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Vaginal bleeding in pregnancy

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 commonin the first 3 months (first trimester), especially with twins.

Causes of Vaginal bleeding in pregnancy

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

During months 4 - 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 is covering all or part of the opening to the cervix (placenta previa)
  • Vasa previa

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 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 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.

Medication is not needed in most cases. Do not take any medicines without talking to your health care provider.

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

When to Contact a Health 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 exam.

You will probably have a pelvic exam 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. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 19.

Houry DE, Salhi BA. Acute complications of pregnancy In Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier; 2013:chap 178.

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.

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Review Date: 3/11/2014
Reviewed By: 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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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