Early Pregnancy
Bleeding In Early Pregnancy
25% of pregnant women experience bleeding in early pregnancy. Most of these pregnancies continue normally but it can be stressful. Some of the causes for bleeding in first trimester could be a sign of miscarriage or an ectopic pregnancy. Often a blood test and an ultrasound scan may be needed to check if the pregnancy is progressing well.
Miscarriage
Some pregnancies unfortunately do not continue in the first trimester. This is called a miscarriage. You may experience vaginal bleeding followed by passage of pregnancy vaginally. Sometimes there is no bleeding with miscarriage and this condition is called a missed miscarriage.
There may be different ways to manage a missed miscarriage.
1. Expectant management: where you would wait for 1-2 weeks for nature to take it’s course. You may have spontaneous pain and bleeding followed by passage of pregnancy. Chance of success of this management is 30%.
2. Medical Management: where you would be given some medication to help pass the pregnancy. You would expect to have some pain and bleeding followed by passage of pregnancy vaginally. Chance of this method working is 95%. Side affects could be pain, nausea, fever, vigours. Sometimes vaginal bleeding may be very heavy and you may need emergency D&C. There is also a small chance of returned tissues of pregnancy and needing a repeat medication or a D&C.
3. Surgical management: where you have a D&C under general anesthesia for miscarriage. The procedure takes about 10-15min and you are able to go home some day. You would expect to have some vaginal bleeding after a D&C for 7-10 days.
Ectopic Pregnancy
An ectopic pregnancy occurs when the fertilised egg begins to develop outside the uterus, usually in one of the fallopian tubes. The embryo cannot continue to grow properly as the developing placenta cannot access the blood supply of the uterus and, in almost all cases, the embryo dies.
Symptoms of an ectopic pregnancy can mimic that of a regular pregnancy with the missed menstrual cycles, morning sickness and breast tenderness.
Other symptoms include:
- Abdominal pain
- Lower back pain
- Cramping in the pelvic region
- Bleeding or spotting
- Sudden & severe pain in the lower abdomen
What are the treatment options for ectopic pregnancies?
In the rare event that the fallopian tube ruptures, women experience extreme pain, internal bleeding and shock. As a medical emergency, this requires immediate medical treatment and you should call 000 or present to accident and emergency at the hospital.
Ectopic pregnancy can be manages conservatively, medically or surgically depending on individual case.
Termination of Pregnancy
Continuing the pregnancy may not an option for all women for personal, medical or social reasons. Some GPs and Sexual Health clinic offer medical termination of pregnancy up to 9 weeks of pregnancy.
We provide surgical termination services up to 13 weeks of pregnancy once each case has been individually assessed. If you think you need this service, please speak to your GP as the first step.
Questions
Some women experience pain and bleeding early in their pregnancy. This can be common and many women go on to have a healthy baby without further issues. In some cases it can be signs of complications or even a miscarriage so it is vital to visit your GP or a hospital to determine what treatment may be required.
To learn more about Bleeding in Early Pregnancy, download factsheet here
A threatened miscarriage is when vaginal bleeding is present but your pregnancy seems to be otherwise progressing well. Please visit your GP or a hospital to determine if the bleeding is a threatened or possible miscarriage.
We utilise blood test to determine how the pregnancy is progressing by monitoring the rising and falling levels of the pregnancy hormone HCG. If the levels are too high, too low or not increasing, it may be identified that the preganancy is not progressing normally.
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