Bleeding and Cramping

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Possible Causes of Bleeding and Cramping in Pregnancy

Normal causes:

  • Early in pregnancy, light vaginal spotting around the time of the expected period (around 10 to 14 days after fertilization) is usually a sign that the fertilized egg has implanted itself into the uterine wall. This spotting might be accompanied by mild uterine cramping similar to menstrual cramps.
  • During the first trimester, cervical changes occurs, including more blood flow to the cervix and softening of the cervix, which may result in harmless vaginal bleeding after intercourse or a pelvic exam. 
  • Near to the end of pregnancy, the cervix begins to thin out and relax in preparation for labor and the thick plug of mucus that seals the opening of the cervix is dislodged which could be noticed in a thick or stringy discharge that may be tinged with blood. This is usually a sign of impending labor that can occur up to a week or two before delivery. 

When to worry?

  • Sometimes vaginal bleeding during pregnancy indicates an impending miscarriage or a pregnancy complication that needs prompt treatment. That is why it is so important to consult your Ob-gyn to rule out any more serious problems and take appropriate steps if necessary.
  • Possible causes of bleeding during the first trimester include: ectopic pregnancy, miscarriage, or cervical infections.
  • Possible causes of bleeding during the second or third trimester include: miscarriage, placenta previa, placenta abruption, preterm birth, premature opening of the cervix which could lead to preterm birth, cervical infections or inflammation, or uterine rupture (rare case).

Consult your Ob-gyn immediately if the bleeding is severe and not the spotting associated with implantation. 

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