Bleeding in Early Pregnancy

Dr. Barra O'Briain, MD, discusses bleeding in early pregnancy.

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Dr. Barra O'Briain, MD, discusses bleeding in early pregnancy.
Video transcript

Featuring Dr. Barra O'Briain, MD

Duration: 3 minutes, 33 seconds

Bleeding in the first part of pregnancy is not always a sign of miscarriage.

There are many causes, probably the most common cause outside of miscarriage would be what we call an implantation bleed, which is when the new placenta - the early placenta - is burrowing into the wall of the uterus and might strike a small little blood vessel causing some bleeding.

And this is often also a cause of a missed period or misdating of pregnancies is this implantation bleeding can be mistaken for the last menstural period kind of thing.

Some of the causes of bleeding in early pregnancy could be miscarriage, it could be this implantation bleeding that I just mentioned. It can also be irritation or inflammation on the cervix itself, which is the opening of the uterus.

There are some rare causes but important causes as well, one is ectopic pregnancy. So bleeding under seven weeks associated with a significant amount of pain can sometimes be signs of ectopic pregnancy, which is a medical emergency.

And last, even rarer still, is what we call triploblastic disease: abnormal or precancerous changes and sometimes cancerous changes of the placenta itself. And again this is a very, very, very rare cause of first trimester bleeding.

Two most common is either a miscarriage or implantation bleeding. The most common cause even in young women, the most common cause of miscarriage is something's wrong with the baby, often genetically, an extra chromosome or an absent chromosome.

And that is the most common cause in young women, and it gets more common as a cause as women get older. And the reality here is that in those circumstances if there's something that's wrong with the pregnancy, miscarriage is Mother Nature's way of taking care of things so that the pregnancy doesn't continue and we're faced with some abnormality with the baby down the road.

So in some ways miscarriage is a good thing. The reality is for women and their partners, once you have that extra stripe on the pregnancy test, dreams are built. And sort of, the grief that comes with the loss of the pregnancy is saying goodbye to those dreams.

And that's often what we face as doctors with these patients in this unfortunate situation. Other causes could be where the pregnancy is implanted in an abnormal part of the uterus, either too low or too high. Or the timing wasn't perfect so the little embryo couldn't get embedded into the wall of the uterus.

Sometimes infections can cause miscarriage but again the most common is something's wrong with the baby. So obviously the first thing to do if you're having any bleeding in the first bit of your pregnancy is to contact your family doctor or midwife or whoever's taking care of you during your pregnancy.

Presenter: Dr. Barra O'Briain, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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