Bleeding During Early Pregnancy: Causes and Concerns

Bleeding during pregnancy?

Dear Doctor: My last menstrual period was on February 9, and I am currently in the 8th week of pregnancy.
I have been experiencing bleeding since the 6th week.
On March 16, I confirmed my pregnancy through an ultrasound.
From March 21 to March 22, I had a small amount of brown discharge (I visited the doctor for an ultrasound and internal examination, and I was prescribed Utrogestan to take three times daily).
On March 23, I experienced a large amount of bright red bleeding, similar to a menstrual period (I visited the doctor for an ultrasound and received a progesterone injection).
From March 24 to March 25, I had a small amount of dry red discharge.
On March 26, I had a moderate amount of dry red discharge (I visited the doctor for an ultrasound).
On March 27, I had a small amount of watery brown discharge, and on March 28, I had a moderate amount of watery brown discharge (I visited the doctor for an ultrasound and received another progesterone injection).
On March 31, I had a large amount of watery brown discharge (I visited the doctor for an ultrasound).
On April 5, I had a large amount of bright red blood (I visited the doctor for an ultrasound).
On April 6, I had another large amount of bright red blood (I visited the doctor for an ultrasound and received a progesterone injection).
1.
What could be the cause of my bleeding? The doctor examined my cervix and said it looked fine, advising me to rest more, but did not provide a reason for the bleeding.
Yesterday, I consulted another doctor who suggested it might be bleeding from within the uterus, but this bleeding continues (initially, the brown discharge decreased, but then I experienced a sudden increase in bright red blood, and this pattern keeps repeating.
The doctor said the heartbeat is normal and the embryo is fine).
What should I do? Is this concerning?
2.
Will the frequent ultrasounds I have been undergoing, almost daily, affect the development of the embryo and potentially cause deformities? Can I carry this pregnancy to term?
3.
Doctors say I should get checked whenever there is bleeding, but with my continuous visits and daily ultrasounds, the doctors seem unsure of how to proceed.
How should I handle this situation? Should I continue to seek medical attention for ongoing bleeding, or are there other methods to manage this?
4.
The doctor mentioned that I have a lot of stool in my abdomen and prescribed magnesium oxide (MgO).
Is this safe?
5.
The doctor indicated that my constipation is due to consuming too much fruit and high-calcium milk powder, advising me to switch to regular whole milk or fresh milk for improvement.
Is this true? If so, do I still need to take magnesium oxide (MgO)?
6.
There is a passage in a book stating, "In the second month of pregnancy, the reproductive organs are completed.
If the baby is a girl, taking certain progesterone to prevent miscarriage may make it difficult to determine the baby's gender." Will taking Utrogestan have this effect? Since I started taking it on March 21, is it too late to be concerned?

Xiao Yu, 30~39 year old female. Ask Date: 2005/04/07

Dr. Lü Lizheng reply Obstetrics and Gynecology

There are many possible reasons for this, including excessive uterine contractions, partial placental abruption, or uterine polyps.
Currently, at 8 weeks, the risk of miscarriage decreases significantly after 10 weeks, so there is no need to worry too much.
What can be done now is to avoid excessive uterine contractions, such as reducing activity levels, avoiding straining during bowel movements, temporarily abstaining from sexual intercourse, and continuing to observe as it is likely to improve on its own.
There is no need to seek medical attention unless the bleeding is heavy.
Frequent ultrasounds, even daily, will not affect the embryo's development or cause malformations.
It is safe to keep magnesium oxide (MGO) medication on hand and take it only if constipation occurs.
Constipation may be caused by consuming too much fruit and high-calcium milk powder; switching to regular whole milk or fresh milk could help improve this.
Is that true? It is recommended to stop drinking high-calcium milk powder and even to avoid whole milk or fresh milk, and to limit supplements, maintaining a normal diet instead.
There is a section in the book stating, "The second month of pregnancy is when the reproductive organs are completed.
If this baby is a girl, taking certain progesterone medications to prevent miscarriage may make it difficult to determine the baby's gender." Will taking "Utrogestan" affect this? Since I took it on March 21, is that too long ago? No, taking Utrogestan does not necessarily have that effect.

Reply Date: 2005/04/07

More Info

Bleeding during early pregnancy is a common concern for many expectant mothers, and it can arise from various causes. Understanding these causes and their implications is crucial for managing your pregnancy effectively.
1. Causes of Bleeding: In early pregnancy, bleeding can occur for several 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 short-lived. However, other causes can include hormonal changes, cervical irritation, or more serious conditions such as a miscarriage or ectopic pregnancy. Given your history of bleeding since the sixth week of pregnancy, it is essential to monitor the situation closely. The fact that your doctor has confirmed a normal heartbeat and healthy embryo is reassuring, but persistent bleeding should always be evaluated.

2. Risks of Miscarriage: The risk of miscarriage is a significant concern when experiencing bleeding in early pregnancy. While some studies suggest that about 20-30% of women experience bleeding in early pregnancy, not all will result in miscarriage. The risk can vary based on individual circumstances, including the amount and duration of bleeding, as well as other clinical findings. Continuous monitoring through ultrasounds, as you have been doing, is a prudent approach to ensure the health of the fetus.

3. Impact of Frequent Ultrasounds: Frequent ultrasounds, especially in the early stages of pregnancy, are generally considered safe and do not pose a risk of causing developmental issues or malformations in the fetus. Ultrasound uses sound waves to create images and does not involve radiation, making it a non-invasive and safe method for monitoring pregnancy. However, it is essential to balance the need for monitoring with the potential for anxiety that frequent visits can cause. If your healthcare provider feels that regular ultrasounds are necessary due to your bleeding, it is likely in your best interest.

4. Managing Constipation: Regarding your concerns about constipation, magnesium oxide (MgO) is often prescribed to help alleviate this issue. It is generally considered safe during pregnancy, but you should always discuss any medications with your healthcare provider. If dietary changes, such as reducing high-calcium milk products and increasing fiber intake, can help improve your bowel movements, it may be beneficial to follow your doctor's advice.
5. Dietary Considerations: Your doctor’s recommendation to adjust your diet to alleviate constipation is valid. High-fiber foods, adequate hydration, and a balanced diet can significantly impact digestive health. If you find that dietary changes improve your symptoms, you may not need to continue taking MgO.

6. Concerns About Hormonal Medications: Regarding the use of progesterone supplements like Utrogestan, there is no evidence to suggest that they cause gender ambiguity in the fetus. Hormonal medications are often prescribed to support early pregnancy, especially in cases of bleeding or a history of miscarriage. The timing of your medication is crucial, and it is essential to follow your healthcare provider's instructions regarding dosage and duration.

In summary, while bleeding in early pregnancy can be concerning, many women experience it without adverse outcomes. Continuous monitoring, open communication with your healthcare provider, and adherence to medical advice are vital in managing your pregnancy. If you have further concerns or if your bleeding changes in nature or intensity, do not hesitate to seek medical attention. Your health and the health of your baby are the top priorities.

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