Periods during pregnancy? Here’s why

Spotting or bleeding?

It is possible for a woman to experience what appears to be ‘periods’ during pregnancy. This is abnormal bleeding. It can either be spotting or vaginal bleeding. The difference between the two is the quantity of blood that is released. Spotting does not warrant a sanitary pad as the bleeding is slight, while in vaginal bleeding the flow of blood appears like a normal period.

Causes of bleeding

The causes of bleeding during early pregnancy can be hormonal or due to an infection on the cervix, which may cause the cervix to bleed. Blood comes from inside the uterus. This condition is referred to as abnormal bleeding of the uterus. The uterus prepares itself early for the egg, long before conception, with the internal lining developing a lot of blood vessels and an enlarged endometrium (the mucous membrane that lines the womb and increases in thickness in the latter part of the menstrual cycle). When the egg implants itself inside the uterus and starts growing the lining of the uterus may get eroded and open up a bleeder (open blood vessel) resulting in bleeding.

For pregnancy to be properly maintained a female sex hormone, called progesterone, necessary in the formation and maintenance of life, is produced. It is released first by a yellow mass of tissue in the ovary to prepare the womb for the fertilized ovum, and later by the placenta to maintain pregnancy.

If the level of progesterone is low the body bleeds in a cyclic manner as if there is no pregnancy. In this case the pregnancy is at risk of aborting. If the placenta is located in the lower part of the uterus, bleeding can also occur.

It is a bit rare for the bleeding to go on for more than two cycles; it mostly occurs during the first and second month of pregnancy.

Ante-partum haemorrhage

Refers to bleeding from the genital tract occurring from the 24th week to birth of a baby. It can result from conditions such as premature separation (partial or complete) of a normally situated placenta from the uterus. This is known as abruption and poses a great danger to the baby.

Cervical tumors or erosion and inflammation of the vaginal tract due to fungal infection can also cause bleeding.

Threatened abortion

Bleeding when pregnant is a warning sign that may point at the first signs of fetal termination (abortion). Abortion is the expulsion of the fetus from the womb before 24 weeks of pregnancy have elapsed.

Slight vaginal bleeding, sometimes accompanied by abdominal pain, means the pregnancy is at stake and is referred to as ‘threatened abortion.’ If the bleeding and pain are accompanied by dilation of the cervix, abortion becomes inevitable.

Missed abortion

Vaginal bleeding when pregnant may also indicate a missed abortion. If the pregnancy fails and the fetal material is retained in the uterus, this is called a missed abortion.

Vacuum extraction of the uterus is necessary to remove the dead fetus. The mother may or may not suffer vaginal bleeding.

When should bleeding worry you?

Any vaginal bleeding in pregnancy is of concern and must be reported to a doctor immediately for proper diagnosis.

Stopping the bleeding

In case you start bleeding during pregnancy it is important to consult the doctor who will examine you and carry out the necessary tests to establish the source of the bleeding. If bleeding is the result of an infection of the cervix appropriate treatment is administered. If hormonal deficiency is suspected, progesterone supplementation is given. This may be in the form of tablets, injections or suppositories (solid conical or cylindrical drug designed to dissolve upon insertion into an organ, for instance the vaginal canal). The treatment is harmless to the unborn child and is beneficial since the progesterone level is brought up.

A mother can reduce her risk of bleeding by giving her doctor a history of her previous pregnancy or pregnancies and revealing any previous cases of spotting or bleeding. This enables advance preventive treatment.

END: PG 2/7