Vaginal bleeding in pregnancy means bleeding that happens at any time during pregnancy before the delivery of the baby.
There are many causes of vaginal bleeding in pregnancy. It occurs in as many as 20% of pregnant women during the first trimester, or first three months of pregnancy. Bleeding can also take place later in pregnancy. A healthcare provider should check into any vaginal bleeding during pregnancy. Some causes of bleeding are not of concern. However, others may be life-threatening to the mother and baby.
Bleeding may be related to conditions other than the pregnancy itself. For example, vaginal tears or certain infections may lead to vaginal bleeding.
Following are some causes of vaginal bleeding during pregnancy:
Common causes of bleeding in late pregnancy are as follows:
Any symptoms that go along with vaginal bleeding during pregnancy should be reported to the healthcare provider. These include:
Diagnosis of vaginal bleeding during pregnancy begins with a medical history and physical exam. The healthcare provider may perform a pelvic examination. This will determine how much bleeding there has been, whether the cervix has opened, and whether fetal tissue is present in the vagina.
The healthcare provider may order these tests:
Early prenatal care will allow the healthcare provider to screen for pregnancy risk factors. Eating a balanced diet rich in folate may prevent miscarriages caused by genetic problems. Avoiding cigarettes, cocaine, and trauma may decrease the risk of the placenta detaching. Practicing safer sex methods can help prevent sexually transmitted diseases. These are a common cause of ectopic pregnancy.
The long-term effects of vaginal bleeding in pregnancy depend on the cause and severity. Potential effects are as follows:
Vaginal bleeding is not contagious. It poses no risk to anyone except the mother and child.
Not all vaginal bleeding in pregnancy needs treatment. If bleeding occurs but a miscarriage or early delivery does not take place, observation is all that is needed. Treatment for other causes is as follows:
Surgery may cause bleeding, infection, and allergic reaction to anesthesia. Blood transfusions carry the risk of infection and allergic reactions. All medicines have side effects, such as allergic reactions and stomach upset.
The aftereffects of vaginal bleeding depend on the underlying cause. Women with bleeding often have pregnancies that continue without further problems. In the event of a miscarriage, a woman may be advised by her healthcare provider to wait 3 to 4 months before attempting another pregnancy.
If premature labor is halted, medicines to relax the uterus may be needed to extend the pregnancy beyond the 36th week. If significant blood loss has occurred, iron and vitamin pills may be recommended to help regain health. Counseling or other supportive therapy might be helpful to relieve distress related to conditions such as miscarriage.
Monitoring depends on the cause of bleeding. In some cases, it may consist of a wait-and-see approach. Repeat pregnancy ultrasounds or blood tests may be used.
Women with molar pregnancies need careful monitoring, as molar pregnancies can recur. When a molar pregnancy comes back, small cells from the placenta can spread to other organs like cancer. Chemotherapy may be needed for a person with recurrent molar pregnancy.
Any additional episodes of vaginal bleeding should be promptly evaluated by the healthcare provider. New or worsening symptoms should be reported to the healthcare provider.
Author:Eva Martin, MD
Editor:Ballenberg, Sally, BS
Reviewer:Barbara Mallari, RN, BSN, PHN