Early pregnancy bleeding occurs in 20 – 30% of pregnancies and can be worrying, but it doesn’t always mean that there’s a problem. However, it can be a warning sign of a miscarriage or recurrent pregnancy loss. 

Reasons for Bleeding in Early Pregnancy

Most common reasons for bleeding in early pregnancy:

• A cause of light bleeding might be the fertilised egg implanting in your uterus. Implantation bleeding can occur from 6-12 days after possible conception. It can occur as some light spotting for a few hours or even for a couple of days.
• Bleeding can also be caused by some type of infection in the pelvic cavity or urinary tract.
• It may also be caused by your cervix softening, forming a raw area. This is called cervical erosion or ectropion. This could lead to bleeding after intercourse. If this happens, you should discontinue intercourse to prevent any further irritation, until you visit your doctor. Normal sexual intercourse does not cause a miscarriage!

Conditions Associated with Vaginal Bleeding

Main conditions associated with vaginal bleeding in early pregnancy:

• Threatened miscarriage: chances for entirely normal pregnancy and birth are 50%. If you have an ultrasound at the time of your evaluation, which shows a fetus with a heartbeat in the uterus, there is a 75%-90% chance of having a normal pregnancy.
• Ectopic or tubal pregnancy: a potentially serious condition where the pregnancy is outside the uterus. 
• Molar pregnancy: a rare condition where the placenta is abnormal.

What To Do In Case of Pregnancy Bleeding

• If you’re bleeding, wear a pad to monitor how much you’re bleeding and what type of bleeding you’re experiencing. Remember to keep track of the number of pads used and if the bleeding is increasing or decreasing.
• Never wear a tampon or introduce anything else into the vaginal area such as douche. 
• Do not have sexual intercourse, if you are currently experiencing bleeding.
• Contact your doctor, especially if the bleeding is accompanied by severe cramping.

Tests That Evaluate Early Pregnancy Bleeding

• A urine or a blood test to confirm pregnancy.
• Blood test to confirm blood type. If you have a Rh negative blood group, then you may be given an injection of anti-D immunoglobulin to protect future pregnancies.
• A vaginal ultrasound examination to confirm pregnancy. If a normal appearing pregnancy with a normal beating heart is seen by ultrasound inside the uterus and you are younger than 40 years, the pregnancy has a less than 3% chance of being a miscarriage. If you are older than 40 years, then there is an 8% chance of a miscarriage. If there is not a definite pregnancy seen within the uterus, then the likelihood of a miscarriage is really unknown but could be up to 50%. A repeat scan is usually necessary after 7 to 10 days, if the pregnancy is very small or has not been seen.

How to Prevent Early Pregnancy Bleeding

Avoid bleeding in pregnancy by controlling your risk factors, especially the use of tobacco and cocaine. If you have high blood pressure, work closely with your doctor to keep it under control.