First Trimester Bleeding

It must be stressed that bleeding during any phase of pregnancy can be dangerous and you should consult your doctor if you notice any vaginal bleeding.

Any blood from the vagina can be categorised as vaginal bleeding (that is abnormal bleeding not associated with regular menstrual cycles).

The first trimester refers to the first three months of the pregnancy period, first trimester bleeding occurs during this period. Vaginal bleeding varies between light spotting and severe bleeding with clotting. Vaginal bleeding is common in early pregnancy, affecting 20-30% pregnancies.

Up to half of bleeding cases may go on to have a miscarriage. About 3% pregnancies are ectopic in location (the foetus is outside the uterus), which is life threatening for the mother.

• Incomplete miscarriage It may be incomplete miscarriage (or leading to miscarriage) if in the pelvic exam it shows the cervix is open and tissue, blood and clots are still passing. If the cervix remains open for too long, it might indicate the miscarriage isn’t complete. This may happen if there is an infection. This may also happen if the uterus is clamping down before all tissue passes.



• Completed miscarriage If bleeding and cramping slow down and the uterus appears empty. It may mean loss of pregnancy.
• Ectopic pregnancy Bleeding from an ectopic pregnancy is the most dangerous cause of first trimester bleeding. This happens when a fertilized egg implants outside of the uterus, mostly in the fallopian tube. The fertilized egg grows and can rupture the fallopian tube causing life-threatening bleeding. Symptoms may include pain, bleeding, or light-headedness. Most ectopic pregnancies result in pain by the tenth week of pregnancy.
• Threatened miscarriage The foetus is definitely still inside the uterus but the pregnancy outcome is not guaranteed. This can be because of infection, like infection of the urinary tract, dehydration, drugs or medications use, abnormal foetus development, or for no reason.
• Blighted ovum This is an embryonic failure. Intrauterine pregnancy can be detected through ultrasound. The embryo fails to develop even though it is in the proper location. This occurs if the foetus is not normal. It cannot be attributed to some mistake on anyone’s part.



• Implantation bleeding small amount of spotting because of implantation bleeding. While very minimal, it occurs on or around the same day as a period is due.
• Intrauterine foetal demise An intrauterine foetal demise (IUFD) may also occur. It’s also referred to as a missed abortion. It’s when the developing baby dies while in the uterus. This can occur at anytime during the pregnancy course and is detectable by ultrasound. The reasons for a threatened miscarriage if occurring in the early stages can lead to this. This is very uncommon during pregnancy’s second, third trimesters. Separation of the placenta and uterine wall (placenta abruption) can however cause this to happen. Another possible cause is insufficient blood flow to the placenta.

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