Bleeding in Pregnancy – Causes & Treatment

By Dr. Rakhi Rawat in Obstetrics & Gynaecology

Nov 10, 2020

Urine pregnancy test positive.wow! I am pregnant.

All family members are elated to welcome the new member in the family.  The mother to be experiences various symptoms of pregnancy some pleasant, others unpleasant. But when she has sudden bleeding per vaginum ,she gets frightened; about the well being of the unborn. Bleeding is a dangerous sign but not always a cause of concern.

Bleeding during 1st three months(First Trimester)

• Implantation bleeding
• Abortion or miscarriage
• Ectopic pregnancy
• Molar pregnancy
• Cervical changes during pregnancy, Infections

Bleeding during Second /Third trimester

• Placenta previa
• Abruptio placenta
• Vasa previa
• Onset of labour
• Polyps , Cancer
• Rupture of Uterus

IMPLANTATION BLEEDING spotting before periods, which is mistaken for periods, occurs when the fertilized egg implants itself in the lining of the uterus.  The bleeding is light and not dangerous.  

MISCARRIAGE OR ABORTION bleeding may lead to abortion but if fetal heart is seen on ultrasound and patient is given supportive treatment. With proper rest, she may continue her pregnancy and may not abort

ECTOPIC PREGNANCY outside uterus usually in fallopian tube is known as ectopic pregnancy if the embryo keeps on growing it can cause fallopian tube to rupture which can be life threatening to mother.

MOLAR PREGNANCY abnormal grape like tissue grows inside the uterus instead of baby. In rare cases it can be cancerous and spread to other parts of the body.

CERVICAL CHANGES IN PREGNANCY during pregnancy extra blood flows to the cervix. PAP test or intercourse can trigger bleeding due to increase blood supply but it not worrisome.

INFECTIONS An infection in the pelvic area or in bladder or urinary  tract may cause bleeding. They may be caused by bacteria, virus or fungus.  Bleeding stops when infection is cured.

PLACENTA PREVIA placenta lies low in the uterus and partially or completely covers the opening of the birth canal. It can cause painless bleeding.

ABRUPTIO PLACENTA separates from the uterus before or during labor and blood collects between placenta and uterus. It is a life threatening condition for mother and the baby.

VASA PREVIA is a rare condition wherein developing baby blood vessels in the placenta cross the opening to the birth canal which can tear open during labour causing the baby to bleed severely and loose oxygen dangerous to both mother and baby.

UTERINE RUPTURE uterus with previous scar (previous caesarean or any other uterine surgery)  might rupture during labour.

ONSET OF LABOUR when the cervix or the mouth of the birth canal starts opening the mucous plug that covers the opening  of the uterus pass out of vagina with small amount of blood known as bloody show, which is not worrisome but If the bleeding begins before the 37th weeks of pregnancy , it is a sign of pre-term labour.

CERVICAL POLYPS are usually benign, they can get inflamed/irritated during pregnancy and lead to bright red bleeding. They are easy to diagnose during routine pelvic examination.

When a women experiences bleeding

• she should consult her doctor immediately
• should wear a pad to keep track of amount of bleeding,
• Check color of blood (brown, red, clots)
• Don’t use tampon, avoid douching and intercourse
• Visit emergency room when the bleeding is heavy or bleeding associated pain or dizziness, chills, fever