Bleeding during pregnancy

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When to see a doctor

By Mayo Clinic staff

It's important to report any vaginal bleeding during pregnancy to your health care provider. Be prepared to describe how much blood you passed, what it looked like, and whether it included any clots or tissue.

First trimester
During the first trimester (weeks one through 12):

  • Tell your health care provider at your next prenatal visit if you have spotting or light vaginal bleeding that goes away within a day.
  • Contact your health care provider within 24 hours if you have any amount of vaginal bleeding that lasts longer than a day.
  • Contact your health care provider immediately if you have moderate to heavy vaginal bleeding, pass tissue from your vagina, or experience any amount of vaginal bleeding accompanied by abdominal pain, cramping, fever or chills.

Second trimester
During the second trimester (weeks 13 through 24):

  • Contact your health care provider the same day if you have light vaginal bleeding that goes away within a few hours.
  • Contact your health care provider immediately if you have any amount of vaginal bleeding that lasts longer than a few hours.
  • Contact your health care provider immediately if you have any amount of vaginal bleeding accompanied by abdominal pain, cramping, fever, chills or contractions.

Third trimester
During the third trimester (weeks 25 through 40):

  • Contact your health care provider immediately if you have any amount of vaginal bleeding before 37 weeks or the bleeding is accompanied by abdominal pain.

In the final weeks of pregnancy, remember that a bloody show — a thick or stringy discharge that may be tinged with blood — is a normal sign of impending labor.

References
  1. Norwitz ER, et al. Overview of the etiology and evaluation of vaginal bleeding in pregnant women. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  2. Garner EI. Management of hydatidiform mole. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  3. Lockwood CJ, et al. Management of placenta previa. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  4. Lockwood CJ. Pathogenesis of preterm birth. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  5. Tulandi T, et al. Spontaneous abortion: Risk factors, etiology, clinical manifestations, and diagnostic evaluation. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  6. Johnson JR, et al. Cervical insufficiency. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  7. Ananth CV, et al. Clinical features and diagnosis of placental abruption. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  8. Tulandi T. Clinical manifestations, diagnosis, and management of ectopic pregnancy. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  9. Berghella V. Repeat cesarean delivery. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  10. Chiang JW, et al. Epidemiology, clinical manifestations and diagnosis of gestational trophoblastic disease. http://www.uptodate.com/home/index.html. Accessed Feb. 10, 2009.
  11. Bleeding during pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp038.cfm. Accessed Feb. 10, 2009.
  12. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 16, 2009.

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June 9, 2009

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