28 December

Spotting during the first trimester

Anjali - My patient called me this morning. I could gather from her tone that she was very anxious. She said “ Doctor, I am very scared, I have noticed some spotting since this morning”

I asked her first to calm down. Spotting or light brown vaginal bleeding can occur in both viable and nonviable pregnancies. Anjali was in her 10th week. It is obviously very easy to panic and fear the worst especially in the first trimester when you are just about sharing the news with your near and dear and are very excited about the future, but try to stay calm. Miscarriage is only one of the many causes of spotting.

Common Causes of Spotting During Early Pregnancy are

- Recent sexual intercourse

- Recent pelvic exam

- Recent transvaginal ultrasound

- Cervical ectopy

- Implantation bleeding

- Cervical infection (cervicitis)

- Placenta issues, such as placenta previa

- Miscarriage or ectopic pregnancy

I told Anjali- "If you are spotting, keep an eye on the flow to see if it gets heavier. If the spotting goes away, it is more likely to be nothing to worry about, but if it gets heavier and begins to resemble a menstrual flow, you should come to the clinic." Bleeding in the second and third trimesters, especially red bleeding, should always be reported to a physician.

Spotting After Sex (Postcoital Bleeding) - Bleeding after sex most often occurs in women. In two-thirds of cases, bleeding after sex is benign and no cause can be found. In other women, however, spotting after sex can be attributed to things like cervicitis, or infection and inflammation of the cervix, which is part of the birth canal and the tissues that link the vagina to the uterus. A common cause of cervicitis among women is chlamydia, which requires treatment with antibiotics.

Placenta Previa

The placenta is normally attache dot the top or side of the uterus, but in placenta previa, the placenta covers the opening of the cervix. The degree to which the placenta can cover the cervix can be marginal, partial. or complete. Women with placenta previa often are prescribed bed rest and pelvic rest (no sex). Furthermore, women with placenta previa receive C-sections because a vaginal delivery may cause too much bleeding. click here to read more about Placenta Previa.

Cervical Ectopy

Cervical ectopy is when the cells of the endocervix, or inner part of the cervix, protrudes into the ectocervix, or outer part of the cervix. Use of oral contraceptives can contribute to the development of cervical ectopy. Typically, cervical ectopy gradually disappears when a woman is in her 20s and 30s. Cervical ectopy can be mistaken for cervicitis or cervical infection.

While there are all the above reasons for spotting during the first trimester, it is always better to call and get your physician’s advice if you notice any spotting or bleeding during pregnancy. Anjali’s spotting subsided in a day and she was happy.

Dr Padma

Dr Padma is a Family care physician and is the Founder and CEO of MedHealthTV.


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