Many pregnant women experience bleeding and spotting at the beginning of pregnancy, specifically during the first trimester. However, not all bleeding or spotting during the first trimester of pregnancy is dangerous, although a medical evaluation is crucial. Doctors can determine the causes of bleeding in the first trimester through various tests and examinations. Once they identify the cause of the bleeding during pregnancy, they develop treatment and management plans.
Causes of bleeding during pregnancy
Nearly 15–25% of pregnant women experience bleeding during the first trimester.
Causes of bleeding in the first trimester:
- Implantation bleeding;
- Subchorionic bleeding;
- Early pregnancy loss;
- Infections and inflammation;
- Ectopic pregnancy.
Read below to learn more about the causes of bleeding in the first trimester:
Implantation bleeding
Light bleeding may occur 1–2 weeks after the fertilized egg implants into the endometrium. This common symptom is known as implantation bleeding and is not a cause for concern.
Subchorionic bleeding
Subchorionic bleeding occurs when bleeding happens between the chorion and the uterine wall. The chorion is the membrane surrounding the embryo that is attached to the uterine wall. The chorion eventually forms the placenta.
Subchorionic hemorrhage in pregnancy is usually diagnosed during an ultrasound examination. This condition can affect even uncomplicated pregnancies. Subchorionic hemorrhage during early pregnancy can increase the risk of preterm birth and miscarriage.
Early pregnancy loss
Doctors refer to early pregnancy loss as a “non-viable pregnancy.” People call this condition a spontaneous abortion or miscarriage.
There are several causes of early pregnancy loss. The most common cause (about half of cases) is chromosomal abnormalities in the fetus. Other causes and conditions include:
- Ectopic pregnancy;
- Gestational trophoblastic disease;
- Anembryonic pregnancy;
- Incomplete abortion;
- Infections, etc.
Signs of bleeding during pregnancy
Implantation bleeding presents as light bleeding or bleeding without other symptoms. Sometimes, pregnant women mistake implantation bleeding for a menstrual cycle disorder, as this can occur at or around the expected time of menstruation.
When bleeding occurs with early miscarriage, women may also experience other symptoms, such as uterine cramping. Another less common sign of early miscarriage is the disappearance of nausea, a common pregnancy symptom.
If vaginal bleeding during the first trimester of pregnancy is caused by an infection, women may experience fever, difficulty or pain during urination, and tenderness in and around the vagina.
Women with an ectopic pregnancy urgently need medical attention. Symptoms they may experience include lower abdominal pain (often on one side), vaginal bleeding, shoulder-tip pain, dizziness or fainting. If you have severe pain, dizziness or fainting, call an ambulance immediately.
Treatment
Implantation bleeding does not require treatment, as it is a normal occurrence in the first trimester and leaves no complications.
A miscarriage in the first trimester usually completes on its own, but sometimes medication or a surgical procedure (vacuum aspiration) is needed. Care can also include expectant management, where the miscarriage is allowed to complete on its own under medical monitoring.
For this reason, a pregnant woman experiencing bleeding during pregnancy should discuss the condition with a gynecologist and undergo the necessary examinations.
Important: Blood in urine during pregnancy
When should you see a doctor?
Women experiencing bleeding during the first trimester or at any stage of pregnancy should definitely consult a doctor. The doctor will likely order blood tests and perform a vaginal examination to determine the cause of the bleeding.
Bleeding does not always mean a miscarriage has occurred. If the doctor suspects any complications with the pregnancy, they will discuss appropriate treatment options together, which may include monitoring the pregnancy, expectant management (watchful waiting), medications, or surgery.
In conclusion, light bleeding during the first trimester is quite common. However, in some cases, bleeding can indicate early pregnancy loss. In such situations, doctors will first identify the cause of the bleeding. Some forms of bleeding are harmless, such as implantation bleeding. Other causes of vaginal bleeding, including subchorionic hematoma (subchorionic bleeding), require specialized examination.
Pregnancy problems: Increased uterine tone during pregnancy
