Vaginal bleeding in early stages of pregnancy is common. It can be due to many reasons.

The important causes  are-

1) IMPLANTATION BLEEDING- bleeding due to attachment of the newly formed fertilized mass of cells which are destined to form the baby to the womb. It usually occurs at the time of expected period. It is normal and is not heavy bleed.

2) MISCARRIAGE- 1 in 5 pregnancies(20%) has the risk of miscarriage in the first three months. Most miscarriages occur as a "one -off"(sporadic) event and there is a good chance of having a successful pregnancy in the future. Most common cause is chromosomal problems. Chromosomes are tiny thread like structures which make our body cells. Risk of miscarriage increases with increasing age, health problems like poorly controlled diabetes and lifestyle factors like smoking and heavy drinking. It can be managed by -

                   (a) Expectant management- Letting the nature take its course

                   (b) Medical management- Taking tablets

                   (c) Surgical management- Having an operation called D & E(dilatation and evacuation)

Depending on your case doctor will offer you treatment most suitable for you.

3) ECTOPIC PREGNANCY- It is when the pregnancy is growing outside the womb; usually in the fallopian tubes. A pregnancy cannot survive in this situation and sadly cannot lead to birth of a baby. You may have symptoms like abnormal bleeding, pain in lower tummy, pain in the tip of the shoulder, upset tummy, severe pain/collapse. If you had previous ectopic, previous surgery over fallopian tube, using progesterone only pills for contraception, IUD/Coil, IVF, are more than 40 yrs or smoker you are at high risk of having an ectopic pregnancy. It can be managed in three ways-

(a) Expectant management- Letting nature take its course, but with serial blood tests for beta HCG (pregnancy hormone) and ultrasound monitoring

 (b) Medical management- with injection Methotrexate which is an anti cancer drug which also dissolves the pregnancy tissue. This is also given with proper monitoring and serial blood tests and ultrasound.

 (c) Surgical management-usually done laparoscopically (key hole) surgery and removal of the tube may be required.

Your doctor will offer you treatment according to your condition considering all pros and cons.

4) MOLAR PREGNANCY- It is much rarer condition where the placenta is abnormal. Once diagnosed this pregnancy needs to be terminated and requires long follow-ups.

5) LOCAL CAUSES- Can be due to local injury, cervical (neck of the womb) erosion.

When you see your doctor for bleeding in early pregnancy, your doctor will offer you-

A) Consultation and Examination- which will include details of your symptoms, date of last menstrual period and your medical history. Vaginal examination to see where the bleeding is coming from. A vaginal examination will not cause you to miscarry.

B) Tests-

            Urine test to confirm pregnancy

            Test for Chlamydia 

            Blood tests to check your blood group and pregnancy hormone (beta-hcg) levels

C) Ultrasound - Either Transvaginal or Tranabdominal Scan. Repeat scan may be necessary after 7-10 days if the pregnancy is very small or has not been seen.

WARNING SINGS-

1) Heavy bleeding

2) Severe pain not relieved by pain reliving drugs

3) Smelly vaginal discharge

4) Shivering or flu like symptoms

5) Feeling faint

6) Have pain in your shoulder

If you have any of the above , please consult your doctor immediately.