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Bleeding And Spotting During Pregnancy

Dr Alex Eskander

The most common cause for bleeding or spotting during pregnancy is impending miscarriage, ectopic pregnancy, bleeding behind the placenta or a low lying placenta. Here, we talk to Dr Eskander, Consultant Gynaecologist & Medical Director at The Gynae Centre, about these causes and what to do if you find it during your pregnancy.

If you discover bleeding during your pregnancy, it’s easy to start panicking. However, it is important to remain calm. If the bleeding is mild and not associated with pain, wait and see. If associated with severe pain in the lower abdomen, see your doctor as soon as possible to exclude extrauterine pregnancy.

Bleeding And Miscarriage

According to, a miscarriage occurs in 12-24% of all recognised pregnancies and most will occur in the first trimester. In the case of a miscarriage, most patients will experience bleeding and pain that is worse than a period. With an impending or threatened miscarriage, however, mild bleeding can occur without pain.

Dr Eskander says, “The first thing to do if you find that you are bleeding or spotting is to check if the pregnancy is normal. This is can be done accurately by an ultrasound six weeks into the gestational period; a pregnancy test is not accurate enough to detect a miscarriage, as it will remain positive for up to four weeks after a miscarriage (this is because it looks for the BHCG hormone which is emitted from the placenta and not the baby).”

Bleeding And Spotting During Pregnancy

Spotting And Ectopic Pregnancy

An ectopic pregnancy is a pregnancy implanted outside the uterus. It takes place most commonly in the fallopian tubes, but it can occur in the neck of the womb (the cervix), over a caesarean scar or the ovaries.

Bleeding or brown watery discharge can occur during an ectopic pregnancy, and can be combined with pain low down on one side of your abdomen or in the tip of your shoulder.

Low Lying Placenta

The placenta looks like a pancake and it is attached to the inside of your uterus during pregnancy, with the umbilical cord attached to the centre. If you have a low lying placenta, it is usually situated near or over the cervix. As Dr Eskander says, a low lying placenta “can cause bleeding because it lies on top of a hole unsupported and is sheared off from the lower part of the uterus as it is growing up.”

A low lying placenta can be diagnosed at the 18-21 week scan, and if the placenta is significantly low it will be checked again at around 32 weeks to see if it has remained in place. It can rectify itself as the uterus grows and most women are not affected by this condition in the later stages of pregnancy; however, if it is found that the placenta is less than 2cm away from the cervical opening, your doctor may advise you to give birth by caesarean section.

If you are experiencing bleeding or spotting during pregnancy, and need to see a gynaecologist, we can help you find a Top Private Consultant Gynaecologist or Private Clinic or Hospital for Gynaecology Care.

What Should You Do If You Experience Spotting Or Bleeding During Pregnancy?

Dr Eskander advises: ‘If the bleeding is light and is associated with mild, cramp-like pain, just wait and see if it settles. If it does settle spontaneously, arrange a viability scan at eight weeks. If the bleeding is associated with a severe and acute stabbing pain, dizziness or fainting, you must seek immediate medical advice to exclude an ectopic pregnancy and abdominal bleeding.

“If the bleeding is heavier and more like a period than spotting, a scan will usually clarify the reason.

“If the pregnancy is viable and there is a heart beat, the best option is to keep an eye on the bleeding and avoid intercourse until 10-14 days after the bleeding settles.”

Related article: Gynaecology Care: Ten Questions You Might Have About Abnormal Vaginal Bleeding 

We would like to thank The Gynae Centre for providing their specialist knowledge for this article.

The Gynae Centre

The Gynae Centre
Suite 23
Milford House
7 Queen Anne Street
London W1G 9HN

Tel: 020 7580 8090

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