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First trimester bleeding

First trimester bleeding (bleeding during first 3 months of pregnancy) could be a symptom of several health conditions. Vaginal bleeding may vary from light spotting to severe bleeding with clots and it can be very stressful for women especially with wanted pregnancies. One of the most frightening things is to experience bleeding during first trimester of pregnancy. It was noted that about 20-30% of all pregnancies experience vaginal bleeding in early stages of pregnancy development. The following situations could be causes for first trimester bleeding:

  • Period during pregnancy (?),
  • Implantation bleeding,
  • Decidual bleeding,
  • Bleeding because of cervical changes,
  • Miscarriage,
  • Ectopic or tubal pregnancy,
  • Molar pregnancy.

First trimester bleeding – Can be period during pregnancy?

In general normal period (not short! not light!) during normal pregnancy is not possible. If somebody told you about period during pregnancy, just listen politely and think about decidual bleeding, implantation bleeding or other threatening bleeding which could happen during pregnancy.

First trimester bleeding – Implantation bleeding

Implantation bleeding can occur anywhere from 6-12 days after possible conception. Many women experience implantation bleeding – some will lightly spot for a few hours, while others may have some light spotting for a couple of days. It happens when the fertilized egg attaches to the lining of the uterus.

First trimester bleeding – Decidual Bleeding

Decidual bleeding usually happens when the usual rise and fall of hormone levels is somehow disturbed and part of the uterine lining is caused to be shed periodically even when there is a pregnancy subsisting. This period-like discharge happens in the early part of the pregnancy, before the placenta has been fully established.

First trimester bleeding – Cervical changes

During pregnancy there is an increase in the blood supply and blood flow to the cervix. Any cervical contacts (intercourse, Pap test) can trigger bleeding. This type of bleeding isn’t cause for concern.

First trimester bleeding – Cervical Infections

Some cervical infections may cause bleeding during first trimester. Main causes for cervititis could be yeast infection and/or sexually transmitted diseases (STDs) such as chlamydia, gonorrhea, trichomoniasis, Gardnerella or herpes. All vaginal infections should be immediately treated.

First trimester bleeding – Cervical Polyps

Harmless small polyps can also cause bleeding during pregnancy. These are overgrowth of benign tissue, probably owing their existence to estrogen levels that made them grow. It is always better getting cervical polyps off as soon as possible.

First trimester bleeding

First trimester bleeding

First trimester bleeding – Miscarriage

If the bleeding occurs during the first trimester then it may be the sign of miscarriage. It is well known that about 15-20% of all pregnancies result in a miscarriage, and the majority occurs during first trimester of pregnancy. Typical symptoms for miscarriage are also strong cramps in the lower abdomen and tissue passing through the vagina.

First trimester bleeding – Ectopic pregnancy

Ectopic (tubal) pregnancy occurs when the fertilized egg implants outside the uterus (mostly in Fallopian tube). 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, feel faint and nauseous and have low/reduced levels of hormone hCG. Modern medicine 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 – Molar pregnancy

Bleeding is the most common symptom of molar pregnancy – it is pretty rare condition in which abnormal tissue grows inside the uterus after fertilization instead of a baby. Tissue can be cancerous and can spread to other parts of the body (also called gestational trophoblastic disease). Other symptoms of molar pregnancy include severe nausea, 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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