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Early pregnancy bleeding (also called first trimester bleeding) is vaginal bleeding before 14 weeks of gestational age. [ 1 ] [ 2 ] If the bleeding is significant, hemorrhagic shock may occur. [ 1 ] Concern for shock is increased in those who have loss of consciousness , chest pain, shortness of breath , or shoulder pain.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Vaginal bleeding occurs during 15–25% of first trimester pregnancies. [29] Of these, half go on to miscarry and half bring the fetus to term. [30] There are a number of causes including complications to the placenta, such as placental abruption and placenta previa.
Implantation bleeding may be confused with a regular period. [4] [5] Heavy vaginal bleeding in the first trimester or bleeding associated with pain, may be a sign of a complication, such as a miscarriage or an ectopic pregnancy, that would need to be assessed by a healthcare provider. [6]
Vaginal bleeding: A circumvallate placenta can increase the risk of frequent vaginal bleeding during the first trimester of pregnancy. In a study conducted with 92 women with a circumvallate placenta, it was concluded that incidences of vaginal bleeding were significantly higher in women with a circumvallate placenta during all three trimesters ...
Symptoms include vaginal bleeding, abdominal pain, premature labor and threatened miscarriage. [6] Ultrasonography is the preferred method of diagnosis. [7] A chorionic hematoma appears on ultrasound as a hypoechoic crescent adjacent to the gestational sac. The hematoma is considered small if it is under 20% of the size of the sac and large if ...
The most common early first trimester medical abortion regimens use mifepristone in combination with misoprostol (or sometimes another prostaglandin analog, gemeprost) up to 10 weeks (70 days) gestational age, [64] [65] methotrexate in combination with a prostaglandin analog up to 7 weeks gestation, or a prostaglandin analog alone. [19]
First trimester bleeding [ edit ] Causes of vaginal bleeding early in pregnancy include miscarriage (including inevitable, incomplete, or complete abortion), embryo implantation and growth outside the uterus ( ectopic pregnancy ), and placenta attachment at the bottom of the uterus over the cervix ( placenta previa ), all of which can cause ...