Vaginal Bleeding During Pregnancy, First Trimester

ExitCare ImageA small amount of bleeding (spotting) is relatively common in early pregnancy. It usually stops on its own. There are many causes for bleeding or spotting in early pregnancy. Some bleeding may be related to the pregnancy and some may not. Cramping with the bleeding is more serious and concerning. Tell your caregiver if you have any vaginal bleeding.

CAUSES

  • It is normal in most cases.

  • The pregnancy ends (miscarriage).

  • The pregnancy may end (threatened miscarriage).

  • Infection or inflammation of the cervix.

  • Growths (polyps) on the cervix.

  • Pregnancy happens outside of the uterus and in a fallopian tube (tubal pregnancy).

  • Many tiny cysts in the uterus instead of pregnancy tissue (molar pregnancy).

SYMPTOMS

Vaginal bleeding or spotting with or without cramps.

DIAGNOSIS

To evaluate the pregnancy, your caregiver may:

  • Do a pelvic exam.

  • Take blood tests.

  • Do an ultrasound.

It is very important to follow your caregiver's instructions.

TREATMENT

  • Evaluation of the pregnancy with blood tests and ultrasound.

  • Bed rest (getting up to use the bathroom only).

  • Rho-gam immunization if the mother is Rh negative and the father is Rh positive.

HOME CARE INSTRUCTIONS

  • If your caregiver orders bed rest, you may need to make arrangements for the care of other children and for other responsibilities. However, your caregiver may allow you to continue light activity.

  • Keep track of the number of pads you use each day, how often you change pads and how soaked (saturated) they are. Write this down.

  • Do not use tampons. Do not douche.

  • Do not have sexual intercourse or orgasms until approved by your physician.

  • Save any tissue that you pass for your caregiver to see.

  • Take medicine for cramps only with your caregiver's permission.

  • Do not take aspirin because it can make you bleed.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You experience severe cramps in your stomach, back or belly (abdomen).

  • You have an oral temperature above 102° F (38.9° C), not controlled by medicine.

  • You pass large clots or tissue.

  • Your bleeding increases or you become light-headed, weak or have fainting episodes.

  • You develop chills.

  • You are leaking or have a gush of fluid from your vagina.

  • You pass out while having a bowel movement. That may mean you have a ruptured tubal pregnancy.