I Am Pregnant And Bleeding
A.
The bleeding can be implantation bleeding that occurs naturally when a pregnancy attaches to the lining of the uterus. This is a normal condition that requires observation and follow-up ultrasounds. It usually occurs between 4-5 weeks into the pregnancy.
B.
It may mean that the pregnancy needs growth support when the progesterone is low. We may need to do a blood test to check the hCG (pregnancy hormone) level and the progesterone level. We may need to repeat those to establish a growth trend to see if this pregnancy is normal.
C.
It may indicate an abnormal implantation site, such as an ectopic pregnancy, which can be a life-threatening situation if not discovered. This requires BOTH repeated blood testing for the HCG pregnancy hormone and ultrasounds.
The goal is to find the ectopic pregnancy early enough before it causes internal bleeding, which can lead to death if untreated. This is a very serious and scary condition. It requires immediate surgery at the hospital and potentially blood transfusions. Often, it results in the loss of the affected fallopian tube and possibly the ovary.
If an ectopic pregnancy is caught EARLY, then the pregnancy can be terminated with the use of a chemotherapy medication called methotrexate, which is given as an injection into a muscle. This treatment requires close attention to the blood levels of the pregnancy hormone and repeated ultrasounds to ensure that the pregnancy is chemically destroyed.
An ectopic pregnancy can often grow enough to develop a heartbeat. This, though, is not a viable pregnancy, and it will lead to maternal death if it bursts internally. This also requires surgery to treat.
D.
Rarely, the bleeding can be from a cancerous condition on the cervix or even a cancerous condition causing abnormal HCG/pregnancy hormone levels. These are conditions incompatible with a normal life for either the mother or the fetus. Then, surgical treatments and chemotherapy are necessary to save a woman’s life.
In our office, we perform ultrasounds and blood testing and offer surgical and chemical treatments via our referral system.
E.
The bleeding may be due to a misplaced intrauterine device. In this situation, the IUD has not protected against pregnancy, and now we need to remove both the IUD and the pregnancy. This is done surgically with the assistance of an ultrasound.
F.
The bleeding and positive pregnancy test can also be the result of either:
- An incomplete natural miscarriage. This is a condition called a missed abortion, where the pregnancy stops growing, but it still stays inside the uterus. There may be some spotting, but there is no further pregnancy growth. This condition may need either the pill abortion or the surgical procedure to treat.
- An incomplete medical abortion. Patients may get pills online for a medical abortion. Sometimes, the pills fail to terminate the pregnancy, and it continues to grow. Such a pregnancy is abnormal and needs to be terminated.