Dear Mary,

 

The answer to your question depends on many things. How long was it after you confirmed the pregnancy that you had the supposed period? Was the bleeding mild, like few drops, or was it heavy? Was it only one episode or it is persisting or recurrent? Is there lower abdomen pain?

 

Normally, during pregnancy, one does not get a period and this is the first sign of pregnancy. The equilibrium of the two hormones estrogen and progesterone changes during pregnancy. In some women, during this transition in balance of hormones, some bleeding may occur in the first trimester. However, it is just in form of spotting and is definitely scanty as compared to a normal period.

 

Sexual intercourse done during pregnancy can cause slight spotting or bleeding. It can be due to pelvic infections which may be sexually acquired or spread due to poor hygiene. Infection of the urinary bladder can cause some vaginal bleeding, apart from other symptoms, like frequency and urgency of urination. Both pelvic and urinary tract infections can cause lower abdominal and back pain as well.

 

Blood thinning drugs like aspirin may cause vaginal bleeding as adverse effect.

 

Among sinister causes, threatened abortion is the most common cause for vaginal bleeding in early pregnancy. Bed rest and timely treatment can save the pregnancy, otherwise it can progress to a complete termination or miscarriage. This is characterised by heavy bleeding and cramp-like abdominal pain. Ectopic pregnancy is a condition where the fertilised egg is implanted outside the uterus. Due to abnormal location of the fertilised embryo, it causes severe abdominal pain and bleeding. If left untreated, it can be fatal. Hence, it needs urgent intervention by surgery, where the abdomen is opened and abnormally located embryo removed.

 

Molar pregnancy is yet another condition where there can be bleeding during pregnancy. In this condition, instead of a normal foetus, blighted tissue is present. 

 

These conditions can be easily diagnosed by ultrasound examination. Hence, it is advisable to go for regular antenatal check-up, where routine ultrasound is done to check the growth of the foetus. Clinical examination and other tests are also done in antenatal clinics to exclude any other condition likely to affect pregnancy. If any such condition is detected, it is treated in time.                            

                       

Dr. Rachna   Pande is a specialist in internal medicine.