Every pregnancy is different; while some women have a blissful one, others may find it to be the toughest time of their lives, with one complication after the other. One of the problems that a considerable number of women encounter during pregnancy is vaginal bleeding, which can be quite scary though not always dangerous. Awareness of the possible causes and implications can help women cope better with the situation.
Whether or not the fate of a pregnancy is going to be influenced by bleeding, depends upon a variety of factors, such as the reason, the timing and the kind of bleeding which takes place (it may be spotting or profuse bleeding, or may be reddish, brownish or accompanied by expulsion of tissue). A woman should know about these factors so that she can recognize the potential dangers of bleeding during pregnancy.
Bleeding during the First Trimester
Bleeding in the first trimester of pregnancy is common phenomena as nearly 20% of women have reported experiencing the same during the initial 12 weeks of the pregnancy. At the same time, it is not necessarily dangerous. There could be a number of reasons for a woman bleeding during early pregnancy.
- Implantation Bleeding
As the name suggests, implantation bleeding occurs as the embryo harbors itself into the uterine lining, at a period of about 6-12 days after it is conceived. Implantation bleeding may not occur at all in some women, while others may have light spotting for a few hours and yet others may experience the same for a couple of days, corresponding with the expected period..
- Bleeding after intercourse
Another reason a woman may bleed during the first trimester of her pregnancy is when she has sexual intercourse, because the cervix is sensitive during this phase and may be influenced by sexual activity. A doctor needs to be consulted immediately and he will probably recommend the couple to abstain for the coming time, though there is nothing alarming about it. A cervical/vaginal infection could also lead to bleeding during pregnancy.
- Ectopic Pregnancy
A rare and potentially life threatening condition called ectopic pregnancy could be another cause of first trimester bleeding in a woman. An ectopic pregnancy is characterized by the embryo implanting itself outside the uterus, probably in the fallopian tube. The condition carries a great risk because the tube may burst as the embryo develops in size, posing threat to the life of the woman. Besides vaginal bleeding, strong abdominal cramps, pain and nausea are the symptoms of the condition, and it has to be treated by immediate surgical removal of the pregnancy.
- Molar Pregnancy
Another rare condition which may cause vaginal bleeding in early pregnancy is molar pregnancy. Medically termed as gestational trophoblastic disease, this condition occurs when there is an abnormal tissue growth in the uterus unlike the normal embryo implantation therein. The uterus enlarges rapidly and the woman suffers from nausea and vomiting, in addition to experiencing bleeding.
A miscarriage is the biggest cause of concern during the first trimester because most of them occur during the initial 12 weeks of gestation. Though bleeding during this time does not necessarily mean that miscarriage is going to ensue, but nearly half of the women may actually lose the baby after it occurs. However, vaginal bleeding alone is not the benchmark for miscarriage; it is suspected if bleeding is accompanied by symptoms such as strong abdominal cramps and passage of tissue from the vagina. A woman should consult her doctor immediately if these symptoms are manifested. Unfortunately, a miscarriage will take place if it is meant to be, because it is nature’s way of preventing an unhealthy pregnancy from reaching its completion
Bleeding during Second and Third Trimester
Unlike the first trimester bleeding, that during the second and third trimesters can point to threatening complications for the mother and the baby and would probably require medical intervention. Here are some possible reasons for the same:
- Placental Abruption
A woman may experience heavy and sudden vaginal bleeding along with abdominal pain uterine tenderness and expulsion of clots from the vagina, if the placenta gets detached from the uterine wall prior to the labor or during it. A rare condition, this is likely to happen during the last 12 weeks of the gestation. Women aged more than 35 years, those having gestational hypertension, stomach injuries and the ones who have had a placental abruption previously, come in the high risk group. The condition is a threat to both the mother as well as the baby.
- Placenta Previa
An uncommon condition in which the placenta lies low in the uterus and covers the birth canal completely or partially, placenta previa can be another reason of vaginal bleeding. This usually happens in the later part of third trimester and is usually painless, but needs emergency medical intervention. Multiple pregnancies, a previous C-section or uterine surgery could increase the risk of placenta previa.
- Vasa Previa
Vasa Previa is another rare condition, which happens when the baby’s blood vessels in the placenta or umbilical cord reach the opening of the birth canal. As the blood vessels may tear open, the life of the baby is at risk because of loss of oxygen and blood. Additionally, the fetal heart rate can become abnormally low in this condition.
- Ruptured Uterus
The uterus of a woman may rupture when a previous C-section scar tears up, which can be a major threat for the woman as well as the baby. This condition has symptoms such as bleeding, pain and abdominal tenderness, and is treated with an immediate Cesarean surgery.
- Preterm Labor
Another reason of vaginal bleeding in the second or third semester is the woman going into premature labor. The mucus plug, which is made from mucus and blood, of the woman may pass before labor sets in and the doctor needs to be seen at once if this is suspected; particularly, if the woman has not crossed 37 weeks of pregnancy. Symptoms like vaginal discharge, a dull backache, abdominal pressure and cramps and regular contractions should be taken seriously as signs of premature labor.
Bleeding during pregnancy should not be ignored, whichever trimester it occurs in, and the doctor should be consulted at once. The patient should inform him about the amount of bleeding as well as its type, whether it is pink, red or brown in color, or it is smooth or accompanied with clots/tissue. Also, sexual intercourse is to be avoided if bleeding is there. The doctor will have an ultrasound performed to find the exact cause of vaginal bleeding, though it cannot be established in many cases and women still deliver healthy, full-term babies. Though bleeding does not necessarily mean that there will be some misfortune, but it is always better to keep one’s best foot forward, more so in an event as delicate and crucial as pregnancy.
Gaudium IVF is a leading infertility clinic, which not only specializes in advanced reproductive techniques, but also helps the patients by generating awareness about all kinds of pregnancy-related complications. Visit Gaudium IVF Centre in Delhi for a free second opinion by the award winning fertility specialist, Dr Manika Khanna.