Bleeding During Pregnancy: When Should You Rush to the Hospital?

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Vaginal bleeding is a common concern during pregnancy, with up to 25% of women experiencing some degree of bleeding. It can range from mild spotting to severe haemorrhage. While not every episode of bleeding signals a serious problem, it should never be ignored. The cause varies depending on the pregnancy stage, and timely medical evaluation is essential to identify the cause and determine the appropriate course of management.

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We spoke to Dr Laxmi Narayan Sahoo, Consultant - Fetal Medicine & Clinical Genetics, Manipal Hospital, Bhubaneshwar, who explained when bleeding during pregnancy becomes a warning sign.

Bleeding During Early Pregnancy

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"In early pregnancy, implantation bleeding can occur and is considered a physiological event. It occurs in approximately 25% of pregnancies as the fertilised egg attaches to the uterine wall. This usually happens about 10 to 14 days after conception and is often light, lasting for a short duration," said Dr Sahoo.

However, bleeding in the first trimester may also indicate conditions that require immediate medical attention. These include ectopic pregnancy, miscarriage, and molar pregnancy. Since these conditions can have significant consequences if left untreated, any bleeding during early pregnancy should be discussed with an obstetrician.

"In most cases, your obstetrician will recommend an ultrasound examination to confirm the location and viability of the pregnancy, identify the cause of bleeding, and guide further management," added Dr Sahoo.

Other Causes of Bleeding

Not all bleeding during pregnancy originates from the uterus. Conditions affecting the cervix can also lead to vaginal bleeding. These include cervical infections, inflammation of the cervix, or cervical growths such as polyps. "Occasionally, vaginal growths that develop during pregnancy may also present with bleeding. Although some of these conditions are not dangerous to the pregnancy, they still require proper evaluation to rule out more serious causes," said Dr Sahoo.

Bleeding in the Second and Third Trimesters

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The causes of vaginal bleeding change as pregnancy progresses. During the second trimester, bleeding is commonly associated with placental abruption or placenta previa. Both conditions require prompt medical assessment because they can affect the health of both the mother and the baby.

"During the third trimester, vaginal bleeding may occur due to placental abruption, placenta previa, or vasa previa. Light bleeding mixed with mucus near the end of pregnancy may also be a sign that labour is beginning. While this may be a normal part of the birthing process, it is still important to inform your obstetrician so that labour can be assessed appropriately," explained Dr Sahoo.

Message From the Expert

Dr Sahoo concluded, "The causes of bleeding differ in each trimester, and so does the management. For this reason, every episode of bleeding during pregnancy should be evaluated by an obstetrician rather than being dismissed as normal. Early assessment, usually supported by ultrasound and clinical examination, helps establish the diagnosis, reassures the mother when appropriate, and ensures timely treatment whenever required."