Here's an article for more information about the various cervical infections during pregnancy and what to do:
Bleeding during pregnancy: Why it happens, what to do
Vaginal bleeding during pregnancy has many causes. Some are serious, and some aren't. Know when to contact your health care provider.
Vaginal bleeding during pregnancy can be scary. It's not always a sign of trouble, however. In fact, most women who experience vaginal bleeding during pregnancy — particularly during the first trimester — go on to deliver healthy babies. By understanding the most common causes of vaginal bleeding during pregnancy, you'll know what to look for and when to contact your health care provider.
Bleeding during the first trimester
Many women experience light vaginal bleeding during the first 12 weeks of pregnancy. Possible causes of vaginal bleeding during early pregnancy include:
Implantation. You may notice a small amount of vaginal bleeding very early in pregnancy, about 10 to 14 days after fertilization. This "implantation bleeding" happens when the fertilized egg attaches to the lining of your uterus. It's usually earlier, spottier and lighter in color than a normal menstrual period, and it doesn't last long. Some women mistake this light bleeding for a period and don't realize they're pregnant.
Cervical changes. When you're pregnant, more blood flows to your cervix. You may experience harmless vaginal bleeding after contact to your cervix, such as after sex or a pelvic exam.
Miscarriage. Up to 15 percent of known pregnancies end in miscarriage, according to the American College of Obstetricians and Gynecologists. Vaginal bleeding is the primary sign of miscarriage. But bleeding doesn't necessarily mean you're having a miscarriage. Remember, most women who experience vaginal bleeding during pregnancy go on to deliver healthy babies.
Ectopic pregnancy. Sometimes an embryo implants somewhere outside the uterus, usually in a fallopian tube. This is known as an ectopic pregnancy. An embryo implanted outside the uterus can't survive. And without treatment, life-threatening blood loss is possible. In addition to vaginal bleeding, an ectopic pregnancy may cause abdominal or pelvic pain.
Molar pregnancy. Rarely, an abnormal mass — instead of a baby — forms inside the uterus after fertilization. Vaginal bleeding is the most common sign of a molar pregnancy.
Infection. Some cervical infections cause bleeding in early pregnancy.
When to contact your health care provider
During the first trimester, if you have slight vaginal bleeding that goes away within a day, tell your health care provider at your next visit. If you have any vaginal bleeding that lasts more than a day, contact your health care provider within the next 24 hours. Contact him or her immediately if you:
Experience moderate to heavy vaginal bleeding
Experience any amount of vaginal bleeding accompanied by abdominal pain, cramping, fever or chills
Pass tissue from your vagina
What to expect next
Your health care provider will likely ask questions about the bleeding and do a physical exam, including a pelvic exam. Depending on the severity of your symptoms, your health care provider may do lab tests or an ultrasound to assess your baby's well-being.
Typically, vaginal bleeding during the first trimester doesn't require treatment. Sometimes, however, your health care provider may recommend resting until the bleeding subsides. If you have a cervical infection, you may be given antibiotics.
If your health care provider diagnoses a miscarriage, you may choose to let it progress naturally or speed the process with medication or a minor surgical procedure known as dilation and curettage (D and C). During this procedure, the doctor dilates your cervix and gently suctions the tissue out of your uterus. Sometimes a long metal instrument with a loop on the end (curet) is used after the suction to scrape the uterine walls.
If you have an ectopic or molar pregnancy, you'll need prompt treatment. Sometimes an ectopic pregnancy can be treated with medication. In other cases, surgery is needed. With a molar pregnancy, a D and C is needed to remove the tumor from the uterus.
Bleeding during the second or third trimester
As the cervix begins to thin out and relax in preparation for labor, the thick plug of mucus that seals the opening of the cervix is dislodged. When this happens, you may notice a thick or stringy discharge that may be tinged with blood. This "bloody show" is a normal sign of impending labor that may occur up to a week or two before delivery.
A bloody show near the end of pregnancy isn't cause for concern. But other causes of bleeding during the second or third trimester are more worrisome, including:
Miscarriage. Vaginal bleeding is the primary sign of miscarriage. Although miscarriage is most common during the first trimester, a risk still exists in the second trimester.
Preterm labor. Light bleeding in the second or third trimester may be a sign of preterm labor, especially when accompanied by regular contractions, dull backache or pelvic pressure.
Problems with the cervix. A cervical infection, inflamed cervix or growths on the cervix may cause vaginal bleeding in the second or third trimester. Occasionally, light bleeding may be a sign that the cervix is opening prematurely (cervical incompetence). This can lead to preterm birth.
Placenta previa. Painless, bright red vaginal bleeding in the second or third trimester may indicate placenta previa — a serious problem in which the placenta partly or completely covers the opening to the birth canal. The bleeding may stop at some point, but it nearly always recurs days or weeks later.
Placental abruption. Rarely, the placenta begins to separate from the inner wall of the uterus before birth. This may cause bleeding that's scant, heavy or somewhere in between. The bleeding is usually accompanied by abdominal pain.
Uterine rupture. Rarely, the uterus tears open along the scar line from a prior C-section. This may cause vaginal bleeding, intense abdominal pain and abdominal tenderness. If your uterus ruptures — either before or during labor — an emergency C-section is needed to prevent life-threatening complications.
When to contact your health care provider
Contact your health care provider if you have any amount of vaginal bleeding in the second or third trimester. You'll likely need an exam in the doctor's office or hospital. Seek immediate care if you have vaginal bleeding accompanied by:
What to expect next
To determine what's causing the bleeding, your health care provider will likely do an ultrasound and a vaginal exam. Monitors may be used to detect contractions and track your baby's heart rate. If you've lost a significant amount of blood, you may need intravenous fluids or a blood transfusion. Your health care provider will closely monitor your baby for signs of distress.
Depending on the cause of the bleeding and various other factors, treatment may include bed rest or medication. If you have a cervical infection, you may be given antibiotics. In some cases, an emergency C-section may be recommended.
Details are key to diagnosis
If you experience vaginal bleeding during pregnancy, don't be shy about explaining your symptoms. Describe how much blood you passed, what it looked like, and whether it included any clots or tissue. If you use pads to soak up the blood, keep track of how many. All this information can help your health care provider determine if the bleeding is a normal part of pregnancy or something more serious — and what to do next.
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Good Luck to you.
mom of 3 and 4th in 7 days at age 41
By Mayo Clinic Staff
May 2, 2007