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Vaginal bleeding in pregnancy
Definition
Vaginal bleeding in pregnancy is bleeding coming through the vagina during pregnancy, for any reason.
Alternative Names
Pregnancy - vaginal bleeding; Maternal blood loss
Considerations
Up to 25% of women have vaginal bleeding at some time during their pregnancy, especially in the first 3 months (first trimester). Bleeding is even more common with twins.
Causes
During the first 3 months, vaginal bleeding may be a sign of a miscarriage or ectopic pregnancy. See the doctor right away. During months 4 - 9, bleeding may be a sign of:
- Abruptio placentae
- Miscarriage
- Placenta previa
- Vasa previa
Other possible causes of vaginal bleeding during pregnancy:
- Cervical polyp
- Early labor (bloody show)
- Ectopic pregnancy
- Infection of the cervix
- Trauma to the cervix from intercourse (small amount of bleeding)
Home Care
Avoid sexual intercourse until your health care provider tells you that it is safe to start having intercourse again. Drink only fluids if the bleeding and cramping are severe.
You may need to decrease your activity or be put on bed rest at home 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.
Medication is usually not needed -- do not take any medication without talking to your health care provider.
Find out from your doctor what to expect -- how much you should be bleeding, and what color it should be.
When to Contact a Medical Professional
Contact your health care 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 health care provider will take a medical history and perform a physical examination.
The physical examination will probably include a pelvic examination.
Tests that may be done include:
- Blood tests
- Pregnancy ultrasound
- Ultrasound of the pelvis
References
Gabbe SG, Niebyl JR, Simpson JL, ed. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2007.
Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 176.
Cunningham FG, Leveno KL, Bloom SL, et al. Obstetrical hemorrhage. In: Cunningham FG, Leveno KL, Bloom SL, et al., eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 35.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
