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Vaginal bleeding in pregnancy

Pregnancy - vaginal bleeding; Maternal blood loss - vaginal

Vaginal bleeding in pregnancy is any discharge of blood from the vagina during pregnancy.

Considerations

Up to 1 in 4 women have vaginal bleeding at some time during their pregnancy. Bleeding is more common in the first 3 months (first trimester), especially with twins.

Causes

During the first 3 months, vaginal bleeding may be a sign of a miscarriage or ectopic pregnancy. Contact the health care provider right away.

During months 4 to 9, bleeding may be a sign of:

  • The placenta separating from the inner wall of the uterus before the baby is born (abruptio placentae)
  • Miscarriage
  • The placenta covering all or part of the opening to the cervix (placenta previa)
  • Vasa previa (babies blood vessels exposed across or near the internal opening of the uterus)

Other possible causes of vaginal bleeding during pregnancy:

  • Cervical polyp or growth
  • Early labor (bloody show)
  • Ectopic pregnancy
  • Infection of the cervix
  • Trauma to the cervix from intercourse (small amount of bleeding) or recent pelvic exam

Home Care

Avoid sexual intercourse until your provider tells you that it is safe to start having intercourse again.

Consume only fluids if the bleeding and cramping are severe.

You may need to cut down your activity or be put on bed rest at home.

  • Bed rest at home may be for the rest of your pregnancy or until the bleeding stops.
  • The bed rest may be complete.
  • Or, you may be able to get up to go to the bathroom, walk around the house, or do light chores.

Medicine is not needed in most cases. DO NOT take any medicines without talking to your provider.

Talk to your provider about what to look for, such as the amount of bleeding and color of the blood.

When to Contact a Medical Professional

Contact your provider if:

  • You have any vaginal bleeding during pregnancy. Treat this as a potential emergency.
  • You have vaginal bleeding and have placenta previa (get to the hospital right away).
  • You have cramps or labor pains.

What to Expect at Your Office Visit

Your provider will take a medical history and perform a physical exam.

You will probably have a pelvic exam, or ultrasound as well.

Tests that may be done include:

References

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 18.

Salhi BA, Nagrani S. Acute complications in pregnancy. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 178.

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    • Ultrasound in pregnancy

      Ultrasound in pregnancy

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    • Female reproductive anatomy

      Female reproductive anatomy

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    • Anatomy of a normal placenta

      Anatomy of a normal placenta

      illustration

    • Placenta previa

      Placenta previa

      illustration

    • Vaginal bleeding during pregnancy

      Vaginal bleeding during pregnancy

      illustration

      • Ultrasound in pregnancy

        Ultrasound in pregnancy

        illustration

      • Female reproductive anatomy

        Female reproductive anatomy

        illustration

      • Anatomy of a normal placenta

        Anatomy of a normal placenta

        illustration

      • Placenta previa

        Placenta previa

        illustration

      • Vaginal bleeding during pregnancy

        Vaginal bleeding during pregnancy

        illustration

      Talking to your MD

       

      Self Care

       

      Tests for Vaginal bleeding in pregnancy

       
       

      Review Date: 1/14/2018

      Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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