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Bleeding in pregnancy: causes and what to do

Vaginal bleeding in pregnancy is a relatively common occurrence that does not always implicate something serious. However, it is important that it be assessed by a doctor as soon as detected, as it can be indicative of a serious issue.  

Slight losses of dark pink, red, or brownish blood may be normal and result from changes that occur in the woman’s body. However, they can also be symptoms of serious situations, such as a miscarriage, or an ectopic pregnancy, which is a pregnancy that occurs outside the uterus. In the case of serious situations like these, usually, the blood loss suddenly becomes more abundant, and the blood becomes bright red. 

The main conditions that can lead to blood loss in pregnancy are:

  • Spotting;
  • Ectopic pregnancy;
  • Subchorionic hematoma:
  • Placental abruption;
  • Placenta previa;
  • Miscarriage;
  • Uterine infection.

As there are many causes for pregnancy bleeding, which makes it difficult to distinguish between them, it is very important to visit an obstetrician as soon as possible so that the necessary exams and treatments can be carried out quickly.

Bleeding in pregnancy: causes and what to do

Additionally, the causes of the bleeding can vary according to the stage of pregnancy:

1. First trimester

Bleeding in the first trimester of pregnancy is common in the first 15 days after conception and, in this case, the bleeding is a pinkish color, lasts about two days, and causes cramps that are similar to period cramps. 

This may be the first pregnancy symptom in some women so it is important to carry out a pregnancy test. 

What it can be: even though this bleeding is normal during this stage of pregnancy if the bleeding becomes intense, very bright red, or accompanied by nausea and cramps, it can indicate a miscarriage or ectopic pregnancy, which is a pregnancy outside the uterus. 

What to do: it is important to be seen by an obstetrician or go to an emergency department in order to be checked and the cause for the bleeding diagnosed.

During the first three months of pregnancy, the mother may also present dark discharge, similar to coffee color, which appears on no particular day as it is not linked to a menstrual cycle. If this is the case, it could be subchorionic hematoma which can lead to a miscarriage. 

2. Second trimester

The second trimester of pregnancy includes the period of time between the 4th and the 6th month of pregnancy, which starts on week 13 and finishes on week 24 of the pregnancy. 

  • What it can be: after the first three months of pregnancy, pregnancy bleeding is not as common and so if it occurs it can indicate placental abruption, miscarriage, placenta previa, cervictis, or a wound in the uterus caused by contact.

  • What to do: it is recommended that the pregnant woman visits an obstetrician or an emergency department as soon as possible.

Serious blood loss generally comes with other warning signals, such as abdominal pain, fever, or a decrease in fetal movement. 

3. Third trimester

When the blood loss happens after the first 24 weeks of gestation, it may be a sign that labor has begun, although it may also indicate a problem.  

What it might be: in some cases, the blood loss can indicate placenta praevia or placental abruption. On the other hand, some women present blood loss at the end of pregnancy due to the onset of labor, loss of the mucous plug, and disruption of the membranes, which normally comes with irregular contractions that show the baby will be born shortly.  

What to do: the pregnant woman should go straight to the hospital and warn her obstetrician.

In the last three months, it is also common for the woman to bleed after sexual intercourse, as the birth canal becomes more sensitive, bleeding easily. In this case, the woman should only go to the hospital if the bleeding lasts more than one hour.

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