Bleeding During Prenancy Vaginal bleeding in pregnancy has many causes. Some are serious and some are not. Early Pregnancy Many women have vaginal spotting or bleeding in the first 12 weeks of pregnancy. If you have bleeding during pregnancy, you may need special care. Miscarriage Bleeding doesn't mean that miscarriage is certain, but it can occur. About half of the women who bleed do not have miscarriages. Miscarriage can occur at any time during the first half of pregnancy. Most occur during the first 12 weeks. Miscarriage occurs in about 15 percent to 20 percent of pregnancies. If you think you have passed fetal tissue, take it to the doctor's office so it can be examined. (If Possible) Most miscarriages cannot be prevented. They are often the body's way of dealing with a pregnancy that was not normal. There is no proof that exercise or sex causes miscarriage. Ectopic Pregnancy(Pregnancy outside of the uterus) Another problem that may cause pain and bleeding in early pregnancy is ectopic pregnancy. If pregnancy occurs in a fallopian tube, it may burst. Ectopic pregnancies are much less common than miscarriages. They occur in about one in 60 pregnancies. Molar Pregnancy A rare cause of early bleeding is molar pregnancy. It is also called gestational trophoblastic disease (GTD) or simply a "mole." It is the growth of abnormal tissue instead of an embryo. Late Pregnancy The causes of bleeding in the second half of pregnancy differ from those in early pregnancy. Common conditions that cause minor bleeding include an inflamed cervix or growths on the cervix. Late bleeding may pose a threat to the health of the woman or the fetus. It may require treatment in a hospital. Heavy vaginal bleeding usually involves a problem with the placenta. The two most common causes of bleeding in late pregnancy are placental abruption and placenta previa. Preterm labor can also cause vaginal bleeding. Placental Abruption The placenta may detach from the uterine wall before or during labor. This may cause vaginal bleeding. Only 1 percent of pregnant women have this problem. It usually occurs during the last 12 weeks of pregnancy. Stomach pain often occurs, even if there is no obvious bleeding. Placenta Previa When the placenta lies low in the uterus, it may partly or completely cover the cervix. This is called placenta previa. It may cause vaginal bleeding. Placenta previa is serious and requires prompt care. Placenta previa occurs in one woman in 200. Labor Late in pregnancy, vaginal bleeding may be a sign of labor. A plug that covers the opening of the uterus during pregnancy is passed just before or at the start of labor. A small amount of mucus and blood is passed from the cervix. This is called "bloody show." It is common. It is not a problem if it happens within a few weeks of your due date. Taking Action Call our office if you have bleeding in late pregnancy. You may need to be admitted to the hospital to find its cause. Ultrasound may be advised. Conditions that cause bleeding in late pregnancy pose a risk to both mother and fetus. Finally ... Many women with bleeding in pregnancy have minor conditions that need no treatment. At other times, bleeding can be a sign of a serious problem. Bleeding anytime in pregnancy — early or late — should be reported to your doctor or nurse-midwife. This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor or nurse-midwife. If you need medical care, have any questions please contact our office.