General Practice 2022

Bleeding in pregnancy: causes and what to do (by trimester)

Bleeding in pregnancy: causes and what to do (by trimester)
Bleeding in pregnancy: causes and what to do (by trimester)

Vaginal bleeding in pregnancy is a very common problem and does not always indicate serious problems, but it is important that it is evaluated by the doctor as soon as the woman notices its presence, as it is also possible that it indicates a serious situation.

Slight blood loss that is dark pink, red or brownish in color may be normal and result from changes that occur in a woman's body. However, they can also indicate worrying situations, such as a miscarriage or an ectopic pregnancy, which is pregnancy outside the uterus, for example, especially if they become abundant and bright red.

So, some situations that can lead to bleeding during pregnancy are:

  • Bleeding or spotting;
  • Ectopic pregnancy;
  • Ovular detachment;
  • Detachment of the placenta;
  • Placenta previous;
  • Spontaneous abortion;
  • Uterine infection.

As there are several causes, making it difficult to differentiate between the causes of bleeding, it is very important to seek the obstetrician's care as soon as possible, so that the necessary evaluations and treatments are carried out as soon as possible.

In addition, possible causes of bleeding may vary according to the period of pregnancy, and may be:

1. In the first quarter

Bleeding in the first trimester of pregnancy is common in the first 15 days after conception and, in this case, the bleeding is pink, lasts about 2 days and causes menstrual cramps.

This may be the first symptom that indicates pregnancy in some women, and it is important to confirm this by performing a pregnancy test.

  • What it could be: although this bleeding may be normal during this period, if it is intense, bright red or accompanied by nausea and cramps, it may indicate a miscarriage or an ectopic pregnancy, which is pregnancy outside the uterus.
  • What to do: it is important to immediately contact the obstetrician or go to the emergency room to assess possible causes.

During the first 3 months of pregnancy, a woman may also experience a dark colored discharge, similar to coffee grounds, which, as it is not related to the menstrual cycle, can appear on any day. In this case, because it may be an ovular detachment that can lead to miscarriage. See more details at: Ovular detachment.

2. In the second quarter

The second trimester of pregnancy includes the period of time between the 4th and 6th month of pregnancy, which begins at the 13th week and ends at the 24th week of pregnancy.

  • What it can be: From 3 months onwards, bleeding in pregnancy is uncommon and may indicate placental abruption, miscarriage, low insertion placenta, cervical infection of the uterus or an injury to the uterus caused by intimate contact.
  • What to do: It is recommended that the pregnant woman go to the obstetrician or emergency room as soon as possible.

Worrying bleeding is usually accompanied by other warning signs, such as abdominal pain, fever or decreased fetal movements, for example. Learn more about how to spot 10 warning signs in pregnancy.

3. In the third quarter

When bleeding occurs after 24 weeks of pregnancy, it can already indicate signs of labor, although it can also indicate some problems.

  • What it could be: Some situations can be placenta previa or placental abruption. In addition, some women may also experience minor bleeding towards the end of pregnancy due to labor, leakage of the mucus plug and rupture of the membranes, which is usually accompanied by irregular contractions that indicate that the baby will be born soon. Learn more about this normal bleeding at: How to identify the mucus plug.
  • What to do: the pregnant woman should immediately go to the emergency room and notify the obstetrician accompanying her.

In the last 3 months, it is still common for women to experience bleeding after intimate contact, since the birth canal becomes more sensitive, bleeding easily. In this case, the woman should only go to the hospital if the bleeding continues for more than 1 hour.

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