About Us | Privacy | Site Map
February 3, 2012
Font Size
A
A
A
1
...

Bleeding During Pregnancy

Medical Author:
Coauthor:
Coauthor:
Medical Editor:

Ectopic Pregnancy Definition

Ectopic pregnancy: A pregnancy that is not in the uterus. The fertilized egg settles and grows in any location other than the inner lining of the uterus. The large majority (95%) of ectopic pregnancies occur in the Fallopian tube. However, they can occur in other locations, such as the ovary, cervix, and abdominal cavity.

An ectopic pregnancy occurs in about 1 in 60 pregnancies. Most ectopic pregnancies occur in women 35 to 44 years of age.

Ectopic pregnancies are frequently due to an inability of the fertilized egg to make its way through a Fallopian tube into the uterus. Risk factors predisposing to an ectopic pregnancy include:

  • Pelvic inflammatory disease (PID) which can damage the tube's functioning or leave it partly or completely blocked;
  • Surgery on a Fallopian tube;
  • Surgery in the neighborhood of the Fallopian tube which can leave adhesions (bands of tissue that bind together surfaces);
  • Endometriosis, a condition in which tissue like that normally lining the uterus is found outside the uterus;
  • A prior ectopic pregnancy;
  • A history of repeated induced abortions;
  • A history of infertility problems or medications to stimulate ovulation; and
  • An abnormality in the shape of the Fallopian tube, as with a congenital malformation (a birth defect).

SOURCE:
MedTerms.com. Ectopic Pregnancy.

Bleeding During Pregnancy Overview

Because bleeding during all phases of pregnancy may be dangerous, a woman should call her health care professional if she has any signs of vaginal bleeding during her pregnancy.

Vaginal bleeding is any blood coming from the vagina (the canal leading from the uterus to the external genitals). This usually refers to abnormal bleeding not associated with a regular menstrual period.

  • First trimester bleeding is any vaginal bleeding during the first 3 months of pregnancy. Vaginal bleeding may vary from light spotting to heavy bleeding with clots. Vaginal bleeding is a common problem in early pregnancy, complicating 20%-30% of all pregnancies.
  • Any vaginal bleeding during the second and third trimesters of pregnancy (the last 6 months of a 9-month pregnancy) involves concerns different from bleeding in the first 3 months of the pregnancy. Any bleeding during the second and third trimesters is abnormal.
  • Bleeding from the vagina after the 28th week of pregnancy is a true emergency. The bleeding can range from very mild to extremely brisk and may or may not be accompanied by abdominal pain. Hemorrhage (another word for bleeding) is the most common cause of death of the mother in the United States. It complicates about 4% of all pregnancies.

Bleeding During Pregnancy Causes

First Trimester Bleeding Causes

Vaginal bleeding in the first trimester of pregnancy can be caused by several different factors. Bleeding affects 20%-30% of all pregnancies. Up to 50% of those who bleed may go on to have a miscarriage (lose the baby). Of even more concern, however, is that about 3% of all pregnancies are ectopic in location (the fetus is not inside the uterus), and vaginal bleeding can be a sign of an ectopic pregnancy. An ectopic pregnancy may be life threatening to the mother. All bleeding associated with early pregnancy should prompt a call to your health care provider for immediate evaluation.

