Bleeding During Pregnancy: A Warning Sign
There are many causes of bleeding in pregnancy. Often slight bleeding will stop on its own, or the cause can easily be corrected. Sometimes, though, bleeding may become serious and may even cause shock from losing too much blood. You should call your doctor or seek medical advice as soon as you can if bleeding occurs.
What Happens in Pregnancy
Pregnancy occurs with the union of a sperm and an egg in the fallopian tube. After a few days, the fertilized egg becomes implanted in the wall of the uterus. In the first few weeks of pregnancy, the lining of the uterus (endometrium) becomes thickened with enlarged blood vessels in order to nourish the growing fetus.
After the egg implants in the uterus, the placenta, which is the connecting organ between mother and fetus, begins to grow. The placenta brings nourishment to the fetus and takes away waste.
Bleeding Early in Pregnancy
At the beginning of pregnancy, a few women may have slight bleeding (spotting or staining). This happens when the fertilized egg first attaches itself to the lining of the uterus; it is called implantation bleeding. Some women may confuse this bleeding with a menstrual period. A pregnancy test can confirm early pregnancy. The most accurate tests are those performed in a hospital or clinical lab. Home pregnancy tests are available, but you should discuss the results with your doctor.
During the first 3 months of pregnancy, there is a possibility of miscarriage. Miscarriage is the spontaneous loss of the fetus and placenta. If pregnancy is not progressing normally, the lining of the uterus may start to break apart and slough off, and the pregnancy ends. The medical term for a miscarriage is spontaneous abortion.
At least 15% of all pregnancies that continue beyond a missed menstrual period end in miscarriage. Miscarriage can occur at any time during the first half of the pregnancy, but most miscarriages occur during the first 3 months.
Two signals tell you something is wrong and there is a chance of miscarriage:
Vaginal bleeding (sometimes some tissue many also pass through the vagina)
Cramping pain (the pain often comes and goes and is felt as cramps low in the abdomen)
Many women who have vaginal bleeding have little or no cramping. Sometimes the bleeding stops, and pregnancy goes on without increasing risks to mother or fetus. At other times the bleeding and cramping continue, becoming increasingly stronger, and a miscarriage occurs. In some ways, a miscarriage feels like a less intense version of labour. The pain is usually stronger than menstrual cramps. If the bleeding is heavier than a menstrual period the best thing to do is contact your doctor right away.
Sometimes a woman may have repeated miscarriages. If a woman has two or three miscarriages in a row, she should discuss with her doctor whether she has a problem that may be corrected. She may be advised to see another doctor with specialized skills in a certain area.
Another problem that may cause bleeding in early pregnancy is the ectopic pregnancy. This is when pregnancy occurs outside the uterus, usually in the fallopian tube. Ectopic pregnancies are much less common than miscarriage, occurring in about 1% of all pregnancies. Symptoms of pelvic pain and vaginal bleeding result when the pregnancy develops in the fallopian tube and eventually causes it to rupture.
In an ectopic pregnancy, much of the bleeding is internal and may cause pain, weakness, fainting, and even shock.
Women who have had an infection in the fallopian tube (such as pelvic inflammatory disease) have an increased risk of ectopic pregnancy. If this applies to you, see your doctor promptly if you miss a period or have a positive pregnancy test.