Prenatal bleeding can be terrifying. Although most women immediately fear the potential for miscarriage, there are many other possible causes for bleeding during pregnancy. We will discussing the various causes for prenatal bleeding and what can be done in each scenario.
Implantation Bleeding:
One potential cause of prenatal bleeding is implantation bleeding. Implantation bleeding occurs between 10 and 14 days following conception. Implantation bleeding occurs in approximately one-third of pregnancies. Often, this occurs prior to when women even know that they are pregnant. Implantation bleeding can be a normal part of pregnancy and should only last for a one or two days.
Sexual Activity:
A second potential cause of bleeding during pregnancy is sex. During pregnancy, there is increased blood flow to the cervix. Sexual activity may irritate the cervix, resulting in spotting. The bleeding should be painless and can be pinkish, brown or light red. If you do experience postcoital bleeding, it is important that you contact your provider for evaluation. Your provider may recommend that you hold off on sexual activity.
Infection:
A third potential cause of prenatal bleeding is infection. Infections, including both sexually and non-sexually transmitted diseases, can cause spotting during pregnancy. If you suspect that you may have an infection, it is important to reach out to your provider for an examination, Often, a simple culture done in the office can be performed to rule out the possibility of infection.
Subchorionic Hematoma:
A fourth potential cause of bleeding during pregnancy is subchorionic hematoma. When women have this condition, blood forms between the wall of the uterus and the chorionic membrane. Although a subchorionic hematoma does not always involve symptoms, some pregnant women experience heavy bleeding as a sign of this condition. An ultrasound can be used to diagnose subchorionic hematoma. Your provider may recommend decreased physical activity or even bedrest following this diagnosis.
Cervical Polyps:
Cervical polyps are a fifth potential cause for spotting during pregnancy. A cervical polyp is a noncancerous growth on the cervix. The polyp may bleed due to increased estrogen levels. A cervical polyp is diagnosed via pelvic examination. Although cervical polyps can be removed in the office setting, your provider may elect to hold off on removing the polyp until after delivery
Ectopic Pregnancy:
A sixth potential cause of prenatal bleeding is ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg grows outside of the uterus. Some of the first warning signs of an ectopic pregnancy include light bleeding and pelvic pain. Ectopic pregnancy can be a life-threatening condition, so it is important for women to immediately seek medical attention.
Miscarriage:
A final potential cause of bleeding during pregnancy is miscarriage. If you are experiencing a miscarriage, the bleeding can vary from very light to heavy. The bleeding can be intermittent and is often associated with cramping. In some cases, such as in the setting of a missed miscarriage, bleeding may not occur. Depending on the stage of pregnancy, miscarriage can be diagnosed by ultrasound or serial hCG laboratory testing.
Closing Message:
Bleeding during pregnancy can be frightening for expectant parents. Although prenatal bleeding may indicate a miscarriage, there are several other potential causes for bleeding. It is important that you reach out to your provider if you experience bleeding during pregnancy, as an evaluation is often indicated.
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