Bleeding During Pregnancy

Vaginal bleeding during pregnancy occurs frequently and may not be a sign of problems. However, you should contact your doctor or seek medical attention if bleeding continues. There are a few different causes related to vaginal bleeding. Below are brief explanations for bleeding during the first half of pregnancy which is followed by explanations for bleeding during the second half of pregnancy.

First Half of Pregnancy

Miscarriage

Bleeding does not mean that a miscarriage is happening, but it can be a sign. Approximately half of pregnant women who bleed do not have miscarriages. Approximately 15-20% of all pregnancies result in a miscarriage, and the majority occur during the first 12 weeks.

Signs of Miscarriage include:

• Vaginal bleeding
• Cramping pain felt low in the stomach (usually stronger than menstrual cramps).
• Tissue passing through the vagina

Most miscarriages cannot be prevented. They are often the body's way of dealing with a pregnancy that was not normal.

Ectopic Pregnancies

Ectopic pregnancies are pregnancies that implant somewhere outside the uterus. The fallopian tube accounts for the majority of ectopic pregnancies. Ectopic pregnancies are less common than miscarriages occurring in 1 of 60 pregnancies.

Signs of Ectopic Pregnancies:

• Cramping pain felt low in the stomach (usually stronger than menstrual cramps).
• Sharp pain in the abdominal area
• A ruptured ectopic pregnancy needs immediate treatment.

Women are at a higher risk if they have had:

• An infection in the tubes
• A previous ectopic pregnancy
• Previous tubal surgery

Molar Pregnancies

Molar pregnancies are a rare cause of early bleeding. Often referred to as a "Mole," a molar pregnancy involves the growth of abnormal tissue instead of an embryo. It is also referred to as gestational trophoblastic disease (GTD).

Vaginal bleeding is the only outward sign of a molar pregnancy.

Second Half of Pregnancy

Common conditions of minor bleeding include an inflamed cervix or growths on the cervix. Late bleeding may pose a threat to the health of the woman or the fetus. See your physician.

Placental Abruption

Vaginal bleeding may be caused by the placenta detaching from the uterine wall before or during labor. Only 1% of pregnant women have this problem, and it usually occurs during the last 12 weeks of pregnancy.

Signs of Placental Abruption:

• Bleeding
• Stomach pain

Women who are at higher risks for this condition include:

• Having already had children
• Are age 35 or older
• Have had abruption before
• Have sickle cell anemia
• High blood pressure
• Blows or injuries to the stomach
• Cocaine use

Placenta Previa

Placenta previa occurs when the placenta lies low in the uterus partly or completely covering the cervix. It is serious and requires immediate care. It occurs in 1 woman in 200. Bleeding usually occurs without pain. Women who are at higher risks for this condition include:

• Having already had children
• Previous cesarean birth
• Other surgery on the uterus
• Carrying twins or triplets

Preterm Labor

Vaginal bleeding may be a sign of labor. A small amount of mucus and blood is passed from the cervix. It is common and not a problem if it occurs within a few weeks of your due date. If it occurs earlier, you could be entering preterm labor and should see your physician immediately.

Signs of Preterm Labor include:

• Vaginal discharge (watery, mucus, or bloody)
• Pelvic or lower abdominal pressure
• Low, dull backache
• Stomach cramps, with or without diarrhea
• Regular contractions or uterine tightening

Reprinted with permission from American Pregnancy Association