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Vaginal bleeding in pregnancy
     
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Vaginal bleeding in pregnancy

Pregnancy - vaginal bleeding; Maternal blood loss - vaginal

 

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

Considerations

 

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.

 

Causes

 

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

 

Home Care

 

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.

  • Bed rest at home may be for the rest of your pregnancy or until the bleeding stops.
  • The bed rest may be complete.
  • Or, you may be able to get up to go to the bathroom, walk around the house, or do light chores.

Medicine is not needed in most cases. DO NOT take any medicines without talking to your provider.

Talk to your provider about what to look for, such as the amount of bleeding and color of the blood.

 

When to Contact a Medical Professional

 

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.

 

What to Expect at Your Office Visit

 

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.

 

 

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 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.

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  • Ultrasound in pregnancy

    Ultrasound in pregnancy

    illustration

  • Female reproductive anatomy

    Female reproductive anatomy

    illustration

  • Anatomy of a normal placenta

    Anatomy of a normal placenta

    illustration

  • Placenta previa

    Placenta previa

    illustration

  • Vaginal bleeding during pregnancy

    Vaginal bleeding during pregnancy

    illustration

    • Ultrasound in pregnancy

      Ultrasound in pregnancy

      illustration

    • Female reproductive anatomy

      Female reproductive anatomy

      illustration

    • Anatomy of a normal placenta

      Anatomy of a normal placenta

      illustration

    • Placenta previa

      Placenta previa

      illustration

    • Vaginal bleeding during pregnancy

      Vaginal bleeding during pregnancy

      illustration

    A Closer Look

     

      Talking to your MD

       

      Self Care

       

      Tests for Vaginal bleeding in pregnancy

       
       

      Review Date: 1/30/2020

      Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. 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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