Intermittent and spotting

What are spotting and are they normal? Spotting, also known as spotting, is very slight vaginal bleeding, comparable to the period, but much weaker. They vary in color from red to brown. Usually the cause is harmless.

It's only natural that you are worried if you notice spotting or blood. But you do not have to worry: In the first few weeks of pregnancy this occurs frequently. A quarter of expectant mothers have some bleeding in the first three months (Weiss et al 2004, NGC 2005, Poulouse et al 2006).

Is my baby safe?

Your baby is almost certainly fine because spotting or mild bleeding is usually harmless. It is only natural that you are worried, but: Most pregnancies end happily despite initial problems with bleeding. Although bleeding may be an early sign of a miscarriage, in this case you would also have abdominal cramps and the bleeding would get worse. Spotting or light bleeding often stops by itself. It is estimated that more than half of expectant mothers seeking medical help for early bleeding give birth without any problems (NGC 2005, Everett 1997).

If you have spotting or bleeding during pregnancy, you should always talk to your doctor or midwife, even if the bleeding ceases. Try to think positively. Spotting or bleeding often turns out to be nothing more than a harmless puzzle.

What causes bleeding? Which cause is most likely?

In the early stages of pregnancy, spotting and bleeding are usually harmless. They are caused by:

hormones that control your menstrual cycle and cause bleeding hormone fluctuations at the time of your period. This is called breakthrough bleeding. You can do this several times, always at the time you had your pre-pregnancy period.

The fertilized egg nests on the wall of the uterus. Then it can come to bleeding. This is called nidus bleeding. This form of light bleeding usually lasts one or two days.

  • What else can cause bleeding?
  • There may be other processes in your body that cause bleeding:

The opening to your uterus (your cervix) may be irritated.Pregnancy hormones change the surface of your cervix and this leads to bleeding. For example, you might notice some blood after sex (Symonds 2009: 323). Even after painting, slight bleeding may occur.

You may have a fibroma. These are growths on the uterine wall. Do not worry, this is not malicious. Sometimes the placenta embeds where a fibroma is (Ouyang et al 2006).
  • You could have a small growth on your cervix. This is called cervical polyp. Do not worry, it's harmless (Symonds 2009: 323).
  • You may have a cervical or vaginal infection (Gracia et al 2005).
  • You may have a hereditary disease, such as von Willebrand syndrome (vWS), that makes it difficult for your blood to clot (James 2006).
  • The likelihood of spotting is greater if you have IVF or similar treatment to get pregnant. For example, if two embryos have been implanted in your uterus (womb), it may be that one has not developed. This is called a lost twin (De Sutter 2006) and can cause mild bleeding. Unfortunately, there are other reasons for bleeding at the beginning of pregnancy that do not come to a happy ending. These are miscarriages and abdominal cavity pregnancies. Abdominal pain and cramps occur along with this type of bleeding.
  • Early miscarriages usually happen when the baby is not developing properly. The bleeding in a miscarriage are getting stronger. An early miscarriage is a heartbreaking event, but it happens quite often. Some women even have a miscarriage before they realize that they are pregnant, and they assume that they have their period.

Ectopic pregnancy or ectopic pregnancy is said to occur when the fertilized egg attaches outside the uterus. If you have an abdominal cavity, the bleeding may persist. They are dark and watery, a bit like the juice of a prune. An abdominal cavity pregnancy can be a serious illness for you. Therefore it has to be removed quickly (RCOG 2004a).

A very rare reason for bleeding is a molar mole (RCOG 2004b). It is very unlikely that your bleeding was caused by it. It affects only about one in 1,000 pregnancies (0.1 percent) (Cancer Research 2009). A molar mole occurs when the embryo is not developing properly, but some of the cells that make up the placenta continue to grow and multiply. To protect your health, a mole must be removed as soon as possible.

All of these reasons for bleeding are related to what's going on in your body. But it is also possible that a blow from the outside on your stomach can cause bleeding.This can be caused by a fall, a car accident or a blow to your stomach (Tillett and Hanson ).

What should I do if I notice bleeding?

Call your doctor, midwife, or hospital for advice, even if the bleeding finally stops. You may need to be examined by a doctor to determine why you had bleeding.

