Early Pregnancy Bleeding: Causes and Concerns

Early pregnancy bleeding

I would like to ask the doctor: My last menstrual period was on July 17.
I experienced some bleeding on August 15 and 16, which I initially thought was my period because it was very light and then stopped.
I found it strange and took a pregnancy test, which turned out positive.
After that, due to long working hours (I work for over ten hours, mostly sitting), on the evening of August 25, I felt very fatigued and noticed more bleeding (dark red in color, more than the previous bleeding, but not enough to soak the entire pad, just about three or four overlapping blood spots).
The next day when I saw the doctor, the color had lightened.
The doctor prescribed Utrogestan 100mg for me to take twice a day.
After taking it, I had no bleeding for a while, but after a full day of work, I experienced slight pink bleeding again.
During these episodes of bleeding, I have not felt any abdominal pain, just fatigue.
I would like to ask the doctor: 1.
Is this intermittent bleeding normal? Does having slight bleeding even after taking the medication indicate that the baby might be unhealthy? Is it okay to continue taking the medication indefinitely? (Or should I stop taking it immediately when there is no bleeding?) 2.
Since I am pregnant and have longer working hours, can I take Silymarin 150mg as a liver supplement during pregnancy? Thank you, doctor, for taking the time to answer my questions.

Ting, 30~39 year old female. Ask Date: 2019/08/29

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The last menstrual period was on July 17.
There was some bleeding on August 15 and 16, which was initially thought to be menstruation because it was minimal and stopped quickly.
However, after taking a pregnancy test, it was confirmed that I was pregnant.
Due to long working hours (over ten hours, mostly sitting), on the evening of August 25, I felt very fatigued and noticed more bleeding that night (dark red in color, more than the previous bleeding, but not enough to saturate the entire pad—about three or four overlapping blood streaks).
The next day, when I saw the doctor, the color had lightened.
The doctor prescribed Utrogestan 100mg to be taken twice daily.
After taking it, there was no bleeding, but after a full day of work, I experienced slight pink bleeding.
During these episodes of bleeding, there has been no abdominal pain, just fatigue.

I would like to ask the doctor:
1.
Is this intermittent bleeding normal?
Answer: It is not normal.
If there is still slight bleeding despite taking the medication, could it indicate that the baby is unhealthy? Is it okay to continue taking the medication? (Or should I stop immediately when there is no bleeding?)
Answer: It is okay to continue taking the medication.
You can stop it after a period without bleeding.

2.
Given the pregnancy and long working hours, can I take Silymarin 150mg for liver support during pregnancy?
Answer: Yes, it is permissible.

Reply Date: 2019/08/29

More Info

Early pregnancy bleeding can be a concerning experience for many expectant mothers, and understanding its causes and implications is crucial for both maternal and fetal health. Based on the information provided, it appears that you have experienced intermittent bleeding during your early pregnancy, which can be attributed to several factors.

1. Is intermittent bleeding normal in early pregnancy?
Intermittent bleeding in early pregnancy can occur for various reasons. One common cause is implantation bleeding, which happens when the fertilized egg attaches to the uterine lining. This type of bleeding is usually light and can be brown or pink in color. However, other causes of bleeding can include hormonal changes, cervical irritation, or even more serious conditions such as a threatened miscarriage or ectopic pregnancy. Since you mentioned that the bleeding has not been accompanied by pain, this is a positive sign, but it does not rule out the need for further evaluation.

The use of progesterone supplements, such as the medication you mentioned (Urogestan), is often prescribed to help maintain the pregnancy, especially in cases where there is a risk of miscarriage. It is generally safe to continue taking these medications as prescribed by your doctor. If you experience bleeding while on progesterone, it does not necessarily indicate that the baby is unhealthy, but it is essential to keep your healthcare provider informed about any changes in your symptoms.

2. Can I take Silymarin during pregnancy?
Silymarin, derived from milk thistle, is often used for liver health. While some studies suggest it may have benefits, there is limited research on its safety during pregnancy. It is crucial to consult your healthcare provider before taking any supplements during pregnancy, especially if you have a demanding work schedule and are experiencing stress. Your doctor can provide personalized advice based on your health history and current condition.

In summary, while some bleeding in early pregnancy can be normal, it is essential to monitor the situation closely. If the bleeding increases, changes in color, or is accompanied by pain, you should seek immediate medical attention. Regular prenatal check-ups are vital to ensure both your health and the health of your baby. Always communicate openly with your healthcare provider about any concerns or symptoms you experience during your pregnancy. They can guide you on the best practices for managing your health and the health of your developing baby.

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