Positive Pregnancy Test Followed by Menstrual-Like Bleeding: What to Know

The pregnancy test shows positive, but there is bleeding similar to menstruation?

Hello Dr.
Huang, I currently have a daughter who is 1 year and 8 months old.
I had a natural delivery (overseas), and my husband and I are trying to conceive a second child.
My menstrual cycle is regular, occurring every 28 days.
My last period started on June 23rd.
On July 28th, I experienced a positive pregnancy test and confirmed it with a blood test at the hospital.
However, starting August 4th, I experienced continuous bleeding.
An ultrasound at the emergency department showed a small white dot, but during my follow-up ultrasound at 8 weeks, the dot was no longer visible.
I continued to have intermittent bleeding, and the clinic eventually informed me that my embryo had been naturally expelled.
The bleeding persisted until the end of September, and my October period was normal.
The issue arose when my November period was 5 days late.
I took a pregnancy test and got three positive results, but on the sixth day of the delay, I started bleeding like a regular period.
I tested again the next day, and it was still positive.
During my last miscarriage, the hospital did not conduct a thorough examination to ensure my uterus was clear.
However, the overseas hospital does not accept patients without a referral from a local clinic.
I am currently unsure about the issues with my body, and we really want to have a second child.
Both sets of parents and relatives are putting a lot of pressure on us.
It is not convenient for us to return to Taiwan at the moment, so I am seeking advice online.
Thank you, Dr.
Huang, for taking the time to respond.

Chen, 20~29 year old female. Ask Date: 2017/11/29

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My period was 5 days late in November, so I took a pregnancy test and got three positive results.
However, on the sixth day of the delay, I started bleeding like a menstrual period.
The next day, I tested again and it was still positive.
I plan to test again in 14 days.

Reply Date: 2017/11/29

More Info

It sounds like you are experiencing a complex situation regarding your pregnancy and menstrual-like bleeding, which can understandably be concerning. Based on the information you've provided, it appears that you have had a history of pregnancy complications, including a previous miscarriage, and are now facing similar symptoms with your current pregnancy.

First, it's important to understand that a positive pregnancy test followed by bleeding can occur for several reasons. In early pregnancy, some women experience what is known as implantation bleeding, which can be light and brownish in color. However, if the bleeding is more significant and resembles a menstrual period, it may indicate a potential issue with the pregnancy.

1. Miscarriage: One of the most common reasons for bleeding after a positive pregnancy test is a miscarriage. This can occur in the early stages of pregnancy, often due to chromosomal abnormalities in the embryo. If you have experienced a miscarriage before, it can increase your anxiety about subsequent pregnancies. Unfortunately, many women experience miscarriages, and they are often not preventable.

2. Ectopic Pregnancy: Another possibility is an ectopic pregnancy, where the embryo implants outside the uterus, often in a fallopian tube. This condition can cause bleeding and abdominal pain and requires immediate medical attention.

3. Subchorionic Hemorrhage: Sometimes, bleeding can occur due to a subchorionic hemorrhage, which is bleeding between the uterine wall and the chorion (the outer fetal membrane). This condition can be monitored, and many women go on to have healthy pregnancies despite this complication.

4. Hormonal Factors: Hormonal fluctuations can also lead to bleeding in early pregnancy. For instance, low levels of progesterone can cause the uterine lining to shed, leading to bleeding.

Given your history and the current situation, it is crucial to seek medical attention. Here are some steps you can take:
- Consult a Healthcare Provider: Since you are experiencing bleeding after a positive pregnancy test, it is essential to consult with a healthcare provider as soon as possible. They may perform blood tests to check your hormone levels (such as beta-hCG) and an ultrasound to assess the status of the pregnancy.

- Monitor Symptoms: Keep track of your symptoms, including the amount and color of the bleeding, any pain, and other unusual symptoms. This information can be helpful for your healthcare provider.

- Emotional Support: Dealing with pregnancy complications can be emotionally taxing. Consider seeking support from friends, family, or a counselor who can help you navigate your feelings during this time.

- Future Pregnancies: If you are considering trying for another child, it may be beneficial to discuss your previous pregnancy history with your healthcare provider. They can provide guidance on what to expect and any precautions you might take in future pregnancies.

In conclusion, while it is possible to experience bleeding during early pregnancy, it is essential to take it seriously, especially given your previous experiences. Early intervention and monitoring can help ensure the best possible outcome for you and your future pregnancies. Please prioritize seeking medical advice to address your concerns and ensure your health and well-being.

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