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Spotting in early pregnancy

05.04.2023

3 min. Reading time

The first weeks of pregnancy are extremely stressful for most pregnant women. This is mainly due to the risk of miscarriage, which is highest in the first trimester. For this reason, any spotting in early pregnancy is worrying and a common reason for a visit to the gynaecological emergency room. Find out what spotting in the first weeks of pregnancy can mean.

Spotting in early pregnancy – causes

According to the American College of Obstetricians and Gynecologists, miscarriages occur in up to 10% of symptomatic pregnancies in the first 13 weeks of pregnancy. This is another reason why genital bleeding is clearly associated with a high risk of pregnancy loss in many pregnant women. In fact, one of the symptoms of miscarriage is bleeding or spotting. If there is necrosis and consequent bleeding from the genital tract, it is a miscarriage. However, it is important to know that not every miscarriage manifests itself through bleeding. It can also be an obstetric miscarriage, which the gynaecologist detects during an ultrasound examination if the embryo does not grow or its heartbeat stops. Also, not all bleeding is a clear sign of a miscarriage. It can be a case of implantation bleeding or a so-called threatened miscarriage if the pregnancy has not yet been terminated. Bleeding in early pregnancy can also be due to an abnormal position of the pregnancy, a so-called tubal pregnancy (ectopic).

Spotting in early pregnancy – are they dangerous?

In case of bleeding or spotting during pregnancy, a gynaecologist must be consulted. He will inform the pregnant woman about the development of the pregnancy and possible anomalies. In the case of an ongoing or completed miscarriage, intervention is no longer possible because the miscarriage has already occurred. However, if the miscarriage is imminent and spotting occurs without the pregnancy terminating, an attempt can be made to prevent a miscarriage, e.g. by taking progesterone. If bleeding is heavy and prolonged, the woman may develop anaemia, which puts her at risk of fainting and feeling unwell. In this case, hospitalisation, hydration or iron supplementation may be necessary.

 

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Spotting in early pregnancy – when should you go to the doctor?

Any pregnant woman who has spotting in the genital area should see her GP. If the bleeding is not heavy, there is no need to go to the emergency room for gynaecology and obstetrics. However, if an appointment with the gynaecologist is far away, many women have no choice but to go to the emergency room of the maternity hospital. There, after an ultrasound examination and the necessary laboratory tests, the expectant mother receives information about the current status of the pregnancy and recommendations for further treatment. If an obstetric abortion occurs or an ectopic pregnancy is suspected, a visit to the hospital is always necessary, where a procedure such as curettage or pharmacological induction of the miscarriage is performed.

Spotting in early pregnancy – treatment

The treatment of spotting in early pregnancy depends primarily on the cause. If it is a persistent miscarriage, it is usually sufficient to check the beta-hcg level after the next menstrual period and to follow up with an ultrasound examination by the gynaecologist. In the case of an obstetric miscarriage, it is necessary to clean out the uterine cavity by curettage or with the help of pharmacotherapy. If the cause of the spotting in the genital area is an ectopic pregnancy, surgery or a treatment trial with methrotrexate may be necessary.

It should be remembered that spotting in early pregnancy is not synonymous with pregnancy loss and affects up to 25% of pregnant women. Necrosis occurs in ten per cent of cases, while the pregnancy develops normally in the remaining cases.

 

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