What are spotting and are they normal?
Spotting, also known as spotting, is very slight vaginal bleeding, comparable to the period, but much weaker. They vary in color from red to brown. Usually the cause is harmless.
It is only natural that you are worried if you notice spotting or blood. But you do not have to worry: In the first few weeks of pregnancy that occurs frequently. A quarter of expectant mothers now and then have bleeding in the first three months (Weiss et al 2004, NGC 2005, Poulouse et al 2006).
Is my baby safe?
Your baby is almost certainly fine, because spotting or mild bleeding are usually harmless. It is only natural that you are worried, but: Most pregnancies end happily despite initial problems with bleeding.
Although bleeding may be an early sign of a miscarriage, in this case you would also have abdominal cramps and the bleeding would get worse. Spotting or light bleeding often stops by itself. It is believed that more than half of the expectant mothers seeking medical help for early bleeding give birth without any problems (NGC 2005, Everett 1997).
However, if you have spotting or bleeding during pregnancy, you should always talk to your doctor or midwife, even if the bleeding ceases. Try to think positively. Spotting or bleeding often turns out to be nothing more than a harmless puzzle.
What causes bleeding? Which cause is most likely?
In the early stages of pregnancy, spotting and bleeding are usually harmless. They are caused by:
- Hormones that control your menstrual cycle and cause bleeding
- Hormone fluctuations at the time of your period. This is called breakthrough bleeding. You can do this several times, always at the time you had your pre-pregnancy period.
- The fertilized egg nests on the wall of the uterus. Then it can come to bleeding. This is called nidus bleeding. This form of light bleeding usually lasts one or two days.
What else can cause bleeding?
There may be other processes in your body that cause bleeding:
- The opening to your uterus (your cervix) may be irritated. Pregnancy hormones alter the surface of your cervix and cause bleeding. For example, you might notice some blood after sex (Symonds 2009: 323). Even after painting, slight bleeding may occur.
- You may have a fibroma. These are growths on the uterine wall. Do not worry, that's not malicious. Sometimes the placenta embeds where a fibroma is (Ouyang et al 2006).
- You may have a small growth on your cervix. This is called cervical polyp. Do not worry, it's harmless (Symonds 2009: 323).
- You may have a cervical or vaginal infection (Gracia et al 2005).
- You may have a hereditary disease, such as von Willebrand syndrome (vWS), that makes it difficult for your blood to clot (James 2006).
The likelihood of spotting is greater if you have an IVF or similar treatment to get pregnant. For example, if two embryos have been implanted in your uterus (womb), it may be that one has not developed. This is called a lost twin (De Sutter 2006) and can cause mild bleeding.
Unfortunately, at the beginning of pregnancy there are other reasons for bleeding that do not come to a happy ending. These are miscarriages and abdominal cavity pregnancies. Abdominal pain and cramps occur along with this type of bleeding.
Early miscarriages usually happen when the baby is not developing properly. The bleeding in a miscarriage are getting stronger. An early miscarriage is a heartbreaking event, but it happens quite often. Some women even have a miscarriage before they realize that they are pregnant, and they assume that they have their period.
One speaks of an ectopic pregnancy or ectopic pregnancy when the fertilized egg is stuck outside the uterus. If you have an abdominal cavity pregnancy, the bleeding may persist. They are dark and watery, a bit like the juice of a prune. An abdominal cavity pregnancy can be a serious illness for you. Therefore it has to be removed quickly (RCOG 2004a).
A very rare reason for bleeding is a mole (RCOG 2004b). It is very unlikely that your bleeding was caused by it. It affects only about one in 1,000 pregnancies (0.1 percent) (Cancer Research 2009). A molar mole occurs when the embryo is not developing properly, but some of the cells that make up the placenta continue to grow and multiply. To protect your health, a mole must be removed as soon as possible.
All of these reasons for bleeding are related to what's going on in your body. But it is also possible that a blow on the outside of your stomach can cause bleeding. This can be caused by a fall, a car accident or a blow to your stomach (Tillett and Hanson 1999).
What should I do if I notice bleeding?
Call your doctor, midwife, or hospital for advice, even if the bleeding ends. You may need to be examined by a doctor to determine why you had bleeding.
Your doctor may carefully examine the inside of your vagina to see if everything is OK or he / she advises you to have an ultrasound. With an ultrasound, it can be determined whether your baby is safe in the uterus and an abdominal cavity pregnancy can be ruled out. A vaginal examination and the ultrasound are safe for you. You do not have to worry that they could affect your pregnancy.
In the last trimester of pregnancy, bleeding may be an indication of a so-called placenta previa (incorrect location of the suckling cake), abruptio plazentae (the cudgel dissolves prematurely from the uterus) or early labor.
If you have bleeding after the 36th week of pregnancy, it is a sign that the cervix softens and expands. You may now be excreting bloody mucus. This could be an indication that the birth is starting.
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