It isn’t those rare cases of women who menstruate throughout their pregnancy that we speak of when we discuss spotting during pregnancy.
It is other cases of light bleeding or spotting at different stages of a pregnancy that can have various different causes, ranging from the normal and innocuous to the worrisome that we discuss in this post.
Spotting during pregnancy – First trimester
Implantation bleeding is the most common cause of spotting in the early part of a pregnancy. In fact this sort of bleeding is known to occur in up to 25% of all pregnancies and is thought to be a perfectly normal cause of first trimester bleeding. This is a brownish or a pinkish discharge that usually occurs about a week to 12 days after ovulation or after conception would have occurred.
However there are many cases during which spotting during pregnancy is a worrisome occurrence. In cases the bleeding could indicate an abortion (threatened, complete or incomplete). An ectopic pregnancy where the embryo implanted at a location other than the uterus can also cause bleeding and typically pain as well.
Certain sexually transmitted diseases or infections of the urinary tract could also result in spotting. In rare cases it could be due to gestational trophoblastic disease (GTD) which is a group of pregnancy-related tumors that could be responsible.
Spotting during pregnancy – Second and third trimester
The general rule is that no bleeding during the second and third trimester of pregnancy should be considered normal and should always be reported.
The most common reasons for bleeding in the later stages of pregnancy is miscarriage (if prior to twenty weeks) and premature labor (if after 20 weeks gestation). Problems with the placenta – placenta previa (where the placenta covers the cervix) or placental abruption (where the placenta detaches from the walls of the uterus) are the other reasons for bleeding during the second and third trimesters of pregnancy.
Certain genetic blood related problems can also cause bleeding; hemophilia and von Willebrand disease could cause bleeding.
In rare cases conditions such as uterine rupture can cause pregnancy bleeding. Women who have had surgery of the uterus, several previous pregnancies, or who have the baby is certain positions are more at risk of this life threatening complication.
Fetal vessel rupture is another uncommon condition that could also result spotting in pregnancy.
Physical trauma or injury to the cervix or vagina can also be responsible for spotting in pregnancy. Polyps or tumors (malignant or benign) in any part of the reproductive tract could also cause spotting.
The doctor will make a diagnosis of what is the underlying cause for the spotting, based on the type of bleeding that occurs: whether it is heavy bleeding or spotting; whether it is brownish or dark in color or whether it is fresh looking blood. The doctor will also look at whether there are any clots or pieces being passed along with the blood.
Also what are the symptoms other than the spotting during pregnancy? Is there any cramping, pain, tenderness, dizziness and so on? All this is looked at as well.