  • Implantation bleeding: There can be a small amount of spotting associated with the normal implantation of the embryo into the uterine wall, called implantation bleeding. This is usually very minimal, but frequently occurs on or about the same day as your period was due. This can be very confusing if you mistake it for simply a mild period and don't realize you are pregnant. This is a normal part of pregnancy and no cause for concern.
  • Threatened miscarriage: You may be told you have a threatened miscarriage if you are having some bleeding or cramping. The fetus is definitely still inside the uterus (based usually on an exam using ultrasound), but the outcome of your pregnancy is still in question. This may occur if you have an infection, such as a urinary tract infection, become dehydrated, use certain drugs or medications, have been involved in physical trauma, if the developing fetus is abnormal in some way, or for no apparent reason at all. Other than these reasons, threatened miscarriages are generally not caused by things you do, such as heavy lifting or having sex, or by emotional stress.
  • Completed miscarriage: You may have a completed miscarriage (also called a spontaneous abortion) if your bleeding and cramping have slowed down and the uterus appears to be empty based on ultrasound evaluation. This means you have lost the pregnancy. The causes of this are the same as those for a threatened miscarriage. This is the most common cause of first trimester bleeding.
  • Incomplete miscarriage: You may have an incomplete miscarriage (or a miscarriage in progress) if the pelvic exam shows your cervix is open and you are still passing blood, clots, or tissue. The cervix should not remain open for very long. If it does, it indicates the miscarriage is not completed. This may occur if the uterus begins to clamp down before all the tissue has passed, or if there is infection.
  • Blighted ovum: You may have a blighted ovum (also called embryonic failure). An ultrasound would show evidence of an intrauterine pregnancy, but the embryo has failed to develop as it should in the proper location. This may occur if the fetus were abnormal in some way and not generally due to anything you did or didn't do.
  • Intrauterine fetal demise: You may have an intrauterine fetal demise (also called IUFD, missed abortion, or embryonic demise) if the developing baby dies inside the uterus. This diagnosis would be based on ultrasound results and can occur at any time during pregnancy. This may occur for any of the same reasons a threatened miscarriage occurs during the early stages of pregnancy; however it is very uncommon for this to occur during the second and third trimesters of pregnancy. If it does, the causes also include separation of the placenta from the uterine wall (called placental abruption) or because the placenta didn't receive sufficient blood flow.
  • Ectopic pregnancy: You may have an ectopic pregnancy (also called tubal pregnancy). This would be based on your medical history and ultrasound, and in some cases laboratory results. Bleeding from an ectopic pregnancy is the most dangerous cause of first trimester bleeding. An ectopic pregnancy occurs when the fertilized egg implants outside of the uterus, most often in the Fallopian tube. As the fertilized egg grows, it can rupture the Fallopian tube and cause life-threatening bleeding. Symptoms are often variable and may include pain, bleeding, or lightheadedness. Most ectopic pregnancies will cause pain before the tenth week of pregnancy. The fetus is not going to develop and will die because of lack of supply of nutrients. This condition occurs in about 3% of all pregnancies.
    • There are risk factors for ectopic pregnancy. These include a history of prior ectopic pregnancy, history of pelvic inflammatory disease, history of Fallopian tube surgery or ligation, history of infertility for more than 2 years, having an IUD (birth control device placed in the uterus) in place, smoking, or frequent (daily) douching. Only about 50% of women who have an ectopic pregnancy have any risk factors, however.
  • Molar pregnancy: You may have a molar pregnancy (technically called gestational trophoblastic disease). Your ultrasound results may show the presence of abnormal tissue inside the uterus rather than a developing fetus. This is actually a type of tumor that occurs as a result of the hormones of pregnancy, and is usually not life-threatening to you. However, in rare cases the abnormal tissue is cancerous. If it is cancerous it can invade the uterine wall and spread throughout the body. The cause of this is generally unknown.
  • Postcoital bleeding is vaginal bleeding after sexual intercourse. It may be normal during pregnancy.
  • Bleeding may also be caused by reasons unrelated to pregnancy. For example, trauma or tears to the vaginal wall may bleed, and some infections may cause bleeding.

Picture of an Ectopic Pregnancy


Parenting and Pregnancy

Get tips for baby and you.



Bleeding During Pregnancy

Miscarriage Overview

A miscarriage (also termed spontaneous abortion) is any pregnancy that spontaneously ends before the fetus can survive. Any vaginal bleeding, other than spotting, during early pregnancy is considered a threatened miscarriage.ÂVaginal bleeding is very common in early pregnancy. AboutÂone out of every four pregnant women has some bleeding during the first few months. About half of these women stop bleeding and complete a normal pregnancy.

  • ThreatenedÂmiscarriage - Vaginal bleeding during early pregnancy.ÂThe bleeding and pain with threatened miscarriage are usually mild and the cervical os (the mouth of the womb) is closed. Your health care provider will be able to determine if the cervical os is open upon performing a pelvic exam. Typically, no tissueÂis passed from the womb. The womb and Fallopian tubes may be tender.

  • InevitableÂmiscarriage ...

Read the Miscarriage article »


Read What Your Physician is Reading on Medscape

Pregnancy, Postpartum Hemorrhage »

Postpartum hemorrhage (PPH) is a potentially life-threatening complication of both vaginal and cesarean delivery.

Read More on Medscape Reference »

Medical Dictionary


Use Pill Finder Find it Now

Pill Identifier on RxList

  • quick,
    easy,
    pill identification

Find a Local Pharmacy

  • including
    24 hour
    pharmacies