Early Pregnancy Bleeding: Causes, Risks, and Care

Early pregnancy heavy bleeding?

Doctor, I had my last menstrual period on May 20.
How many weeks am I currently? I had light brown spotting before confirming my pregnancy on July 2 (after a medical visit and ultrasound).
After sexual intercourse on July 11, I experienced bright red bleeding.
On July 13, I had bleeding similar to a menstrual period with mild pain (I went to the doctor, had an ultrasound, and was prescribed medication: GESTANON 0.5 mg, BUSCOPAN 1 mg, KMT 1 mg).
On July 16, after consuming cold drinks and riding a motorcycle, I experienced heavy bright red bleeding with clots and abdominal pain.
I went to the doctor, who said the embryo had moved down and there was a possibility of miscarriage, and prescribed UTROGESTAN 1 mg.
1.
What is the cause of my bleeding? During my first visit, the doctor only performed an ultrasound, prescribed medication, and said the embryo was normal, advising me to return in a month if the bleeding did not stop.
They did not mention anything about stopping sexual intercourse.
Is that okay?

2.
Three days later, while still taking the medication, the bleeding increased and became bright red with clots.
Could this be due to drinking cold water? Is the embryo moving down due to instability, or is it because I rode a motorcycle?
3.
The doctor mentioned that if I continue to have heavy bleeding, it could lead to a natural miscarriage.
Would this affect my chances of conceiving again or lead to infertility?
4.
How can I ensure the safety of my pregnancy? My job requires me to move around, and I often sit for long periods.
Does riding a motorcycle increase the risk of miscarriage? Would it be safer to drive instead? How long should I wait before seeing the doctor again? How long until I know if I have had a miscarriage?

Linlin, 20~29 year old female. Ask Date: 2005/07/17

Dr. Lü Lizheng reply Obstetrics and Gynecology

Due to the lack of a personal examination and ultrasound, the following opinions are for reference only.
My last menstrual period started on May 20; how many weeks am I currently? Counting from the menstrual period, it is over eight weeks.
An ultrasound may provide a more accurate assessment.
I am experiencing heavy bleeding, bright red in color, with blood clots, and abdominal pain.
I sought medical attention, and the doctor mentioned that the embryo has moved down, which may indicate a risk of miscarriage.
What could be the cause of my bleeding? During my first visit, the doctor only performed an ultrasound and prescribed medication, stating that the embryo appeared normal, and advised me to return in a month.
If the bleeding does not stop, I should come back, but there was no mention of needing to refrain from sexual intercourse.
Is that okay? There are many possible reasons for the bleeding, such as cervical irritation from intercourse or potential embryo issues leading to miscarriage.
The increased bleeding volume, bright red color, and presence of clots—could this be due to drinking cold water? Is the embryo moving down due to instability, or could it be because I rode a motorcycle? Based on the symptoms, the likelihood of embryo issues and miscarriage seems high.
The doctor said that if the heavy bleeding continues, it could lead to a natural miscarriage.
If that happens, will it affect my chances of conceiving again or lead to infertility? What can I do to try to keep my baby? My job requires me to be active, and I often sit for long periods.
Will riding a motorcycle affect the risk of miscarriage? Would it be safer to drive instead? How long should I wait before I go for another check-up? When will I know if I have experienced a miscarriage? If the embryo is indeed not viable, there may be nothing that can be done.
I should observe for a week, and if the ultrasound still does not show a heartbeat, it is likely that the embryo is not viable.

Best regards,
Lu Li Zheng

Reply Date: 2005/07/17

More Info

Early pregnancy bleeding can be a concerning experience for many women, and understanding its causes, risks, and appropriate care is crucial for both maternal and fetal health. Based on the information you provided, let's break down your questions and concerns regarding your situation.

1. Understanding the Timing of Your Pregnancy: If your last menstrual period (LMP) was on May 20, and you confirmed your pregnancy on July 2, you would be approximately 6 weeks pregnant at that time. Pregnancy is typically calculated from the first day of your last menstrual period, so it’s important to keep that in mind when discussing your gestational age.

2. Causes of Bleeding: The bleeding you experienced can have several potential causes. Early pregnancy bleeding can be due to implantation bleeding, which occurs when the fertilized egg attaches to the uterine lining. This type of bleeding is usually light and may be brown or pink. However, the bright red bleeding you experienced after sexual intercourse and later, with clots, raises concerns for possible complications such as threatened miscarriage or ectopic pregnancy. The fact that you experienced abdominal pain alongside the bleeding is also a significant symptom that warrants careful monitoring.

3. Impact of Activities on Bleeding: Activities such as riding a motorcycle or consuming cold beverages are generally not directly linked to causing bleeding in early pregnancy. However, if your body is already in a precarious state, any physical activity could potentially exacerbate the situation. It’s essential to listen to your body and avoid strenuous activities if you are experiencing bleeding or discomfort.

4. Risks of Miscarriage and Future Pregnancies: Your doctor’s advice regarding the possibility of a miscarriage is valid. If you continue to experience heavy bleeding, it could indicate a higher risk of miscarriage. However, not all bleeding leads to miscarriage, and many women go on to have healthy pregnancies despite experiencing bleeding in the early stages. It’s important to follow up with your healthcare provider to monitor the situation closely. If a miscarriage does occur, it does not necessarily mean that future pregnancies will be affected, but it’s wise to discuss any concerns with your doctor.

5. Maintaining a Healthy Pregnancy: To help preserve your pregnancy, it’s crucial to follow your doctor’s recommendations. This may include taking prescribed medications like progesterone (e.g., UTROGESTAN) to support the pregnancy. Additionally, minimizing stress, avoiding heavy lifting, and reducing physical strain can be beneficial. If your job requires prolonged sitting or moving around, try to take regular breaks to rest and avoid excessive fatigue.

6. Follow-Up Care: Regular follow-up appointments with your healthcare provider are essential. If you experience any significant changes in bleeding, pain, or other concerning symptoms, you should seek medical attention promptly. Your doctor may recommend ultrasounds or blood tests to monitor the status of your pregnancy and ensure that everything is progressing as it should.

In summary, early pregnancy bleeding can be caused by various factors, and while it can be alarming, it does not always indicate a problem. It’s essential to maintain open communication with your healthcare provider, adhere to their recommendations, and prioritize your health and well-being during this critical time. If you have further questions or concerns, do not hesitate to reach out to your doctor for personalized advice and support.

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