Bleeding or spotting is common during early pregnancy and does not always mean that something is wrong. Some people experience light spotting, while others may have bleeding that looks more like a period.
There are several possible causes of bleeding during early pregnancy. While many pregnancies continue normally, bleeding can sometimes be associated with miscarriage, ectopic pregnancy, or other pregnancy complications. Please let us know if you experience bleeding so we can help determine whether any evaluation is needed.
Bleeding in early pregnancy can happen for several reasons. The cervix has increased blood flow during pregnancy and may bleed more easily, particularly after intercourse or a pelvic exam. Cervical irritation from a vaginal infection or sexually transmitted infection (STI) can also cause spotting, and benign growths called cervical polyps may bleed easily during pregnancy.
Bleeding can also come from a subchorionic hemorrhage, which is a collection of blood next to the pregnancy that may be seen on ultrasound. Sometimes bleeding occurs without a clear cause, and the pregnancy continues normally.
Bleeding can also occur with a miscarriage or ectopic pregnancy, which is why we want you to let us know about any bleeding so we can determine whether evaluation is needed.
A subchorionic hemorrhage (or hematoma) is a collection of blood between the pregnancy and the wall of the uterus. These are relatively common findings on early pregnancy ultrasounds and can sometimes cause spotting or bleeding.
Most small subchorionic hemorrhages resolve on their own, although the amount of bleeding and the appearance on ultrasound can vary. We will let you know if your ultrasound findings require any additional monitoring or recommendations.
The evaluation depends on how far along you are, how much you're bleeding, whether you're having pain, and what we've already seen during your pregnancy. We may recommend a pelvic exam, blood work, an ultrasound, or a combination of these.
In very early pregnancy, sometimes a single ultrasound or blood test cannot give us a definite answer. In that situation, we may recommend repeating your pregnancy hormone level (hCG) or ultrasound after a period of time.
Your blood type may also be important. If you have an Rh-negative blood type, we may discuss whether an Rh immune globulin (RhoGAM) injection is recommended based on how far along you are and your individual situation.
Please contact our office if you experience vaginal bleeding during pregnancy, even if it is light, so we can help determine whether any evaluation is needed.
Please let us know especially if:
Bleeding is becoming heavier or more persistent
You're having increasing pelvic or abdominal pain or cramping
You're passing clots or tissue
You have questions about whether what you're experiencing is normal
Seek prompt medical evaluation for heavy bleeding, severe or one-sided abdominal or pelvic pain, shoulder pain, significant dizziness or fainting, or other severe or concerning symptoms.
For urgent concerns, please call rather than waiting for a MyChart response.
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