Bleeding in pregnancy
Many women experience minor bleeding during pregnancy and many go on to have healthy pregnancies and babies. Here's what it could mean and when to get help. 
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There are several reasons for vaginal bleeding. Your progesterone levels might be too low, which puts you at risk of miscarriage. Bleeding with lower abdominal or pelvic cramping is abnormal and requires speedy medical attention. The course of action will depend on what stage of your pregnancy you are in. Bleeding that occurs from the vagina before the 26th week of pregnancy.

BLIGHTED OVUM 

The pregnancy sac develops with no embryo and no evidence of foetal heart. Conceptus comes away.

IMPLANTATION BLEEDING 

This occurs at the time when the fertilised ovum burrows into the lining of the uterus to take hold. It is often confused with the bleeding of a period as it may occur just before a period is due and can cause you to calculate your due date incorrectly. It usually settles down within a few days.

TISSUE SENSITIVITY

Due to increased blood flow and hormone changes during pregnancy, the cervical tissue becomes highly sensitive. Sometimes a small polyp (a bit like a skin tag that is present before pregnancy) becomes sensitive and bleeding from the cervix occurs. It usually settles down with no threat to the baby.

BREAKTHROUGH BLEEDING 

This is a slight bleed in the first trimester every time your period is due. It is usually due to low hormone levels and doesn’t always lead to miscarriage.

MISCARRIAGE

The peak time for miscarriage is between six and ten weeks of pregnancy. The most common causes of miscarriage are medical problems, infections, uterine abnormalities, extreme emotional stress, some drugs and Rhesus incompatibility. The bleeding will be heavy and bright red and accompanied by abdominal cramps and backache. Although bleeding can be a sign of miscarriage it may not mean that miscarriage is imminent. Approximately half of pregnant women who bleed do not have miscarriages. Approximately 15-20 percent of all pregnancies result in a miscarriage, and the majority occur during the rst 12 weeks.

Signs of miscarriage:

  • Vaginal bleeding.
  • Cramping paint felt low in the stomach (stronger than menstrual cramps).
  • Tissue passing through the vagina.

ABORTION

This is classified as the interruption of pregnancy before the 26th week. The peak time for abortions is between the sixth and tenth week of pregnancy. There are many causes, some being spontaneous and some being induced. Spontaneous abortions may be due to medical problems, infections, uterine abnormalities, extreme emotional stress, some drugs and Rhesus incompatibility.

ECTOPIC PREGNANCY

The fertilised egg embeds outside the womb, usually in the fallopian tube or, in rare cases, in the abdomen. Ectopic pregnancies are less common than miscarriages, occurring in one in 60 pregnancies. It is life threatening for the mother, and the symptoms, besides vaginal bleeding, includes severe lower abdominal pain.

Signs of Ectopic pregnancies:

  • Cramping pain felt low in the stomach(stronger than mentrual cramps).
  • Sharp pain in the abdominal area. 
  • Low levels of hCG (need a blood test).
  • Vaginal bleeding. 

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