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Vaginal bleeding in pregnancy
Pregnancy - vaginal bleeding; Maternal blood loss - vaginalVaginal bleeding in pregnancy is any discharge of blood from the vagina during pregnancy.
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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.
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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
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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.
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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.
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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
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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.
