Periods – The unexpected guest during Pregnancy

Is it actually possible to have one?
February 19, 2021

12 Minutes

Before you get to read the entire blog, I want to make sure that you understand – It is not possible to have a true menstrual period during pregnancy. This is because your hormone levels during pregnancy will change to prevent you from menstruating, and it is not possible for your body to shed its entire uterine lining while maintaining a pregnancy.

You must have heard from a lot of women around, read in newspapers and listened to interviews and that they would have shared their stories, which you cannot refuse to believe. Especially the ones who get pregnant unknowingly, and give a reason that they have been getting periods hence, they didn’t realise that they were pregnant.

Err, how biologically is that possible?

It is, however, possible to have menstrual-like bleeding for a variety of reasons during pregnancy. Read on to know more on why the unexpected guests show up for some women during pregnancy.

Let’s get our basics straight and learn to differentiate spotting and bleeding,

Spotting usually refers to a few drops of blood that would not cover a pad or panty liner, whereas bleeding refers to blood flow that is heavy enough to require wearing a pad.

If bleeding occurs during the first trimester, wear a panty liner or pad so that you are able to get an idea of the amount of bleeding that is occurring and can tell the health care professional. However, you should not use a tampon in the vagina or douche during pregnancy.

Okay, now coming to the unexpected, unwelcome guest – periods, during the first trimester

Possible causes of first trimester bleeding may include:

Implantation bleeding

You may experience some normal spotting within the first six to 12 days after you conceive as the fertilized egg implants itself in the lining of the uterus. Some women don’t realize they are pregnant because they mistake this bleeding for a light period. Usually the bleeding is very light and lasts from a few hours to a few days.

Miscarriage

There are can be different reasons and one of the major fear which every preggy shudder is Miscarriage. It is most common during the first 12 weeks of pregnancy, it tends to be one of the biggest concerns with first trimester bleeding. But then, you can be relieved if you have seen the heartbeat on an ultrasound and Over 90% of women who experience first trimester vaginal bleeding will not miscarry.

So how do you find out the other one? The most common symptoms are strong cramps in the lower abdomen and you find tissue(bigger clots) passing through your vagina.

Miscarriage during pregnancy

Molar pregnancy

Molar pregnancy, also known as gestational trophoblastic disease or hydatidiform mole. It is an abnormality of fertilization that results in the growth of abnormal tissue within the uterus. Though you cannot call it a pregnancy, however, you start having the typical symptoms of early pregnancy. There are two ways in which this tissue will grow. In a complete hydatidiform mole, there is only abnormal tissue in the uterus and no fetus. But in the other, there is abnormal tissue growing along with the presence of a fetus. But then, this fetus will have severe birth defects. 

Usually, the fetus is consumed by the abnormal growth of tissue in the uterus itself. Hence there is no probability of having a normal fetus or delivery or both. Since there is no fetus, you tend to have vaginal spotting or bleeding. Other symptoms of molar pregnancy are severe nausea and vomiting, and rapid enlargement of the uterus.

Ectopic pregnancy

In this pregnancy, the fertilized embryo is placed outside of the uterus, usually in the fallopian tube. It is not just misplaced but the embryo keeps growing. As the baby grows and the tube distends, abdominal pain becomes increasingly severe. The fallopian tube isn’t big enough to host the fast-growing embryo and it causes it to burst. This can be life-threatening to the mother. Although ectopic pregnancy is potentially dangerous, it only occurs in about 2% of pregnancies.

Other symptoms of ectopic pregnancy are strong cramps or pain in the lower abdomen, and lightheadedness.

Additional causes of bleeding in early pregnancy include:

● Cervical changes. During pregnancy, extra blood flows to the cervix. Intercourse or a Pap test, which causes contact with the cervix, can trigger bleeding. This type of bleeding isn’t cause for concern.

● Infection. Any infection of the cervix, vagina, or a sexually transmitted infection (such as chlamydia, gonorrhea, or herpes) can cause bleeding in the first trimester.

Bleeding in the Second and Third Trimesters

Abnormal bleeding in late pregnancy may be more serious, because it can signal a problem with the mother or baby. Call your doctor as soon as possible if you experience any bleeding in your second or third trimester.

Possible causes of bleeding in late pregnancy include:

Placenta previa

Placenta which generally supplies oxygen and nutrients to the baby, sits low in the uterus and partially or completely covers the opening of the birth canal. 

The probability of placenta previa is very rare in the late third trimester, occurring in only one in 200 pregnancies. Though it causes painless bleeding, it requires immediate medical attention.

Placental abruption

Sometimes, in super rare cases, the placenta detaches from the wall of the uterus. It can happen before or during labor and blood pools between the placenta and uterus. This can be very dangerous to both the mother and baby.

Other signs and symptoms of placental abruption are abdominal pain, clots from the vagina, tender uterus, and back pain.

Uterine rupture. In rare cases, a scar from a previous C-section can tear open during pregnancy. Though it is very much possible to have a vaginal birth after a C section, there are chances of uterine rupture. It can be life threatening and requires an emergency C-section.

Other symptoms of uterine rupture are pain and tenderness in the abdomen.

Premature labor

Premature Labor

Your body is just getting ready to deliver. A few days or weeks before labor begins, the mucus plug that covers the opening of the uterus will pass out of the vagina, and it will usually have small amounts of blood in it (this is known as “bloody show”). If bleeding and symptoms of labor begin before the 37th week of pregnancy, contact your doctor right away because you might be in preterm labor.

Other symptoms of preterm labor include contractions, vaginal discharge, abdominal pressure, and ache in the lower back.

What to Do If You Have Abnormal Bleeding During Pregnancy?

So now that you know the difference between bleeding and spotting, you should also be aware of what to do if you have abnormal bleeding. Vaginal bleeding in any trimester can be a sign of a problem, so call your doctor immediately. Wear a pad so that you can keep track of how much you’re bleeding, and record the type of blood (for example, pink, brown, or red; smooth or full of clots or tissues). Bring any tissue that passes through the vagina to your doctor for testing. Don’t use a tampon or have sex while you are still bleeding.
You should expect to receive an ultrasound to identify what the underlying cause of your bleeding may be. Vaginal and abdominal ultrasounds are often performed together as part of a full evaluation.

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