1. Identify Harmless Bleeding
Bleeding during pregnancy, especially in the first trimester, is relatively common among pregnant women and doesn't mean you are having a miscarriage. Light spotting, known as implantation bleeding, may occur during the first two weeks of pregnancy, when the fertilized egg attaches to the uterus. This often is mistaken for a light period. However, implantation bleeding generally occurs right before your normal period cycle, is significantly lighter and is light brown to light red.
Harmless, early bleeding also may be due to changes in the cervix. During pregnancy, blood flow increases to the cervix. Vaginal bleeding can occur after you have sex or after a pelvic exam because of contact to the cervix.
Generally, bleeding during the last two trimesters is a cause for concern. However, there is one exception. Late in the final trimester, your cervix relaxes and thins in preparation for labor. Mucus, containing trace amounts of blood, that seals the opening of the cervix dislodges to cause a thick or stringy discharge from your vagina. This is often referred to as a "bloody show." It commonly indicates approaching labor and usually occurs two weeks or less before delivery.
Although all of these instances of bleeding are common and will not threaten the pregnancy, tell your doctor when bleeding occurs just to be sure it does not indicate something more serious.
2. Identify Life-Threatening Bleeding
During the first trimester, an ectopic pregnancy can cause heavy bleeding that may be life-threatening. This condition occurs when the embryo implants in the fallopian tube rather than the uterus. The bleeding is accompanied by abdominal and pelvic pain. The embryo cannot survive, and the excessive blood loss can threaten the mother.
Generally, signs of bleeding late in the pregnancy are serious. Vaginal bleeding can be caused by pre-term labor contractions that begin to open the cervix before week 37. A typical pregnancy lasts 38 to 42 weeks. If you are experiencing pre-term labor, you may experience contractions, a dull backache or pelvic pressure in addition to bleeding.
If you experience light to heavy bleeding accompanied by abominal pain,and you have eliminated other causes, you may have a placental abruption. Typically, the placenta will detach from the inner wall of your uterus during birth. On rare occasions, however, it separates prematurely, causing bleeding.
A uterine rupture is a serious but rare cause of bleeding. This event occurs when the scar line from a previous C-section tears the uterus open. Severe pain and tenderness in the abdomen accompanies the bleeding. This can occur before or during labor, and it represents a life-threatening complication that requires an emergency C-section.
3. Identify Potential Problems
Placenta previa is another potential problem, although it is relatively harmless. The placenta partially or completely covers the birth canal, causing vaginal bleeding. Typically, no pain is involved and the blood is bright red. Bleeding may stop, but it probably will return days or weeks later. Placenta previa usually is detected through ultrasound before you are at risk for miscarriage. Although treatable, diagnosis is key to keeping you and baby healthy.
A molar pregnancy, a rare condition in which an abnormal mass forms inside the uterus after fertilization, also can cause heavy bleeding. Get immediate treatment to remove the growth from your uterus if you are diagnosed with a molar pregnancy.
