Bleeding during pregnancy, must be the precursor of abortion?

Everyone should have seen the scenes of pregnant women often showing blood flowing down the river in TV plays, and then there was a sad ending-the child was gone! It seems that as long as it is bleeding during pregnancy, it must be abortion. In fact, it is not. The causes of bleeding are various and the outcomes are quite different.

Pregnancy [1] is a process in which embryos and fetuses develop and mature in the mother’s body. In this special physiological process of nearly ten months, Bleeding is indeed a common phenomenon. Especially in the first three months of pregnancy (0 ~ 13 weeks), This is an important period for fertilized eggs to differentiate into embryos and fetuses and for the formation of important organs. Before the placenta is completely formed, embryo implantation is not stable. Data from the American Pregnancy Society show that [2], about 20% ~ 30% of pregnant women have experienced vaginal bleeding of different degrees during early pregnancy, most of which are minor bleeding or intravenous bleeding.

Normal fertilized egg implantation can cause drip bleeding.

Intravenous bleeding is often only a slight hemorrhage found on underpants or a little blood on toilet paper wiped after going to the toilet, with blood colors ranging from red to brown.

Why is this phenomenon happening? If such hemorrhage occurs within 6-12 days after conception, it may be implantation hemorrhage of fertilized eggs. Although fertilized eggs should not bleed during normal implantation, a small number of women will have a little hemorrhage due to physiological and physical problems, some may only have transient hemorrhage, and some will last for 1-2 days [2, 3].

A few pregnant women still have a small amount of menstrual bleeding in the month after conception. If the amount of bleeding is obviously less than the normal amount of menstruation, and there are no other accompanying symptoms (such as abdominal pain, menstrual discomfort), this may only be a physiological reaction of egg implantation. This kind of situation should be kept clean, generally will not affect embryo development.

In addition, after pregnancy, Hormones dilate blood vessels in the uterus and abdominal cavity, Change the state of the surface of the cervix, Make the cervix softer and more fragile, This makes it easier to bleed. Even slight stimulation or exercise may cause bleeding, such as a small amount of bleeding after sex. Women with cervical inflammation, such as cervical polyps, may also have a small amount of spontaneous bleeding or contact bleeding due to dilatation of capillaries on the cervical surface after pregnancy [4].

Small bleeding may also be a big hidden danger.

Most of the small amount of bleeding in the early stage of pregnancy will not affect the continuation of pregnancy. Of course, it is better to make a more accurate judgment and inform the doctor of the situation. Because sometimes, vaginal bleeding may be the manifestation of some serious pathological conditions, such as abortion, ectopic pregnancy or hydatidiform mole [1].


Almost all early abortions take vaginal bleeding as the first symptom, followed by paroxysmal lower abdominal pain. If bleeding and abdominal pain worsen, abortion is often inevitable. Most spontaneous abortions are caused by abnormal development of the fetus itself and usually cannot continue pregnancy, which is the result of natural elimination.


Ectopic pregnancy refers to the implantation of fertilized eggs outside the uterine cavity. Under normal circumstances, fertilized eggs should be implanted and developed in the uterine cavity. If the fertilized egg is implanted in the fallopian tube or ovary or even in the abdominal cavity due to tubal inflammation and other reasons, It can lead to ectopic pregnancy. Ectopic pregnancy may cause abdominal pain and a small amount of bleeding. If rupture suddenly occurs, it is manifested as acute severe abdominal pain and vaginal bleeding. The disease develops rapidly and can lead to hemorrhagic shock with serious consequences, which requires high attention. If it is a high-risk group with a history of ectopic pregnancy, adnexal inflammation and assisted reproductive conception, bleeding requires immediate medical treatment.


Hydatidiform mole is relatively rare, named from its appearance. Pregnant objects are blisters of different sizes, with pedicles connected and grapes in appearance. Most vaginal bleeding occurs 8 ~ 12 weeks after menopause, with a small amount and a gradual increase. When hydatidiform mole grows rapidly, it will cause lower abdominal pain, blood hCG level is significantly higher than normal pregnancy, and B-ultrasound examination can help diagnose the disease.


Although bleeding during pregnancy is always worrying, But don’t panic when you meet, Learn to observe the nature and amount of bleeding. If it is drip or small bleeding during early pregnancy, you don’t need to worry too much. They may last for a few hours or a day or two and then stop. They will not affect the development of the embryo and the continuation of pregnancy. They are a very small episode in the whole pregnancy and will pass quickly. However, if bleeding continues to increase or is accompanied by abdominal pain, tissue is discharged with the blood or bleeding in the middle and third trimester of pregnancy, you must seek medical treatment in time [5].

Do not use tampons or other articles to stop bleeding after bleeding, so as not to cause infection or abortion. Sanitary napkins should be used, which can help estimate the amount of bleeding. When going to the hospital, take clothes stained with blood or cushions with blood accumulation, etc. If there is a large amount of bleeding, collect the blood in containers or sealed bags as much as possible and take it to the doctor.

What questions will doctors ask when they go to see a doctor?

There are many reasons for bleeding during pregnancy, and doctors may ask these questions in order to obtain comprehensive information [6]:

    How long have you been pregnant? Have you had vaginal bleeding this time or before? When did what start bleeding? Is the bleeding intermittent or persistent? What is the amount of bleeding? What’s the color of the blood? Is there any pain or colic? Do you feel weak or weak? Do you feel dizzy? Do you have nausea, vomiting or diarrhea? Do you have a fever? Have you ever fallen or suffered any other injuries? Is there any physical activity abnormality? Have you had any extra stress lately? When was the last time you had sex? Is there any bleeding after that? … …

Pregnancy is a very delicate and complicated process. Mothers-to-be can not only experience the changes inside the body and the joy of giving birth to new life, but also may experience the magic of life. Therefore, keep a happy mood, be prepared to overcome all difficulties and welcome the coming of small life.