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Pregnancy first trimester bleeding

Bleeding during pregnancy could be dangerous at all phases. First trimester bleeding is any vaginal bleeding during the first 3 months of pregnancy. 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 in the first part of the pregnancy. Vaginal bleeding is a common problem in early pregnancy, complicating 20-30% of all pregnancies.

Pregnancy first trimester bleeding causes

  • Period during pregnancy (???)
  • Implantation Bleeding
  • Decidual Bleeding
  • Bleeding because of cervical changes
  • Miscarriage
  • Ectopic or Tubal pregnancy
  • Molar pregnancy
Important to know:

If you have bleeding during first trimester of pregnancy, it is recommended to wear a pad or panty liner so that you can monitor how much you are bleeding and what type of bleeding you are experiencing. It is very important information for doctors.

During bleeding (even very light bleeding) never use tampons or introduce anything else into the vaginal area such as douche or sexual intercourse.

If you are experiencing any kind of bleeding during first trimester of pregnancy in combination with pain, weakness, nausea, etc., immediately contact your doctor.

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.

Implantation bleeding

Bleeding during pregnancy

Bleeding during pregnancy

Implantation bleeding can occur anywhere from 6-12 days after possible conception. Every woman will experience implantation bleeding differently—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. This kind of bleeding is lighter and spottier in color than a normal menstrual period. Some women don’t realize they are pregnant because they mistake this bleeding for a light period. It doesn’t last for long and should not be mistaken as a menstrual cycle.

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. It is common that this period-like discharge happens in the early part of the pregnancy, before the placenta has been fully established. Decidual bleeding is more common during the early part of pregnancy, however many women do continue to get a period like discharge throughout their pregnancy. This is usually not something that has to be worried about generally.

Decidual bleeding is usually a hormonally stimulated collection of menstrual-like tissue that can often be confused with a miscarriage. The stabilization of the uterine lining depends on estrogen and progesterone. It’s possible that there are lags in the amounts of hormones so that lining not involved with implantation loses its grip and sheds. In general such shedding of only decidual tissue has no impact on pregnancy development. If it’s just tissue debris, it can mean nothing.

Cervical changes

During pregnancy there is an increase in the blood supply and blood flow to the cervix. Intercourse or a Pap test, which cause contact with the cervix, can trigger bleeding. This type of bleeding isn’t cause for concern.

Cervical Infections

Some cervical infections (called cervicitis) also may cause bleeding in early pregnancy. 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.

Cervical Polyps

Harmless small polyps can also cause bleeding during pregnancy. These are overgrowths of benign tissue, probably owing their existence to estrogen levels that made them grow. Most often they can be gently and painlessly twisted off during a physical exam. If not, they’re usually destroyed by the very act of delivering the baby. It is always better getting cervical polyps off as soon as possible.


If the bleeding occurs during the first trimester then it may be the sign of miscarriage. Approximately 15-20% of all pregnancies result in a miscarriage, and the majority occur during the first 12 weeks. Because miscarriage is most common during the first 12 weeks of pregnancy, it tends to be one of the biggest concerns with first trimester bleeding. Typical symptoms for miscarriage are also strong cramps in the lower abdomen and tissue passing through the vagina.

Most miscarriages cannot be prevented. They are often the body’s way of dealing with an unhealthy pregnancy that was not developing. A miscarriage does not mean that you cannot have a future healthy pregnancy or that you yourself are not healthy.

Ectopic pregnancy

Ectopic (Tubal) pregnancy occurs when the fertilized egg implants outside the uterus (mostly in the 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 hCG.

However, an embryo implanted outside the uterus can’t develop into a normal baby. It can cause serious internal bleeding. In this case fallopian tube may need to be removed along with the pregnancy but this does not mean that the mother will have trouble conceiving in future provided other ovary and fallopian tube are healthy.

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.

Molar pregnancy

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, and 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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