Vaginal Bleeding During Pregnancy, Second Trimester

A small amount of bleeding (spotting) is relatively common in pregnancy. It usually stops on its own. There are many causes for bleeding or spotting in 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

  • Infection, inflammation or growths on the cervix.

  • The placenta may partially or completely be covering the opening of the cervix inside the uterus.

  • The placenta may have separated from the uterus.

  • You may be having early/preterm labor.

  • The cervix is not strong enough to keep a baby inside the uterus (cervical insufficiency).

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

SYMPTOMS

  • Vaginal spotting or bleeding with or without cramps.

  • Uterine contractions.

  • Abnormal vaginal discharge.

  • You may have spotting or spotting after having sexual intercourse.

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.

  • If you are having uterine contractions, you may be given medication to stop the contractions.

  • If you have cervical insufficiency, you may have a suture placed in the cervix to close it.

HOME CARE INSTRUCTIONS

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

  • Keep track of the number of pads you use each day 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.

  • Do not exercise, do any strenuous activities or heavy lifting without your caregiver's permission.

SEEK IMMEDIATE MEDICAL CARE IF:

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

  • You have uterine contractions.

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

  • You develop chills.

  • You pass large clots or tissue.

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

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