Vaginal bleeding in pregnancy

Definition

Vaginal bleeding in pregnancy is any discharge of blood from the vagina during pregnancy.

Alternative Names

Pregnancy - vaginal bleeding; Maternal blood loss - vaginal

Considerations

Up to 1 in 4 women have vaginal bleeding at some time during their pregnancy. Bleeding is more common in the first 3 months (first trimester), especially with twins.

Causes

A small amount of light spotting or bleeding may be noted 10 to 14 days after conception. This spotting results from the fertilized egg attaching itself to the lining of the uterus. Assuming it is light and does not last very long, this finding is most often nothing to be concerned about.

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

During months 4 to 9, bleeding may be a sign of:

Other possible causes of vaginal bleeding during pregnancy:

Home Care

Avoid sexual intercourse until your provider tells you that it is safe to start having intercourse again.

Consume 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. Your provider will talk to you about the specific kinds of activity changes you may need to make.

Medicine is not needed in most cases. DO NOT take any medicine without talking with your provider.

Also, talk to your provider about what to look for, such as the amount of bleeding and color of the blood.

When to Contact a Medical Professional

Contact your provider if:

What to Expect at Your Office Visit

Your provider will take a medical history and perform a physical exam.

You will probably have a pelvic exam, or ultrasound as well.

Tests that may be done include:

You may be referred to a high risk pregnancy specialist (maternal fetal medicine specialist or perinatologist) for the duration of the pregnancy.

References

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 18.

Henn MC, Lall MD. Complications of pregnancy. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 173.

Turocy J, Williams Z. Early and recurrent pregnancy loss: etiology, diagnosis, treatment. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 16.



Review Date: 3/31/2024
Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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