INFORMATION FOR WOMEN WHO HAVE BLOOD SPOTTING DURING PREGNANCY OR BREASTFEEDING
What is blood spotting during pregnancy?
The term spotting, or blood spotting, during pregnancy generally refers to light vaginal bleeding, or a reddish vaginal discharge, during the first trimester of pregnancy.
How common is blood spotting during pregnancy?
This condition is extremely common. Light vaginal bleeding develops at least once in 20-40 percent of pregnancies.
How is light bleeding (blood spotting) during pregnancy diagnosed?
The pregnant woman notices dark or red spots on her underwear or notices blood or other dark discharge from the vagina in the toilet. She reports this to her obstetrician who will then examine her cervix for evidence of membrane rupture, and perform ultrasound to check whether or not the developing baby is healthy.
Does blood spotting cause problems during pregnancy?
Light bleeding itself does not cause any major problems, but very often is a sign of an underlying event or condition that can threaten, or destroy the developing baby. When bleeding happens very early during pregnancy, it sometimes is simply the result of the embryo implanting in the uterine wall, in which case it is not harmful. In rare cases, bleeding can be the result of an infection, cut, polyps, or cancer in the vagina, cervix, uterus, ovaries, or fallopian tubes. In 1-2 percent of cases, bleeding is the result of ectopic pregnancy, which means that the embryo has implanted somewhere other than the endometrial lining of the uterus, typically in a fallopian tube, although it can happen anywhere within the pelvis or abdomen. Such a pregnancy must be terminated, as the baby cannot survive and will threaten the mothers life. If the pregnancy continues, it will become a surgical emergency. 10-20 percent of bleeding during early pregnancy is the result of spontaneous abortion (miscarriage), warning sign of miscarriage, or progression toward miscarriage. Along with expelling the developing baby, spontaneous abortions can also lead to infections.
Does blood spotting during pregnancy cause problems for the baby?
As with the mother, the bleeding itself is the result of a problem that can be harmful. If it is the result of an ectopic pregnancy, there really is no baby, as the technology does not yet exist to transfer the developing baby into a place where it can survive. As for miscarriage of a developing baby that is implanted in a good location, the earliest stage along the progression of seriousness is called threatened abortion, a situation in which the baby is on a pathway that could proceed to spontaneous abortion (miscarriage), but still has a chance of surviving. Inevitable abortion is a situation in which the baby is no longer viable, but has not yet been expelled. Incomplete abortion is when part of the developing baby has been expelled, but part remains in the uterus and must be removed with medical, or surgical help. Complete abortion means that the body has expelled the baby entirely. This is usually the case when the miscarriage happens very early in pregnancy. Use of the word “abortion” in these cases does not mean that a doctor removes a living baby – we are not talking about elective abortions in which the mother does not want to be pregnant or has a health problem that requires ending her pregnancy.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the blood spotting
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat blood spotting during pregnancy?
Antibiotics are given for an infection caused by a complete or partial miscarriage. Many types of partial spontaneous abortions (miscarriages) are treated with a drug called methotrexate, as are many early ectopic pregnancies. Methotrexate would be deadly to a developing baby but it is given only when the pregnancy is no longer viable. Medications for bleeding conditions that cause spotting often play a supportive role, such as analgesia (pain management) for cases that must be treated surgically.
Who should NOT stop taking medication for blood spotting during pregnancy?
Medications that your doctor prescribes for a bleeding condition are usually necessary. If you have an ectopic pregnancy, for instance, and it is being treated with methotrexate, you cannot stop the treatment at midpoint, but usually, only a few doses are required.
What should I know about choosing a medication for blood spotting during pregnancy?
You may find Pregistrys expert reports about the individual medications to treat blood spotting here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for my blood spotting when I am breastfeeding?
Generally, light bleeding as an abnormality requiring treatment is an issue of early pregnancy. Women often experience post-partum light bleeding, which usually resolves, although it should be reported to, and checked by, your doctor.
What alternative therapies besides medications can I use to treat blood spotting during pregnancy?
Along with medications that vary depending on the cause, pregnant women experiencing light bleeding can be managed with supportive measures, such as monitoring with ultrasound, and maintenance of fluids by drinking adequate amounts of liquids.
What can I do for myself and my baby when I have blood spotting during pregnancy?
You should cooperate with your physicians and take your medication as directed.
Resources for blood spotting in pregnancy:
For more information about blood spotting during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles: