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First trimester bleeding and cramping

Many women experience bleeding and cramping during first trimester of pregnancy – one out of every two pregnant women experience first trimester bleeding and cramping. In most cases these symptoms can be nothing to worry about for the majority of women but sometimes they can be symptoms of miscarriage or ectopic pregnancy or infections or molar pregnancy.

First trimester bleeding and cramping – miscarriage

If you notice bleeding with fresh red blood and clots, possibly accompanied by cramping, it is the best to visit your doctor urgently as this can signal the start of miscarriage.

Miscarriage bleeding is likely to be heavy and dark in color, it could contain clots or clumps of tissue. When spotting first starts, it’s a good idea to wear a pad so you can monitor blood loss. When the amount of blood is the same or more than you usually have during monthly periods and combined with severe cramping, it could mean miscarriage with negative prognosis.

The combination of bleeding and cramping together is a stronger sign that there’s something wrong. According to statistics, about 15-20% of known pregnancies end up with miscarriages (mainly during first 12 weeks of pregnancy). So spotting and cramping in the early stages of pregnancy are serious.

Typical symptoms for miscarriage are also strong cramping in the lower abdomen and tissue passing through the vagina.

First trimester bleeding and cramping – ectopic pregnancy

Ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, usually in Fallopian tubes but sometimes in the ovaries, cervix or somewhere else in the pelvis, such as the bowel. Ectopic pregnancy cannot develop – the embryo implanted outside the uterus can’t develop into a normal baby. It can cause serious internal bleeding, vaginal bleeding and severe cramping. During ectopic pregnancy the grow can cause cramping – as a result of the expansion of the uterus ligaments and the hormonal processes that are needed for the pregnancy to progress. These kinds of painful cramps in lower tummy (often on one side) are very common during the first trimester. Besides the bleeding, women with ectopic pregnancy will experience cramping pain felt low in the stomach (usually stronger than menstrual cramps), sharp pain in the abdominal area combined with faint and nauseous and reduced levels of HCG.

First trimester bleeding and cramping

First trimester bleeding and cramping

Although ectopic pregnancies are rare, occurring one in every 150 pregnancies, they do happen. If left untreated, it can potentially harm future fertility.

Presently modern medications can treat tubal pregnancy without removing the Fallopian tube. Although ectopic pregnancy is potentially dangerous, it only occurs in about 2% of pregnancies.

First trimester bleeding and cramping – infections

During first trimester of pregnancy women could experience different types of infections which can trigger bleeding and cramping.

Infections such as urinary tract infections, which develop easily during pregnancy, can sometimes lead to blood in the urine from the bladder. Treatment is crucial as urinary tract infections have the potential to turn into a kidney infection, which can lead to premature labour.

Sometimes light bleeding can be the sign of vaginal infections (Chlamydia, yeast infection, trichomoniasis, gonorrhea, Gardnerella or herpes) – they can cause inflammation of cervix, bleeding and cramping. All vaginal infections should be immediately treated.

First trimester bleeding and cramping – molar pregnancy

Molar pregnancy occurs when an egg is fertilized but there is unusual abnormal cell growth. This mimics the true pregnancy with increased levels of HCG but combined with bleeding and cramping. In a molar pregnancy there is no embryo and therefore no heartbeat.

Bleeding is the most common symptom of molar pregnancy (often referred to as a “mole”). This is a very rare condition in which abnormal tissue grows inside the uterus after fertilization instead of a baby. In rare cases, the tissue is cancerous and can spread to other parts of the body (also called gestational trophoblastic disease).

Other symptoms of molar pregnancy are severe nausea and vomiting, rapid enlargement of the uterus, absent fetal heart tones and grape-like clusters are seen in the uterus by an ultrasound. Unusually high HCG levels are very typical for molar pregnancy.


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