Why is there blood when I'm pregnant?

Menstruation will only come every month when you are not pregnant, but you will not normally have menstruation during pregnancy. If there is bleeding during pregnancy, it is not related to menstruation. It is very likely a manifestation of abnormal vaginal bleeding, including signs of premature birth, signs of abortion, and some are due to physiological bleeding during pregnancy.

Risks of vaginal bleeding during pregnancy

Abnormal vaginal bleeding is a common problem starting from early pregnancy, experienced by about 1 in 4 pregnant women. The causes and conditions of bleeding during pregnancy vary from person to person, and the degree of danger varies. In order to ensure the safety of pregnant women and fetuses, every pregnant mother should have some knowledge and understanding of various situations that may cause bleeding.

Generally speaking, the timing of bleeding during pregnancy is clinically divided into two categories: "bleeding in early pregnancy" and "bleeding in mid-to-late pregnancy".

1. Early stage (1-3 months of pregnancy)

Possibility 1: Miscarriage

Risk factors

Fetal chromosomal abnormalities, hormonal imbalances, congenital uterine developmental abnormalities and acquired defects, immune system problems, infections, habitual miscarriages, chronic diseases such as heart disease, kidney disease and blood diseases, overwork, excessive stress, intense sex life, staying up late, SPA massage, environmental pollution, drug abuse, smoking, drinking, caffeine intake or any food that promotes uterine contraction...

【Doctor’s advice】

Since embryo implantation is not stable before the placenta develops, many factors can easily cause miscarriage. When miscarriage occurs, the embryo and the uterine wall will separate to varying degrees. Once the blood vessels at the separation surface rupture, vaginal bleeding symptoms will occur. According to a medical research statistic, more than half of pregnant women who experience bleeding in early pregnancy can get through it safely and continue to have a successful pregnancy; about 30% of pregnant women may face the fate of spontaneous abortion; and nearly 10% of pregnant women may have ectopic pregnancy or other problems. Some pregnant women worry that abnormal vaginal bleeding in the early stages of pregnancy will cause the baby to be unhealthy. Many studies have shown that more than half of miscarriages may be caused by abnormalities in the embryo itself. Because humans have the ability to self-eliminate, most fetuses are normal if the pregnancy can continue.

Possibility 2: Ectopic pregnancy

Risk factors

She has had pelvic inflammation, pelvic adhesions, fallopian tube surgery, or an ectopic pregnancy in her last pregnancy.

【Doctor’s advice】

If the fertilized embryo does not implant in the uterus, it is called an ectopic pregnancy, which occurs in about 1% of cases, and 95% of ectopic pregnancies occur in the fallopian tube. Because the wall of the fallopian tube is very thin and cannot provide the embryo with sufficient blood circulation and nutrition, abnormal vaginal bleeding will occur at 7-8 weeks of pregnancy, and there may even be severe abdominal pain or shock due to massive intra-abdominal bleeding. In the early stages of pregnancy, if ultrasound examination fails to reveal any signs of an embryo in the uterus, it is necessary to test the human chorionic gonadotropin (Beta-HCG) in the blood as soon as possible to diagnose the possibility of ectopic pregnancy and take appropriate measures in real time.

Possibility 3: Hydatidiform mole

Risk factors

The mother is younger than 20 years old and older than 40 years old, the food lacks carotene and animal fat, the father is older, there is a history of miscarriage, a history of hydatidiform mole, and smoking.

【Doctor’s advice】

Hydatidiform mole is a benign chorionic disease that occurs in approximately one in a thousand pregnancies. Because of the abnormal proliferation of trophoblastic cells of the placental villi, the terminal villi turn into blisters, which are connected in clusters and resembling grapes, hence the name hydatidiform mole. In the early stages of pregnancy, there may be symptoms such as abnormal vaginal bleeding, severe morning sickness, and even palpitations. Usually, the diagnosis can be made by ultrasound combined with a blood test for chorionic villus. The treatment is to remove the hydatidiform mole by endometrial vacuum aspiration, and then track the chorionic villus index until it is normal for 3 consecutive weeks, and then track it again every month until it is normal for 6 consecutive months. If the index does not drop as expected, chemotherapy should be considered. Strict contraception must be followed during the follow-up period, and pregnancy planning should be started after one year.