Bleeding in early pregnancy does not always mean that you are miscarrying. It is quite common and this article will explain the possible reasons for bleeding in early pregnancy and what investigations should be performed.
We consider early bleeding to be bleeding that occurs up to 12 weeks of pregnancy. Around 20% of women will have some sort of bleeding in those first 3 months. Do not panic, the majority of pregnancies progress normally and lead to a perfectly healthy baby.
Spotting is a few drops of blood on your knickers, or a smear of blood on the toilet tissue. It is not enough to cover a panty liner. If it persists for more than a day, it is wise to get it checked out with your GP or call Helen, Dr Penman’s secretary to make a scan appointment. It may be accompanied by some mild cramps.
If you are needing to use a sanitary pad to stop the bleeding, this is more than just spotting and must be investigated. Dr Penman always has emergency appointments in his scan clinics each day. Please ring Helen on 07880701732 if you need an urgent scan.
The scan will tell Dr Penman what the cause is. He can check where the pregnancy is located, ensuring it is in the uterus, whether it is the right size for your dates etc.
Dr Penman may decide to do an internal examination and look at the cervix. If there is tissue coming through the cervix or the cervix is open, the pregnancy is miscarrying.
Unfortunately, if the pregnancy at this stage is going to miscarry, there is nothing that can be done to stop it from happening.
Causes of Early Pregnancy Bleeding
There are many causes of early pregnancy bleeding. It could be as a direct result of pregnancy or another gynaecological issue.
This is bleeding that occurs when the fertilised egg starts attaching to the endometrium or lining of the uterus. It can happen from around the time a menstrual period would be due or up to a week afterwards. This is assuming that the menstrual cycle is a regular 28 day cycle. This will be in the form of spotting/light bleed, nothing heavy and no clots and may continue for a few days. Don’t use tampons and don’t use a douche.
An ectopic pregnancy is a pregnancy that implants outside the uterus, usually in the fallopian tubes. The blood supply is inadequate and the tube distends, causing pain. This can be a medical emergency if the tube ruptures.
An ectopic pregnancy can cause mild bleeding and cramping pain. This should always be investigated.
1:60 pregnancies end in an ectopic pregnancy.
For more information ECTOPIC PREGNANCY INFO
The possibility of a miscarriage can be ruled out with an ultrasound scan with Dr Penman. There may be some cramping and mild bleeding, but the fetus has a heart beat and the cervix is closed. Bleeding will slowly stop and the pregnancy will continue. There is still a possibility that it may end in miscarriage but with a heartbeat and closed cervix, the odds reduce.
For more information MISCARRIAGE INFO
General Gynaecological Reasons
There could be other general gynaecological reasons for early pregnancy bleeding. These conditions may well be of no consequence under normal circumstances but during pregnancy they can bleed causing a lot of worry.
These could include cervical polyps – small overgrown areas of tissue on the cervix that under normal circumstances would not be causing any issues but with the increase in oestrogen due to the start of a pregnancy, they may start to bleed.
Or an ectropion – a small patch of cervical tissue that you may have no symptoms from, but once a pregnancy starts, the ectropion may bleed.
Investigations into Early Pregnancy Bleeding
Ultrasound scan is usually the investigation of choice as it is immediate and Dr Penman can reassure you that the pregnancy is progressing well.
He can check the position of the pregnancy and rule out an ectopic pregnancy as the cause. (usually there is pain too with an ectopic but not always)
Dr Penman can check the size of the fetal sac even at 6 weeks and monitor the heartbeat (6 weeks is the earliest this can be detected).A heartbeat at 6 weeks is very encouraging and the chances of this proceeding to miscarriage in this situation is less than 1:20.
Blood tests may also be performed to check the level of hCG(human chorionic gonadotrophin).
If this is lower than expected, it might mean you are not as far pregnant as you think, maybe your menstrual cycle is prolonged and you ovulated later than you thought. This is nothing to worry about, but have a repeat scan and blood test in a week. If your dates are correct, it might be a sign of a problem with the pregnancy. Dr Penman would recommend a further scan and blood test after a few days.
If the blood results are raising but slower than they should, this may be that the pregnancy is slowly failing.
If the blood results are falling, the pregnancy is ending and will miscarry.
If you want to book a scan with Dr Penman either as a routine or because you are experiencing bleeding,
call Helen on 07880701732 or you can book online and Helen will call you.