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Bleeding in early pregnancy

Bleeding in pregnancy occurs in 20-40% of all pregnancies. While relatively common, it can obviously be quite distressing if it happens.

What can cause bleeding in early pregnancy?

A number of things may cause bleeding in early pregnancy.

As the developing placenta creates connections to the mother’s blood vessels, some leakage may occur. This is called an “implantation bleed” and generally settles spontaneously.

Unfortunately, not all pregnancies continue and bleeding may be a sign of a miscarriage. The bleeding will tend to be heavier and may be associated with crampy pain.

One condition which needs to be excluded is ectopic pregnancy (where the pregnancy implants outside the cavity of the womb). This condition is potentially life threatening for the mother and needs to be diagnosed and treated promptly.

Bleeding may occur from other sources like the cervix, vagina, urinary tract or bowel, and be confused with bleeding associated with pregnancy.

What should you do if you have any bleeding in early pregnancy?

You should always seek advice and see a doctor promptly with any episode of bleeding, no matter how small. It is important that you seek advice so that the correct diagnosis can be made and the most appropriate treatment advice be given.

How do we find out what is going on?

In order to make the right diagnosis, your doctor will take a history (of the pregnancy and your symptoms), perform an examination (checking your abdomen for tenderness, using a speculum
to examine the cervix – similar to when you have a PAP smear), and organise some investigations (blood tests, ultrasound).

Once the diagnosis is clear, then they will be able to discuss with you what is the best management. This will vary depending on what the cause of the bleeding is (each one is a topic on their own!).

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