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Two month pregnancy bleeding


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.

Bleeding during pregnancy | Pregnancy Birth and Baby

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Contact your doctor or midwife if you notice bleeding from your vagina at any time during your pregnancy. If you have very heavy bleeding, strong pain or feel very unwell, call triple zero (000) immediately and ask for an ambulance.

Is it normal to bleed during pregnancy?

Bleeding during pregnancy, especially in the early stages, is quite common. About 1 in 4 women will experience vaginal spotting or bleeding during the first trimester. Many of these women will go on to have healthy pregnancies.

However, vaginal bleeding may be the first sign of a problem, so it’s important to contact your doctor or midwife if you experience vaginal bleeding at any stage of your pregnancy for advice on what to do next.

What are the causes of bleeding during pregnancy?

The causes of bleeding during pregnancy are generally divided into two categories — bleeding before 20 weeks and bleeding after 20 weeks gestation.

Before 20 weeks gestation, causes of bleeding may include:

  • Implantation bleeding — in very early pregnancy (4 to 5 weeks gestation) some women may experience bleeding when the pregnancy implants itself in the lining of the uterus (womb).
  • Miscarriage — bleeding may be the first sign of a miscarriage. About 1 in 15 women who experience bleeding in early pregnancy end up having a miscarriage.
  • Ectopic pregnancy — a rare but serious cause of bleeding when a fertilised egg starts growing outside the uterus (womb). An ectopic pregnancy can rupture (burst) and cause heavy bleeding, and may be life-threatening.

Bleeding in later pregnancy (after 20 weeks) is usually caused by problems with the placenta such as:

  • Placenta previa — also known as a 'low lying placenta', when the placenta implants close to the cervix (neck of the uterus). If the cervix starts to open or the uterus contracts, this can cause bleeding.
  • Placental abruption — when the placenta starts to separate from the uterus during pregnancy but before birth, causing bleeding from the place where the placenta has peeled away. Bleeding caused by placental abruption is usually associated with sudden, severe abdominal pain.

Less common causes of bleeding, which may happen at any stage of pregnancy, may include:

  • genital tract infections
  • injuries to the genital tract
  • growths or tumours of the reproductive system
  • bleeding from vulvovaginal varicosities (varicose veins in the vulva or vagina)

What should I do if I bleed during pregnancy?

If you bleed during pregnancy, contact your doctor or midwife. Your antenatal care provider can give you advice about what to do next.

It can be helpful to note down details about what you have been experiencing. This may include:

  • the amount and colour of any discharge
  • whether you have passed any clots
  • whether you have had any abdominal pain

If you are having heavy bleeding, it’s a good idea to keep your pads or stained clothes to show your doctor or midwife.

How will my doctor or midwife diagnose the cause of my bleeding?

Your doctor or midwife will ask you questions about the bleeding, any other symptoms you have been having and about your pregnancy and general health. Your doctor or midwife may also perform a vaginal examination to check the bleeding and look for any visible cause.

You may be referred for a blood test to check your human chorionic gonadotropin (hCG) level. hCG is a hormone made by the placenta that can be found in your blood and urine. Your hCG level can give your doctor important information about how your pregnancy is progressing.

You may also be referred for an ultrasound scan, which may be used to:

  • check your baby’s heartbeat
  • check for signs of a miscarriage
  • look for signs of an ectopic pregnancy
  • check the position and health of the placenta

It may take some time to work out what is causing your bleeding. You may need to have several blood tests or ultrasound scans over a few days or weeks. This can be a stressful time, so consider seeking support from your partner or someone else you trust.

In some situations, your bleeding may resolve on its own without your doctor or midwife finding a cause.

When should I seek medical attention?

If you have bleeding at any stage of pregnancy, contact your doctor or midwife for advice and support.

You should contact your doctor urgently, or visit the nearest emergency department, if:

  • your bleeding becomes very heavy
  • you have strong pains
  • you feel dizzy or faint
  • you feel short of breath

If you have very heavy bleeding, strong pain or feel very unwell, call triple zero (000) immediately and ask for an ambulance.

Does bleeding mean I am having a miscarriage or might lose my baby?

Bleeding in early pregnancy is very common and does not necessarily mean you are having a miscarriage. Many women who experience bleeding in early pregnancy go on to have healthy babies.

In some cases, bleeding can be the first sign of a miscarriage. If you are experiencing bleeding in early pregnancy, contact your doctor or midwife for advice.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:
The Royal Women's Hospital (Bleeding in early pregnancy), Safer Care Victoria (Bleeding in early pregnancy), Royal Women's Hospital (Placenta problems), Safer Care Victoria (Antepartum haemorrhage: assessment and management), Australian Family Physician (Early pregnancy bleeding)

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Last reviewed: June 2022


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Need more information?

Bleeding or pain in early pregnancy

One in 4 women will experience bleeding and/or pain during their first 12 weeks of pregnancy. Unfortunately half of these pregnancies may also end in miscarriage, which cannot be prevented.