant? They may include:
Morning sickness
This can start as early as 4 weeks after conception (10-14 days after embryo transfer), although more often it happens after about 6 weeks. Luckily for those who go through this, morning sickness is usually temporary and usually improves by 16-20 weeks of pregnancy.
Sensitivity to smells and tastes
Sudden sensitivity to smell and taste can be a sign of early pregnancy and no doubt contributes to the long tales of pregnancy “cravings” for certain foods. Both heightened sensitivity and morning sickness are the result of hormonal changes taking place in your body.
Frequent urination
It seems strange when your baby is still very young, but the need to urinate more often during early pregnancy is one of the most common symptoms. It is also the result of hormonal changes that cause faster blood flow through the liver and kidneys to remove waste as efficiently as possible. In addition, the uterus rapidly increases in size even at this early stage of pregnancy and therefore puts more pressure on the bladder, especially at night.
Breast tenderness
The well-known symptom of breast tenderness is another sign of early pregnancy. This is the result of an increase in blood flow and fluid retention in the mammary glands against the background of a sharp increase in the level of female sex hormones in the blood serum.
Stomach cramps
Spasms may occur on their own or be accompanied by slight bleeding, which may be a signal of implantation. You might think that all these possible early signs and symptoms of pregnancy will help to be easily confident in its onset. But the fact is that some symptoms are also present in some people as a harbinger of their normal monthly cycle in premenstrual syndrome. Thus, despite all the possible clues, the only way to be sure of pregnancy is to take a pregnancy test, and with it, confirm the pregnancy with your doctor.
People undergoing IVF or any other assisted fertility treatment often wonder if pregnancy symptoms will be the same if embryo transfer and implantation is successful. In a word, yes. Although some stages of IVF are drug-driven, and despite the fact that the actual pairing of the egg and sperm takes place in the laboratory, the end result is identical.
Let's look at a summary of the steps that led to the implantation of the embryos. The first step is ovarian stimulation, which causes the ovaries to produce a number of oocytes. Then, when the oocytes have reached a suitable stage of maturity, they are retrieved during ovarian puncture in order to be fertilized with prepared sperm in the embryology laboratory. This is the point at which fertilization occurs and embryos are formed. They are cultivated - "grow" in special incubators and pass the necessary tests (if a genetic study of the embryos is performed). The healthiest and most viable embryo is then transferred into the woman's uterus. This is, in a nutshell, the final stage of the process. The implantation of the embryo into the uterine wall after it has been transferred is not part of the assisted reproduction process; it is something that happens naturally in the same way as in normal conception. This final stage is not guaranteed as a result of IVF treatment, just as unprotected sex during ovulation is not guaranteed to lead to pregnancy. This explains the absolute similarity of symptoms in the case of assisted reproduction and natural pregnancy, which you can expect, including any bleeding during implantation.