Causes of Pregnancy Bleeding
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Summary: Bleeding during pregnancy can be a dangerous sign. Contact your health
care provider right away if you experience any vaginal bleeding during
pregnancy.
Your health care provider will want to know the quantity of blood (how many pads have you soaked through) and the quality of bleeding or sometimes called spotting (color, clots or tissue, etc). If you pass any clots, you may be asked to bring them with you to be analyzed in the lab. Pay close attention to any other symptoms you experience combined with the bleeding. Other symptoms could include dizziness, extreme thirst, fatigue, or fainting. Any time that you feel that something is not right, contact your health care provider. Staying in close contact with your provider can help you avoid pregnancy complications.
Early pregnancy bleeding can be caused by many factors. It is estimated that one in four women will have some bleeding during the early stages of pregnancy. The most common reason for bleeding in the first trimester is implantation. Implantation bleeding can occur 10 to 14 days after fertilization when the embryo implants itself into the uterine wall. Implantation bleeding is generally light and is not a cause for concern. Implantation bleeding is sometimes mistaken for a light period. Bleeding combined with cramping can be the symptom of a threatened miscarriage. Threatened miscarriages are sometimes caused by medications, dehydration, urinary tract infections, or physical trauma. They can also appear with no specific cause. Threatened miscarriages are not caused by stress, sexual intercourse, or other normal physical activity. Bleeding, known as post-coital bleeding, sometimes occurs after sexual activity. Post-coital bleeding is normal. Although bleeding in the first trimester is common, contact your health provider to be on the safe side.
Some early pregnancy bleeding can be a sign of a serious problem. A miscarriage will cause bleeding. A miscarriage can either be incomplete (in progress) or complete (finished). A completed miscarriage is also known as a spontaneous abortion, which means you have lost the pregnancy. Miscarriage is the most common type of pregnancy loss. Possible causes for miscarriage include hormonal issues, infection, smoking, drug use, poor nutrition, excessive caffeine consumption, maternal age, trauma, or by the embryo not implanting properly. Bleeding can also be caused by an embryo that fails to develop normally, which is known as embryonic failure or blighted ovum. Embryonic failure occurs when a fetus is abnormal in some way; it does not have anything to do with your actions. Intrauterine fatal demise (IUFD), commonly called a missed abortion, still birth, or embryonic demise, can cause bleeding as well. IUFD occurs when the baby dies in the uterus. This term is generally applied to pregnancy losses occurring after 20 weeks of gestation
The most serious cause of early pregnancy bleeding is an ectopic pregnancy. Ectopic pregnancy can be life threatening due to complications that lead to heavy blood loss. Ectopic pregnancy is sometimes called tubal pregnancy, because the embryo implants outside of the uterus – often in the fallopian tube. A growing embryo threatens to rupture the fallopian tube, which can lead to life threatening blood loss. The first symptoms of ectopic pregnancy are vaginal bleeding and intermittent sharp, stabbing pain in your pelvis or abdomen. Other symptoms include dizziness, fainting, low blood pressure, and lower back pain. The risk of ectopic pregnancy can be increased by getting pregnant while on the pill or when using the morning after pill, pelvic inflammatory disease (PID), endometriosis, previous surgery on the fallopian tube, previous ectopic pregnancy, infertility problems, or medication used to stimulate ovulation. Alert your health care provider if you feel that you are at risk. Call your doctor immediately if you are at risk and experience any of the above symptoms.
An uncommon cause of pregnancy bleeding is a molar pregnancy. It's not an actual pregnancy. An ultrasound will reveal that the tissue in your uterus is not a fetus; it is abnormal tissue. In rare cases, the abnormal tissue can be cancerous and spread throughout your body. Symptoms may include dizziness, nausea, vomiting, vaginal bleeding, increased hCG levels, high blood pressure, rapidly growing uterus, and no fetal movement or heartbeat detected. The exact cause of molar pregnancy is unknown, but researchers speculate it is caused by a problem during fertilization.
Late pregnancy bleeding can be caused by several factors. The most common causes of bleeding at this late stage are complications involving the placenta. The is an organ that develops in the uterus and functions as the life support system for the baby by providing nourishing oxygen and nutrients, as well as removing waste products. Placenta previa occurs when it's partially or completely covers the opening of the cervix. Symptoms include bright red painless bleeding or premature contractions. Risk factors include multiple pregnancies, prior placenta previa, and prior cesarean delivery. Placenta previa can be fatal for the baby or the mother. It can cause jaundice and respiratory distress syndrome in babies, and serious blood loss in mothers. Fortunately, this can easily be detected by ultrasound.
Placental abruption is a dangerous condition that occurs when it separates from the uterine wall before birth. Placental abruption can be partial or complete (total). It causes internal bleeding. The severity of the bleeding depends on the location of the uterus and the type of separation. In severe cases the babies may have to be delivered and the mother may have to have a blood transfusion – depending on the amount of blood loss. Symptoms include vaginal bleeding, contractions, abdominal pain, rapid contractions, and fetal heart rate distress. The cause is not known. However, risk factors can include smoking, drug use, a maternal age of over 35, preeclampsia or hypertension, previous placental abruptions, trauma, or abnormalities of the uterus. If you experience any of the associated symptoms, seek medical care immediately.
Uterine rupture, rupturing of the uterus, can cause late term pregnancy bleeding. Uterine rupture is rare and extremely dangerous for baby and mother. Risk factors for uterine eruption can include: trauma, multiple pregnancies (four or more), excessive use of medicine to start contractions, baby’s position, and delivery with forceps. Uterine rupture poses a serious threat to baby’s and mother’s life. Alert your health provider if you feel that you are at risk for uterine rupture, so that you can obtain the best possible care for you and baby.
Contact your doctor when you have any abnormal vaginal bleeding during pregnancy. Even if the bleeding is light, it is important that a doctor evaluates your condition.
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