Vaginal bleeding is a common symptom that occurs during pregnancy and it causes anxiety to the expectant mother and family. Several medical conditions can present with vaginal bleeding during pregnancy as it can occur early or late in pregnancy. There shouldn't be vaginal bleeding related to the pregnancy, but when this occurs it indicate problem that needs expert attention.
Bleeding vary from heavy vaginal bleeding to small amount of light red loss or even brownish vaginal discharge (which usually means that the amount of bleeding is very slight). In this article, we will discuss 7 causes of vaginal bleeding to look out for during pregnancy. However, it is important to consult your physician if there is an episode of vaginal bleeding at any time during your pregnancy as it can be an indication of impending danger.
1. Abortion
This is the sudden loss of pregnancy before the age of viable. This is the age in which the growing fetus can be sustained outside of the womb. It varies in different countries and it depends on the availability of incubators and skilled neonatal physicians, nurses and other health workers. However, in Nigeria, the age of viability is around 28-32 weeks. Abortion accounts for about 40% of vaginal bleeding cases during early pregnancy. Common causes of abortion include: Fetal abnormalities incompatible with life (e.g. chromosomal disorders), induced abortion by instrumentation or drugs and hormonal imbalance.
2. Ectopic pregnancy
This is another important cause of vaginal bleeding during pregnancy. It occurs when the fertilized egg implants outside of the uterus. This can occur at any site along the length of the fallopian tubes, in the ovaries, ligaments of the uterus and even within the abdominal cavity giving rise to abdominal pregnancy. It is one of the top causes of vaginal bleeding to look out for during pregnancy. With vaginal bleeding, there is severe abdominal pain, pallor from bleeding inside the abdomen, weak pulse and generalized body weakness.
3. Placenta previa
In a normal healthy pregnancy, the placenta is located at the fundus (upper) portion of the uterus, but in placenta previa, the placenta is attached to the lower segment of the uterus and it may encroach to cover the doorway into the uterus (cervix). With this, the placenta is at the greatest risk of bleeding on slight provocation. It is an important cause of vaginal bleeding to look out for during pregnancy.
4. Abruptio placenta
This is a life threatening cause of vaginal bleeding that occurs during pregnancy. It is the premature and sudden separation of the placenta from the uterus before the onset of labour. It is frequently characterized by sudden onset painful abdominal bleeding which may lead to fetal demise and/or death of the mother. It is a very dramatic cause of vaginal bleeding that requires prompt medical treatment.
5. Cervical polyps
This is another important cause of vaginal bleeding during pregnancy. A polyp is a teardrop-shaped extra piece of tissue seen emerging through the opening of the cervix. They are not harmful to the mother or baby and are usually only discovered if they cause vaginal bleeding. It is diagnosed using a speculum to observe the cervix.
6. Infection of the genital tract
Infection is another cause of vaginal bleeding to look out for during pregnancy. The most common vaginal infection in pregnancy is Candida infection characterized by whitish vaginal discharge, vaginal itching and soreness but in severe cases, can cause the vagina to bleed. If you experience vaginal bleeding which was preceded by vaginal discharge, then cervical infection may be the most likely cause of the vaginal bleeding. Other causes of vaginal infection may lead to vaginal bleeding.
7. Implantation bleeding
This is the bleeding that occurs from the site where the ovum implants. It usually occurs early in pregnancy within the first 10 to 16 days after the ovum implants in the uterus. Characteristically, it presents with spotting of blood via the vagina.
Bleeding in early pregnancy needs immediate attention, and monitoring is mandatory. There is the need to ascertain the source of the bleeding and a concrete decision taken regarding the treatment of such vaginal bleeding.
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