Pregnancy is definitely one of the most fulfilling and amazing experiences a woman can have. With it, she becomes co-creator with God. Just the thought of a human growing inside of you is more than words can ever express. However, with pregnancy come a lot of risks and problems, although most of them are manageable once identified early. One of which is spotting during pregnancy.
Spotting, as a gynecologic term, is defined as light bleeding or drops of blood on the underwear or panty liner, coming from the vagina. The color varies from pink to red to brown (the color of dried blood). Bleeding, on the other hand, has a heavier blood flow, soaking feminine pads. For pregnant women, having any tinge of blood on the underwear can be alarming to them. However, in a recent research presented at the Society of Maternal-Fetal Medicine, wherein 16,000 women were looked into, the risk for complication from spotting is found to be less than five percent. This is according to Dr. Joshua Weiss, a clinical fellow of Maternal-Fetal Medicine at Columbia Presbyterian Hospital in New York City, and lead author of the study. Still, that is not enough to pacify any pregnant woman who values the child within her.
About twenty to thirty percent of women in their first trimester experience spotting during pregnancy. Light bleeding that occurs early in pregnancy is commonly caused by implantation, or when the fertilized egg attaches itself to the uterine wall, a little bleeding happens resulting to brown spotting. This lasts for about two to three days. Implantation usually occurs even before a woman discovers that she is pregnant.
Another cause of spotting is a cervical polyp, which is a harmless fleshy growth in the cervix. The bleeding results from the higher estrogen levels during pregnancy and from the increased number of blood vessels in surrounding areas of the cervix that contact with it (by sexual intercourse or gynecologic examination) may lead to spotting.
Spotting after sexual intercourse may be due to the fact that there is increased development of blood vessels in the cervix and around it during pregnancy. With sex, the cervix is highly sensitive that minor bumps and irritation may cause it to be inflamed and irritated and prone to bleeding.
Physical examination of a pregnant woman including Pap smear and internal examination may induce spotting afterwards due to the hypervascularization and hypersensitivity of the cervix.
More serious causes of spotting include miscarriage or ectopic pregnancy. Both conditions would present as having abdominal pain or cramps.
Early miscarriage usually occurs when the fetus is not developing properly. The bleeding becomes steady and heavier, sometimes with passage of blood clots or meaty materials. It is fairly common that sometimes women who have miscarriage will only then know that they are pregnant. With a miscarriage, the products of conception should be removed so as not to pose a threat to the mother. If parts of the fetus or placenta are left inside the woman, these can become poison and eventually develop into sepsis. If an ultrasound was done around 7-11 weeks age of gestation and it documented the presence of a healthy heart, there is 90 percent chance of being able to continue the pregnancy to term.
Ectopic pregnancy happens when a fertilized egg implants in a lining outside of the uterus, usually in one of the fallopian tubes (called tubal pregnancy). There will be severe pain near the area of implantation. The vaginal discharge may be dark and watery and continuous. This case is life-threatening and immediate surgical intervention to terminate the ectopic pregnancy is warranted.
Molar pregnancy (also called gestational trophoblastic disease) is an unusual cause of bleeding, affecting only about one in 700 pregnant women. It occurs when an embryo does not develop properly but some cells of the placenta continue to increase in number. Removal of molar pregnancy is needed as soon as possible.
Conditions unrelated to pregnancy that cause spotting during pregnancy are vaginal infections (like yeast infection or bacterial vaginosis). Sexually transmitted illnesses as trichomoniasis, gonorrhea, Chlamydia, and herpes can lead to cervical inflammation, may become irritated, and eventually produce spotting.
In the second and third trimester, spotting may be a sign for a much worse condition. These include placental abnormalities as placenta previa (placenta lies low in the uterus, partially or completely blocking the cervical opening.) Abruptio placenta, on the other hand, is early or premature removal of the placenta from its attachment.
What To Do?
If spotting during pregnancy is experienced, wear a feminine pad or napkin, not a tampon, rest, and drink plenty of fluids.
While spotting during the first trimester may be considered normal, or at least, harmless, it is still best to contact the obstetrician to ensure that the bleeding is not due to complications like ectopic pregnancy or miscarriage. The doctor may order for an ultrasound to be done to rule out ectopic pregnancy. He or she will also examine the vagina and cervix to look for infection, polyp. Laboratory requests may be sent out to rule out infectious causes.
As long as the pregnant mother does not experience severe cramping, heavy bleeding and passage of meaty or tissue-like materials, the doctor may most probably say that the spotting is inconsequential. However, if these symptoms are experienced, rush to the nearest emergency room for further evaluation and management.
If spotting occurs later in the pregnancy, the American Pregnancy Association recommends that the patient consult her physician immediately for this may be caused by a more serious problem. Certain medical conditions may pose as a threat to pregnancy, hence, warrants a consult with the obstetrician.
Suffice it to say, no pregnancy is the same for anyone, not even to the same person with multiple pregnancies. Each experience is unique in itself. Some may spot, others do not. What is important is to keep oneself educated and never panic. With regards to spotting during pregnancy, no guideline has been established, but as a general rule, when in doubt, go consult your doctor.