Bleeding in pregnancy can be roughly divided and discussed in two groups.
Bleeding in early pregnancy i.e. before 13 weeks
Bleeding in later pregnancy
Bleeding in early pregnancy
It is common, occuring in about 15 to 25% of patients. It may not always be a serious problem. But it's better to inform your doctor even if you are having any brownish discharge and not actual bleeding. It may be accompanied with lower abdominal pain or menstrual like cramps.
Causes
Implantation bleeding - can occur few weeks post fertilisation, need to rule out other causes.
Pregnancy loss or miscarriage -
Around 1 in 5 pregnancy end in miscarriage. It may be threatened abortion, inevitable abortion, complete abortion, incomplete abortion, missed abortion. Treatment depends on the type.
Additional progesterone support may be added in injection,oral or vaginal form.
Subchorionic hemorrhage - It is not always problematic. It needs to be assessed individually.
Ectopic pregnancy - Implantation of embryo in location other than
normal, most commonly in fallopian tubes is called ectopic pregnancy.
Patient may have fainting, severe pain abdomen along with bleeding.
Molar pregnancy - A rare type of pregnancy, can be diagnosed on sonography.
Local cervical causes like infections or growth
Bleeding in late pregnancy
It is less common and can be a serious problem.
Causes
Placenta previa - When placenta covers the os partially or completely. Placenta may be low lying in earlier weeks but it usually shifts above as uterus increases in size. Persistent placenta previa in late pregnancy is a high risk pregnancy and needs close monitoring.
Placental abruption - When placenta detaches from uterus before delivery with internal and external bleeding. It can be very serious complications with multiple system involvement.
Preterm labour - Recurrent spotting with pain abdomen may occur.
Local cervical causes like infections and growth.
Disclaimer - These are the views of a qualified doctor and author. These are general suggestions and do not replace actual check up by a doctor. Any resemblance to anybody is coincidental.
Author information - Dr Harita N Kothia, Obstetrician and gynecologist, Mumbai.
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