Bleeding during pregnancy
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/bleeding-during-pregnancy/MY00628
Free
E-newsletter
Subscribe to Housecall
Our weekly general interest
e-newsletter keeps you up to date
on a wide variety of health topics.
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Definition
Vaginal bleeding during pregnancy can be scary. It's common, however, and it isn't always a sign of trouble. Most women who experience vaginal bleeding during pregnancy — particularly during the first trimester (weeks one through 12) — go on to deliver healthy babies.
Still, it's important to take vaginal bleeding during pregnancy seriously. Sometimes vaginal bleeding during pregnancy indicates an impending miscarriage or a condition that needs prompt treatment. By understanding the most common causes of vaginal bleeding during pregnancy, you'll know what to look for — and when to contact your health care provider.
Causes
Vaginal bleeding during pregnancy has many causes. Some are serious, and some aren't.
First trimester
Possible causes of vaginal bleeding during the first trimester, listed in alphabetical order, include:
- Cervical cancer
- Cervical changes, including more blood flow to the cervix and softening of the cervix, which may result in harmless vaginal bleeding after sex or a pelvic exam
- Ectopic pregnancy
- Implantation bleeding: Normal in early pregnancy? (which occurs about 10 to 14 days after fertilization when the fertilized egg attaches to the lining of the uterus)
- Miscarriage
- Molar pregnancy (a rare occurrence in which an abnormal mass — instead of a baby — forms inside the uterus after fertilization)
- Some cervical infections
Second or third trimester
Possible causes of vaginal bleeding during the second or third trimester, listed in alphabetical order, include:
- Miscarriage
- Placenta previa
- Placental abruption
- Premature opening of the cervix (cervical insufficiency), which can lead to preterm birth
- Preterm labor, which may result in light bleeding — especially when accompanied by regular contractions, dull backache or pelvic pressure
- Problems with the cervix, such as a cervical infection, inflamed cervix or growths on the cervix
- Uterine rupture, a rare but life-threatening occurrence in which the uterus tears open along the scar line from a prior C-section
Normal vaginal bleeding near the end of pregnancy
In addition to potentially worrisome causes of bleeding, some vaginal bleeding near the end of pregnancy is normal. As the cervix begins to thin out and relax in preparation for labor, the thick plug of mucus that seals the opening of the cervix is dislodged. When this happens, you might notice a thick or stringy discharge that may be tinged with blood. This "bloody show" is a normal sign of impending labor that can occur up to a week or two before delivery.
When to see a doctor
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
- Contact your health care provider immediately if you have vaginal bleeding 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.
- Norwitz ER, et al. Overview of the etiology and evaluation of vaginal bleeding in pregnant women. http://www.uptodate.com/home/index.html. Accessed Dec. 28, 2010.
- Garner EI. Gestational trophoblastic disease: Management of hydatidiform mole. http://www.uptodate.com/home/index.html. Accessed Dec. 28, 2010.
- Lockwood CJ. Pathogenesis of spontaneous preterm birth. http://www.uptodate.com/home/index.html. Accessed Dec. 28, 2010.
- Bleeding during pregnancy. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp038.cfm. Accessed Dec. 28, 2010.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 4, 2011.
Share on:
Find Mayo Clinic on