Bleeding and spotting during pregnancy: symptoms & causes

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WHEN a woman sees blood on her underpants during pregnancy, it’s typically a frightening and worrisome sign. But not all bleeding is a sign of trouble.
Bleeding or spotting can happen at any point during pregnancy, from the time the embryo is conceived to before a woman gives birth. Some causes of vaginal bleeding or spotting are serious, such as possibly indicating a miscarriage or a problem with the location of the placenta, while others are not.
Although vaginal bleeding is not that unusual a symptom, especially in the first 12 weeks of pregnancy, it’s a symptom that a woman should not ignore, said Dr. Haywood Brown, chief of obstetrics and gynecology at Duke University School of Medicine in Durham, North Carolina. She should notify her health care provider immediately about bleeding to obtain guidance, he recommended.
“Bleeding in early pregnancy is fairly common and occurs in about 20 to 30 percent of pregnancies during the first trimester,” Brown said. “Some pregnancies in which bleeding occurs continue on to have normal outcomes,” he noted.
Bleeding in the later stages of pregnancy is far less common, Brown told Live Science.
Here are the differences between bleeding and spotting, some possible causes and what to do when bleeding occurs.
Spotting differs from bleeding both in terms of the amount of blood seen and its appearance.
Spotting during pregnancy is when a few drops of blood soil a woman’s underpants, Brown said. Blood flow is light and there is not enough of it to cover a panty liner.
Spotting may typically occur in the early first trimester of pregnancy, Brown said. It can be a sign of a “threatened miscarriage,” he said, which is why a woman should call her health care provider right away, who may then request an ultrasound to determine if the pregnancy is a viable one.
In comparison, bleeding during pregnancy involves a heavier flow of blood, an amount that if a woman weren’t wearing a panty liner or pad, the blood would soak her clothes.
When contacting a health care provider, a pregnant woman should be able to describe when her bleeding began, the color of the blood she observes, such as dark red or light brown, and how frequently she is bleeding.
A woman may be asked whether her blood flow is getting heavier or lighter, and if she has seen clots or clumps of tissue passed from the vagina. Other questions may include how frequently a woman needs to change sanitary pads while she is bleeding and whether she has pain with bleeding, according to the March of Dimes.
Even if bleeding stops, a pregnant woman should still call her health care provider to understand why it occurred.