Some Causes and Features of Vaginal Bleeding During Early Pregnancy
Cause | Common Features* | Diagnostic Approach† |
|---|---|---|
A miscarriage that
| Vaginal bleeding, sometimes with passage of tissue from the pregnancy Crampy pain in the pelvis and throughout the abdomen | Sometimes a doctor’s examination alone Usually tests as for ectopic pregnancy Monitoring for fetal heart rate auscultation A blood test to measure a hormone produced by the placenta (human chorionic gonadotropin, or hCG) Complete blood count Ultrasonography of the pelvis |
An ectopic pregnancy (an abnormally located pregnancy—not in its usual place in the uterus) | Vaginal bleeding, with or without pelvic or abdominal pain, that may be dull and come and go or may be severe, sudden, and constant If the ectopic pregnancy has ruptured, fainting, light-headedness, or a rapid heart rate | A pregnancy blood test Ultrasonography of the pelvis Sometimes laparoscopy (insertion of a viewing tube through an incision in the abdomen) or laparotomy (surgery involving an incision into the abdomen) |
A molar pregnancy (abnormal placental growth with or without a fetus due to an abnormally fertilized egg) | Vaginal bleeding, with or without crampy abdominal pain A uterus that is larger than expected No heartbeat or movement detected in the fetus (or no fetus) Sometimes high blood pressure, swelling of the feet or hands, or severe vomiting If more advanced, sometimes passage of grapelike tissue from the vagina | Tests as for miscarriage Blood tests Chest x-ray |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† In pregnant women with concerning symptoms, the doctor assesses maternal vital signs, does a physical examination, and evaluates the status of the fetus with a fetal heart rate monitor or ultrasound. | ||