10 Types Of Spotting Or Bleeding During Pregnancy That Require Your Doctor's Urgent Attention

Ideally, you shouldn't be spotting or bleeding if you're pregnant, so it can be alarming. Still, it depends on how far along you are in your pregnancy. 

Spotting or bleeding during the first trimester of pregnancy is quite common. About 20% of women have some bleeding within the first 12 weeks of pregnancy. Most women go on to have uncomplicated pregnancies and ultimately deliver a healthy baby.

If you're spotting or bleeding, it doesn't always mean you're having a miscarriage. Depending on what stage your pregnancy you're in, there are many possible causes of pregnancy bleeding. All of them, however, need your doctor's urgent attention. 

Why do pregnant women bleed in the first trimester

Implantation bleeding

Implantation bleeding occurs within six to 12 days following fertilization (when the sperm fertilizes the egg), and the resulting embryo attaches itself to the uterus's lining, also known as the endometrium. This can cause little blood vessels to burst, hence, a bit of spotting or bleeding.

Some women don't realize they are expecting, mistaking implantation bleeding for a light period. The discharge is color if implantation bleeding should be bright to dark red instead of your period, which is pale pink to dark brow. It should only last for a few hours up to three days max. 

According to the American Pregnancy Association (APA), implantation bleeding may be accompanied by light or faint cramping. It should be less painful than an average period cramp, and you may not even notice it.

Ectopic pregnancy

Typically, an ectopic pregnancy happens when the fertilized egg implants itself in the fallopian tube, carries the egg from the ovaries to the uterus instead of the uterine lining. Also called a tubal pregnancy, it's the most common type of ectopic pregnancy.

Sometimes, an ectopic pregnancy can also occur in the ovary, abdominal cavity, or the lower part of the uterus such as the cervix. On any account, there is no way to proceed with an ectopic pregnancy because the fertilized egg cannot survive outside of the uterus. 

The first red flags of an ectopic pregnancy would be light vaginal bleeding accompanied by pelvic pain. You may also feel shoulder pain or an urge to poop if blood leaks from the fallopian tube. Other symptoms depend on where blood collects and which of your nerves are affected. 

If not removed, the growing tissue may cause the fallopian tube rupture that can cause life-threatening bleeding for the mother. Alert your doctor if you experience extreme lightheadedness, fainting, and shock. 

Molar pregnancy

Also called gestational trophoblastic disease, a molar pregnancy is a very rare condition in which abnormal tissue grows inside the uterus instead of a baby. Although rare, the tissue may be cancerous and can spread to other parts of the body.

Aside from vaginal spotting or bleeding, other molar pregnancy symptoms are severe nausea and vomiting and accelerated uterus growth. An ultrasound can confirm a molar pregnancy. 

Cervical changes and infections

During pregnancy, your body produces more blood, and much of it is directed towards the pelvic area. It's why pregnant women have increased vaginal discharge. This makes them prone to infections in the vagina or cervix and even sexually transmitted illnesses (STI), which may cause bleeding in the first trimester.

Sex or a Pap test can also trigger some bleeding due to the increased blood flow down there. It usually isn't a cause of concern. 

Subchorionic hemorrhage

Also called subchorionic bleed or hematoma, subchrorionic hemmorhage is blood accumulation between the uterine lining and the chorion or the outer fetal membrane next to the uterus or under the placenta. This may cause bleeding in some pregnant women. 

The presence of subchorionic hemorrhage and vaginal bleeding increases a pregnant woman's risk of miscarriage. Your doctor can detect this during an ultrasound and prescribe medication to help stop the bleeding. 

Miscarriage or threatened miscarriage

If you're bleeding early in the pregnancy, a miscarriage must be ruled out first. Your doctor will be monitoring your pregnancy via ultrasounds to check if the fetus is still thriving and prescribe the necessary medication. 

A threatened miscarriage usually presents as bleeding and mild cramping, but the cervix is still intact, and the fetus is still viable. In some cases, the bleeding continues and eventually miscarries. 

Pregnancy bleeding during the second and third trimester

Placenta issues

Placental abruption is when the placenta detaches itself from the uterus prematurely before or during labor and causes blood to pool between the placenta and uterus. Aside from bleeding, placental issues may cause abdominal pain, back pain, tenderness in the uterus, and clots from the vagina.

Placenta previa is not an urgent matter if you're far from giving birth since it can move as your baby grows inside. It occurs in only one in 200 pregnancies during the third trimester.

Your age, family history, and underlying conditions such as hypertension or smoking and drinking alcohol during pregnancy can contribute to these placental complications. Your routine prenatal checkups should help you and your doctor monitor this.

Uterine rupture

In extremely rare cases, uterine rupture or the spontaneous tearing of the uterus happens late in the pregnancy or during active labor. The tear often happens along healed scar lines in women who have had prior cesarean deliveries.

Labor induction, giving birth to a large baby, uterine abnormalities, other uterine surgical procedures, advanced maternal age, and post-term delivery may also factor in a uterine rupture.

Symptoms of uterine rupture include vaginal bleeding, abdominal pain and tenderness, and a rapid pulse or other evidence of internal bleeding. 

Vasa previa

It's a rare condition wherein the developing baby's blood vessels in the umbilical cord or placenta are trapped between the fetus and the cervix. Vasa previa is life-threatening for the baby because the blood vessels can tear open, bleed, and cause him to lose oxygen.

Apart from excessive bleeding, another symptom of vasa previa is abnormal fetal heart rate.

Premature labor

Typically at 37 weeks pregnant or later, a preggo will experience a "bloody show," a red, pink, or brown discharge. It's one of the signs that you're about to go into labor . For many women, it happens simultaneously as they lose their mucus plug or the blood-tinged gelatin-like substance that detaches from the cervix's opening.

It's can also happen earlier than 37 weeks. If it does, you should alert your doctor and head to the hospital's emergency room right away since you might be in preterm labor.

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