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Vaginal bleeding in pregnancy

Pregnancy - vaginal bleeding; Maternal blood loss - vaginal

 

Vaginal bleeding in pregnancy is any discharge of blood from the vagina during pregnancy.

Considerations

 

Up to 1 in 4 women have vaginal bleeding at some time during their pregnancy. Bleeding is more common in the first 3 months (first trimester), especially with twins.

 

Causes

 

During the first 3 months, vaginal bleeding may be a sign of a miscarriage or ectopic pregnancy. Contact the health care provider right away.

During months 4 to 9, bleeding may be a sign of:

  • The placenta separating from the inner wall of the uterus before the baby is born (abruptio placentae)
  • Miscarriage
  • The placenta is covering all or part of the opening to the cervix (placenta previa)
  • Vasa previa

Other possible causes of vaginal bleeding during pregnancy:

  • Cervical polyp or growth
  • Early labor (bloody show)
  • Ectopic pregnancy
  • Infection of the cervix
  • Trauma to the cervix from intercourse (small amount of bleeding) or recent pelvic exam

 

Home Care

 

Avoid sexual intercourse until your provider tells you that it is safe to start having intercourse again.

Drink only fluids if the bleeding and cramping are severe.

You may need to cut down your activity or be put on bed rest at home.

  • Bed rest at home may be for the rest of your pregnancy or until the bleeding stops.
  • The bed rest may be complete.
  • Or, you may be able to get up to go to the bathroom, walk around the house, or do light chores.

Medicine is not needed in most cases. DO NOT take any medicines without talking to your provider.

Talk to your provider about what to look for, such as the amount of bleeding and color of the blood.

 

When to Contact a Medical Professional

 

Contact your provider if:

  • You have any vaginal bleeding during pregnancy. Treat this as a potential emergency.
  • You have vaginal bleeding and have placenta previa (get to the hospital right away).
  • You have cramps or labor pains.

 

What to Expect at Your Office Visit

 

Your provider will take a medical history and perform a physical exam.

You will probably have a pelvic exam as well.

Tests that may be done include:

  • Blood tests
  • Pregnancy ultrasound
  • Ultrasound of the pelvis

 

 

References

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 19.

Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 178.

 
  • Ultrasound in pregnancy

    Ultrasound in pregnancy - illustration

    The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing numbers of conditions in the fetus including meningomyelocele, congenital heart disease, kidney abnormalities, hydrocephalus, anencephaly, club feet, and other deformities. Ultrasound does not produce ionizing radiation and is considered a very safe procedure for both the mother and the fetus.

    Ultrasound in pregnancy

    illustration

  • Female reproductive anatomy

    Female reproductive anatomy - illustration

    External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.

    Female reproductive anatomy

    illustration

  • Anatomy of a normal placenta

    Anatomy of a normal placenta - illustration

    The placenta provides the fetus with oxygen and nutrients and takes away waste such as carbon dioxide via the umbilical cord.

    Anatomy of a normal placenta

    illustration

  • Placenta previa

    Placenta previa - illustration

    Placenta previa is a condition of pregnancy when the placenta implants in the lower part of the uterus, partly or completely obstructing the cervical outlet to the vagina (birth canal). 

    Placenta previa

    illustration

  • Vaginal bleeding during pregnancy

    Vaginal bleeding during pregnancy - illustration

    There are many possible causes of bleeding during pregnancy. Bleeding should always be evaluated by a health care provider.

    Vaginal bleeding during pregnancy

    illustration

    • Ultrasound in pregnancy

      Ultrasound in pregnancy - illustration

      The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing numbers of conditions in the fetus including meningomyelocele, congenital heart disease, kidney abnormalities, hydrocephalus, anencephaly, club feet, and other deformities. Ultrasound does not produce ionizing radiation and is considered a very safe procedure for both the mother and the fetus.

      Ultrasound in pregnancy

      illustration

    • Female reproductive anatomy

      Female reproductive anatomy - illustration

      External structures of the female reproductive anatomy include the labium minora and majora, the vagina and the clitoris. Internal structures include the uterus, ovaries and cervix.

      Female reproductive anatomy

      illustration

    • Anatomy of a normal placenta

      Anatomy of a normal placenta - illustration

      The placenta provides the fetus with oxygen and nutrients and takes away waste such as carbon dioxide via the umbilical cord.

      Anatomy of a normal placenta

      illustration

    • Placenta previa

      Placenta previa - illustration

      Placenta previa is a condition of pregnancy when the placenta implants in the lower part of the uterus, partly or completely obstructing the cervical outlet to the vagina (birth canal). 

      Placenta previa

      illustration

    • Vaginal bleeding during pregnancy

      Vaginal bleeding during pregnancy - illustration

      There are many possible causes of bleeding during pregnancy. Bleeding should always be evaluated by a health care provider.

      Vaginal bleeding during pregnancy

      illustration

    A Closer Look

     

      Self Care

       

      Tests for Vaginal bleeding in pregnancy

       

       

      Review Date: 4/5/2016

      Reviewed By: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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