Your doctor may carefully examine the inside of your vagina to see if everything is OK or he / she advises you to have an ultrasound. With an ultrasound, it can be determined whether your baby is safe in the uterus and an abdominal cavity pregnancy can be ruled out. A vaginal examination and the ultrasound are safe for you. You do not have to worry that they could affect your pregnancy.

In the last trimester of pregnancy, bleeding may be indicative of a so-called placenta previa (incorrect location of the nut cake), abruptio plazentae (which dissolves prematurely from the uterus), or premature labor.

If you have postpartum hemorrhage 36, it's a sign that the cervix is ​​softening and expanding. You may now be excreting bloody mucus. This could be an indication that the birth is starting.

Do not forget to download our free app for interesting daily information about your pregnancy. ""My Baby Today"" gives you all the expert-tested answers you need - always at hand!


Anderson-Berry AL, Zach T. 2008.

Vanishing twin syndrome.

eMedicine. emedicine. Medscape. com [As of April 2010]

Cancer Research. 2009. www. cancer help. org. uk [as of April 2010] Crafter H. 2009. Problems of pregnancy. In: Fraser DM, Cooper MA. eds. Myles Textbook for Midwives. Edinburgh, Churchill Livingstone, 333-59, De Sutter P, Bontinck J, Schutyser's V, et al. 2006. First-trimester bleeding and pregnancy outcome in singletons after assisted reproduction.

Hum Reprod

. 21 (7): 1907-11. humrep. oxford journals. org [pdf file, April 2010] Everett C. 1997. Incidence and outcome of bleeding before the 20th week of pregnancy: prospective study from general practice. BMJ

315: 32-34 Gracia CR, Collection MD, Chittams J, et al. 2005. Risk factors for spontaneous abortion in early symptomatic first-trimester pregnancies. Obstet Gynecol

. 106 (5): 993-9 Hasan R, Baird DD, Herring AH, et al. 2009. Association between first-trimester vaginal bleeding and miscarriage. Obstet Gynecol

114 (4): 860-7. Healy DL, Breheny S, Halliday J, et al. 2010. Prevalence and risk factors for obstetric haemorrhage at 6730 singleton births after assisted reproductive technology in Victoria Australia. Hum Reprod

25 (1): 265-74 James AH. 2006. Von Willebrand disease. Obstet Gynecol Survey

61 (2): 136-45 NGC. 2005. First trimester bleeding

. National Guideline Clearinghouse (USA) Ouyang DW, Economy KE, Norwitz ER. 2006. Obstetric complications of fibroids. Obstet Gynecol Clin North Am

33 (1): 153-69 Poulouse T, Richardson E, Ewings P, Fox R. 2006. Probability of early pregnancy loss in women with vaginal bleeding and a singleton live fetus at ultrasound scan. J Obstet Gynaecol

. 26 (8): 782-4. RCOG. 2003. The investigation and treatment of couples with recurrent miscarriage.

Royal College of Obstetricians and Gynecologists, Green-top guideline, 17th London: RCOG press. www. rcog. org. uk [pdf file, as of April 2010] RCOG. 2004a. The management of tubal pregnancy.

Royal College of Obstetricians and Gynecologists, Green-top Guideline, 21st London: RCOG press. www. rcog. org. uk [pdf file, as of April 2010] RCOG. 2004b. The management of gestational trophoblastic neoplasia.

Royal College of Obstetricians and Gynecologists, Green-top guideline, 38. London: RCOG press. www. rcog. org. uk [pdf file, as of April 2010] RCOG. 2006. The management of early pregnancy loss.

Royal College of Obstetricians and Gynecologists, Green-top Guideline, 21st London: RCOG press. www. rcog. org. uk. [pdf-file, April 2010] Symonds IM. 2009. Abnormalities of early pregnancy. In: Fraser DM, Cooper MA. eds. Myles Textbook for Midwives. Edinburgh: Churchill Livingstone, 313-32

Tillett J, Hanson L. . Midwifery triage and management of trauma and second / third trimester bleeding. J Nurse Midwifery . 44 (5): 439-48

Weiss JL, Malone FD, Vidaver J, Ball RH, Nyberg DA, Comstock CH, Hankins GD, Berkowitz RL, Gross SJ, Dugoff L, Timor-Tritsch IE, D'Alton ME , FASTER Consortium. 2004. Threatened abortion: A risk-based pregnancy outcome, a population-based screening study. At J Obstet Gynecol . 190 (3): 745-50.

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