Bleeding or spotting during pregnancy is a very common sign noticed by most pregnant women. Research indicates that around 12% of women report spotting or bleeding during their first 12 weeks of pregnancy. This bleeding is usually very light compared to your regular periods and often varies in colour from pink to red to brown. Although this spotting is not something you should worry about, but any kind of bleeding during your pregnancy has to be reported to your obstetrician to ensure the cause is validated to rule out anything serious and to make sure you and your baby are healthy.
This article will help you understand the causes of bleeding or spotting during each trimester.
First Trimester
As indicated earlier most women report spotting or bleeding in the first 3 months of their pregnancy. Possible causes of first trimester bleeding include:
Implantation bleeding: Bleeding that occurs when the fertilised egg implants itself into the uterine lining is called implantation bleeding. This is usually experienced within 6 to 12 days of conception, even before you know you are pregnant, and is often mistaken as a pending period. This bleeding is usually very light and lasts from a few hours to a few days.
Miscarriage: Miscarriage is one of the biggest concerns associated with the first trimester bleeding as it also occurs within 12 weeks of pregnancy. However, bleeding during the first trimester does not necessarily mean that you’ve lost the baby or going to miscarry. 90% of women who experience first trimester bleeding will not miscarry if there is a heartbeat noticed in the ultrasound.
Strong cramps in the lower abdomen and tissue passing through the vagina are the other symptoms of miscarriage.
Ectopic Pregnancy: An ectopic pregnancy occurs when the fertilised embryo implants outside of the uterus, usually in the fallopian tube. It occurs in about 2% of pregnancies and is potentially dangerous. If untreated immediately, the embryo keeps growing and can cause the fallopian tube to burst and can be life-threatening to the mother.
Molar pregnancy: This is a less common condition in which abnormal tissue grows inside the uterus instead of a baby. In some cases, this tissue is cancerous and can affect the other parts of the body.
Apart from bleeding, nausea and vomiting and rapid enlargement of the uterus are the other symptoms of this condition.
Second and Third Trimesters
Bleeding in the second or third trimester of your pregnancy calls for immediate attention as this may be more serious and can signal a problem with the mother or the baby. You must report to your Obstetrician with no further delay.
Here are few possible causes of bleeding in late pregnancy:
Placenta Previa: This is a condition when the placenta is attached to the lower part of the uterus and covers the cervix partially or completely. In this scenario, a vaginal delivery is not possible and a C-section is recommended as the placenta blocks the baby’s path of your body. This is very rare in the late third trimester, and stats show only 1 in 200 pregnancies have placenta previa. A bleeding placenta previa is an emergency which requires immediate medical attention.
Placental Abruption: This is a serious condition wherein the placenta detaches itself from the uterus wall before or during labor. The abruption usually causes stomach pain and the other symptoms may include abdominal pain, clots from the vagina, tender uterus and back pain.
Uterine Rupture: Uterine rupture occurs when a scar from a previous C-section tears open during pregnancy. This is a life-threatening condition and requires an emergency C-section. Pain and tenderness in the abdomen are the other symptoms of uterine rupture.
Vasa Previa: This is a very rare condition in which the developing baby's blood vessels in the umbilical cord cross the opening to the birth canal. Vasa previa can be very dangerous as it can cause the blood vessels to tear open which in turn causes the baby to bleed severely and lose oxygen. Abnormal fetal heart rate and excessive bleeding are signs to look out for.
Premature Labor: This is the most common sort of bleeding seen late in pregnancy wherein a small amount of blood with mucus leaves the body. This is an indication that your body is preparing for labor. This is also called as ‘Show’. If bleeding and symptoms of labor begin before the 37th week you should contact your obstetrician immediately as this might be a sign of preterm labor.
Contractions, vaginal discharge, abdominal pressure, and ache in the lower back are the other symptoms of Premature labor.
Other causes of bleeding in late pregnancy could be injury to the cervix or vagina, polyps or cancer.
What should you do if you have unusual bleeding during pregnancy?
Vaginal bleeding in any trimester should not be ignored and you should report to your Obstetrician immediately. Use a sanitary napkin to track the flow and record the type of blood. Do not use a tampon and refrain from having sex while you are bleeding. Make sure you bring any tissue that passes through your vagina to your obstetrician for testing.
You will be expected to undergo an ultrasound scan to understand the underlying cause of bleeding and treatment is given accordingly depending on the stage of your pregnancy.
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