Vaginal bleeding in pregnancy

Definition

Vaginal bleeding in pregnancy is bleeding coming through the vagina during pregnancy, for any reason.

Alternative Names

Pregnancy - vaginal bleeding; Maternal blood loss

Considerations

Up to 25% of women have vaginal bleeding at some time during their pregnancy, especially in the first 3 months (first trimester). Bleeding is even more common with twins.

Common Causes

During the first 3 months, vaginal bleeding may be a sign of a miscarriage or ectopic pregnancy. See the doctor right away. During months 4 - 9, bleeding may be a sign of:

• Abruptio placentae
• Miscarriage
• Placenta previa
• Vasa previa

Other possible causes of vaginal bleeding during pregnancy:

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

Home Care

Avoid sexual intercourse until your health care 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 decrease your activity or be put on bed rest at home 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.

Medication is usually not needed -- do not take any medication without talking to your health care provider.

Find out from your doctor what to expect -- how much you should be bleeding, and what color it should be.

Call your health care provider if

Contact your health care 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 health care provider's office

Your health care provider will take a medical history and perform a physical examination.

The physical examination will probably include a pelvic examination.

Tests that may be done include:

• Blood tests
• Pregnancy ultrasound
• Ultrasound of the pelvis

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References

Gabbe SG, Niebyl JR, Simpson JL, ed. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2007.

Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 176.

Cunningham FG, Leveno KL, Bloom SL, et al. Obstetrical hemorrhage. In: Cunningham FG, Leveno KL, Bloom SL, et al., eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 35.