Bleeding in the First Trimester
A review of the various causes of bleeding during the first trimester of pregnancy
Most couples expect to get pregnant at some point, and when they do for the first time it suddenly dawns on them what a gamble pregnancy actually is. One of the most frightening things is to experience bleeding in the first part of the pregnancy. First trimester bleeding is any bleeding noted during the first 12 weeks of pregnancy, and it is one of the most common symptoms to send a woman to her obstetrician. And rightly so, because until a non-threatening cause is identified, all first trimester bleeding is labeled “threatened miscarriage,” or “threatened AB.”
Possible causes of bleeding in the first trimester unrelated to miscarriage:
Cervicitis is a condition in which the delicate cells at the mouth of the womb (or the cervix) bleed due to the mechanical action of intercourse, the alteration of acidity in the vagina (pH), or the effects of infections on these cells. There are two causes of Cervicitis:
- Ectopy (ectropion). With the hormonal changes of pregnancy, the fragile internal cells peek out a bit onto the external portion of the cervix, which is a harsher environment for them. Normally nestled deeply away from sexual activity and the acidity of the vagina, they can now be battered both chemically and mechanically. They’re easily damaged, causing bleeding. Of course, we’re not talking about a whole lot of bleeding — merely what is perceived as spotting. It must also be noted that these cells don’t normally bleed with sex –there is usually a predisposing condition, such as cervicitis. When these internal cervical cells are brought to a more external position, this is called ectopy.
- Infection. Cervicitis is inflammation due to infection. Yeast is the most common culprit, and a simple prescription or even over-the-counter cream can end this concern quickly. Other infections are more worrisome. Sexually transmitted diseases (STDs), such as gonorrhea, chlamydia, trichomonas, and Gardnerella can do the same, so a microscopic evaluation is the best approach rather than just assuming it’s yeast. Some infections may be silent for years, meaning that even though there is no question of fidelity in a couple, there may have been an infection long before they even met each other; because of this, cultures for STDs have become standard in all pregnancies.
YOU MIGHT BE INTERESTED IN