Managing Early Pregnancy Bleeding: What to Know After 13 Weeks

Bleeding at 13 weeks of pregnancy and measures to support the pregnancy?

Hello Doctor, I would like to ask you about my situation.
Before I experienced any bleeding, I had vaginal itching with a cottage cheese-like discharge and a feeling of heaviness in my lower abdomen, so I sought medical attention.
I used an external ointment prescribed by the doctor for about three days, and the itching and cottage cheese-like discharge almost disappeared, and there was no pain.
However, the next morning, I experienced bleeding when I went to the bathroom.
The amount of blood on the tissue was about a quarter of the tissue and was a light fresh red color, similar to the first day of menstruation.
After wiping 2-3 times, I went to the doctor immediately during the day.
The doctor prescribed a medication for threatened miscarriage and advised me to lie down and rest for 3-5 days, and only gradually resume activity if there is no further bleeding.

I have a few questions for the doctor:
1.
If the threatened miscarriage treatment is working and the bleeding is gradually decreasing in color and turning darker with some dark cottage cheese-like discharge, is this normal? What should I expect?
2.
I still have a little itching at the vaginal opening; should I continue to apply the ointment? Is it normal to still have some itching?
3.
Could the bleeding be a result of a worsening vaginal infection? I am very anxious and would appreciate your guidance.
Thank you.

Xīnshǒu yùnfù, 30~39 year old female. Ask Date: 2021/05/11

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
It is normal, but tofu-like discharge is generally a sign of a fungal infection, and you should consult a physician for treatment.
2.
Please continue to maintain local hygiene and adhere to the medication regimen.
3.
No, it is not.

Reply Date: 2021/05/11

More Info

Managing early pregnancy bleeding can be a source of anxiety for many expectant mothers, especially when it occurs after the 13-week mark. It’s important to understand the potential causes and implications of bleeding during this stage of pregnancy, as well as how to manage it effectively.

Firstly, it’s crucial to recognize that some bleeding in early pregnancy can be relatively common and not necessarily indicative of a serious problem. In your case, the initial symptoms you experienced, such as vaginal itching and the presence of a discharge resembling "cottage cheese," suggest a possible yeast infection, which is not uncommon during pregnancy due to hormonal changes. The subsequent light bleeding you experienced could be attributed to several factors, including irritation from the infection or even the physical changes occurring in your body as it adapts to pregnancy.

1. Bleeding Color and Consistency: The fact that your bleeding has transitioned from a bright red to a darker color, possibly mixed with remnants of the previous discharge, can be a normal part of the healing process. Darker blood often indicates older blood that is being expelled from the body. However, it is essential to monitor the amount and duration of the bleeding. If it becomes heavier or is accompanied by severe pain, it would be prudent to seek medical attention immediately.

2. Vaginal Itching: The continued itching you are experiencing may still be related to the initial yeast infection. It’s advisable to continue using the topical medication prescribed by your doctor, as long as it has been recommended for the duration of your symptoms. Maintaining good hygiene and avoiding irritants (such as scented soaps or douches) can also help alleviate discomfort. If the itching persists or worsens, or if you notice any unusual discharge, you should consult your healthcare provider for further evaluation.

3. Connection Between Infection and Bleeding: While it’s understandable to be concerned that a vaginal infection could lead to bleeding, it’s important to note that not all infections will cause bleeding. In many cases, the bleeding may be a result of other factors, such as cervical irritation or changes in the cervix due to pregnancy. However, if the infection is severe or left untreated, it could potentially lead to complications. Therefore, it’s essential to follow up with your healthcare provider to ensure that the infection is adequately treated and that your pregnancy remains healthy.

In conclusion, while some bleeding can be normal in early pregnancy, it’s crucial to stay vigilant and maintain open communication with your healthcare provider. Regular prenatal check-ups are essential for monitoring the health of both you and your baby. If you have any concerns or if your symptoms change, do not hesitate to seek medical advice. Remember, your health and the health of your baby are the top priorities, and your healthcare team is there to support you through this journey.

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