We distinguish between physiological or pathological vaginal spotting during pregnancy. The first type occurs in the form of implantation bleeding, while the second is caused by microtrauma of the mucous membrane during sexual intercourse, chronic infection, subchorionic hemorrhage or discharge of the plug (the final days before labor). Bleeding while pregnant is always a threatening symptom. It can develop in case of disturbance of the course of pregnancy – normal or ectopic or in case of a hydatidiform mole. It can also be associated with placental pathologies. It is required to consult a gynecologist, observing any amount of blood, discharged from the vagina. Among other things, bleeding also requires hospitalization.
Vaginal discharge in early pregnancy contains abundance of cervical mucus. In most cases, joining of blood admixtures, in the form of pink discharge, is an unfavorable symptom, which should be reported to a specialist.
Physiological vaginal spotting during pregnancy
Implantation is the process of the ovum’s “invasion” into the endometrial thickness (mucous lining of the uterine cavity). It can be accompanied by disturbed integrity of highly arborescent vascular network, which supplies blood to the mucous membrane, prepared to fertilization. This is when pink discharge or a few drops of brown blood on the underwear may be observed.
In order to tell implantation bleeding from any other type of bleeding, one should keep in mind, that:
- It occurs a few days prior to the anticipated periods and lasts for no more than 3 days;
- There is very little bloody discharge observed;
- Such scanty bleeding is never accompanied by pain (the only exception is overlapping of implantation with flatulency, when abdominal dragging pain is wrongly attributed to implantation or confused with uterine cramps);
- Early pregnancy symptoms are observed, namely: morning sickness, disturbance of taste, chronic fatigue and drowsiness.
Pathological vaginal spotting while pregnant
The relatedness of spotting to sex should be noted in the first place. Bloody spots on the underwear, following sexual intercourse can be indicative to:
- Microtraumas, including traumas of the mucous membrane of the uterine cervix, which, similar to the uterine mucous lining, is especially well nourished during pregnancy;
- Presence of a chronic sexually transmitted disease. In such cases, bloody discharge may be observed at any time, but most often it occurs after sex;
- Disturbed course of pregnancy, which may be associated with high uterine tonus or deficiency of the cervical os (it might be loose).
In order to prevent the last-mentioned condition, one should immediately consult a birth attendant, observing early pregnancy symptoms. Taking all the necessary tests, the doctor will carefully monitor the course of pregnancy and will let you know when it is required to abstain from sex, if necessary.
Subchorionic hemorrhage is rather an infrequent case. This phenomenon involves a little discharge of blood, which had been accumulated in the folds of the chorion – placental membrane. It is not virulent in itself, as long as the hematoma does not grow, mechanically exfoliating the placenta and endometrial lining. In order to accurately diagnose the SH and control its harmless course, it is required to inform your doctor about any type of spotting.
Pink discharge closer to the labor can also be associated with the mucous plug, which usually comes out a few days prior to labor. This is some kind of a “safety-lock”, which throughout the whole course of pregnancy separates your baby from the external environment. In weeks 39-41 it appears no more necessary and comes out on its own.
Vaginal bleeding during pregnancy – 4 causes
In the first situation, it should be noted that bleeding while pregnant is never physiological. It always indicates to a serious complication of pregnancy.
- The first and the saddest cause for the pregnant woman is interruption of childbearing. Interruption of pregnancy before the 22nd week, or before the weight of the fetus reaches 500g. is referred to as miscarriage, whereas later on it is considered to be premature delivery. Interruption of ectopic pregnancy is referred to the same category. On the early stages “eccyesis” develops similar to uterine pregnancy, however the course of pregnancy is interrupted as soon as the fetus reaches a certain weight. Symptoms that accompany these conditions are quite similar: bleeding, acute cramping pain, deterioration of general well-being.
- The second, fortunately, less frequent cause is the so-called hydatidiform This genetic pathology is about absence of the embryo in the growing ovum. Initially, this pathology involves processes, which are characteristic to normal pregnancy, but sooner or later, the “empty fetus” is being rejected. Presence of bubbles in the bloody discharge is a peculiar feature of a hydatidiform mole.
- The third cause of bleeding during pregnancy is premature abruption of а normally located placenta. As it has already been mentioned, the mechanism of this phenomenon involves development of a subplacental Abruption of the placenta is classified according to the level of completeness. Depending on its prominence, the doctor recommends the extent of medical intervention – Caesarean operation or applying conservative means of hemostasis (arrest of bleeding).
- Low insertion of the placenta, otherwise referred to as a placental presentation, constitutes the fourth possible factor, causing bleeding while pregnant. Normally, the “uterine cake” is inserted along the back or front uterine wall, a little above the place where it joins the cervix. Insertion of placenta lower, than the mentioned level is fraught with premature abruption and its affection by the fetal head during the first cramps.
Thus, any kind of bleeding during pregnancy requires immediate hospitalization. Observing bleeding the woman should try to keep calm and call an ambulance. To save the pregnant woman from unwanted emotional stress, the doctor will conduct a number of tests, including ultrasonography of the fetus, detecting the cause and prognosis of spotting while pregnant.