Bleeding in Early Pregnancy

Bleeding in early pregnancy can occur in up to 20-40% of all pregnancies, and does may not necessarily mean you are going to have a miscarriage.  Many of the women with bleeding in early pregnancy will go on to deliver healthy babies in that pregnancy.  Understandably, it can be very distressing for many women, and it is important to seek medical attention in order to clarify the diagnosis.  Sometimes no cause can be found for the bleeding, and the bleeding just settles over time.  One possible cause is an “implantation bleeding”, when the developing placenta connects with the maternal circulation, and some leakage of blood occurs.  The amount of bleeding is usually small, and generally settles spontaneously.

Early pregnancyUnfortunately, if the bleeding is due to a miscarriage, there is no medical treatment that will stop the miscarriage from occurring.  However it is still very important to see your doctor, as sometimes the bleeding can be very heavy, and may require more urgent treatment.

The other serious cause of bleeding in early pregnancy is where the pregnancy is not situated within the womb (uterus), and this is known as an “ectopic pregnancy”.  This can affect around 1% of all pregnancies.  These pregnancies are usually growing within the Fallopian tube.  It usually presents with vaginal bleeding and abdominal pain.  It is important to see your doctor if you have these symptoms.

Other causes of bleeding may include a polyp or lesion at the cervix or vagina, and for this reason, it is important to seek medical attention and to establish the cause of the bleeding.

Pain in early pregnancy can be associated with vaginal bleeding

Internal Examination

It is important to have an internal examination to:

  • check for the cause of the bleeding
  • assess the amount of bleeding
  • sometimes swabs may be taken to look for signs of infection

An internal examination is safe, and will not cause a miscarriage.

Blood clots can be seen in women with heavy periods

Ultrasound Scan

An internal (transvaginal) scan can usually detect the baby’s heart beat from around 6 weeks gestation.  A vaginal scan offers the best possible view of the pregnancy.  A narrow probe is put inside the vagina, and this will feel similar to an internal examination, and is very safe for the pregnancy, and does not cause a miscarriage.

An ultrasound scan before 6 weeks will usually not give a definitive answer as to whether the pregnancy is viable, but may still be important especially if there is a possibility of an ectopic pregnancy.Ultrasound is safe during pregnancy

Blood Tests

A blood test can be done to check the pregnancy hormone level (hCG).  A single blood result however will not give a definitive answer as to whether the pregnancy is viable.  A repeat blood test for the hCG level after 48 hours may be helpful, to see if the hormone level is rising appropriately.

You may also need a blood test to check your blood group, and if your blood group is Rhesus negative, a prophylactic anti-D injection may be recommended if you have significant bleeding during the pregnancy.

Greenslopes Obstetrics and Gynaecology