Bleeding in Early Pregnancy

When bleeding occurs in early pregnancy it is called a “threatened miscarriage” even though the majority of small bleeds are innocent and probably arise from the wall of the womb and not the pregnancy. An ultrasound helps to check that the baby is OK, that a heartbeat is still present and whether the bleeding has collected into a small clot inside the womb.

Women with bleeding but a normal fetal heartbeat on the scan have a less than 1 in 6 chance of going on to miscarry.

Sometimes ultrasound will show us that the fetus no longer has a heart beat and that the pregnancy is no longer viable. Unfortunately early pregnancy failure is a relatively common thing. About 1:5 women will have a miscarriage at some stage. Studies in IVF women have shown us that miscarriage of very early pregnancies is even higher than we had realized with probably 1 in 3 pregnancies miscarrying before the woman is aware that she is pregnant.

In the majority of cases this happens because of a problem that is not likely to happen again so most woman who experience a miscarriage will go to have children.

The treatment of miscarriage has changed in recent years and not all women will need a curettage. Each case needs discussion with an experienced GP or specialist to decide the best course of action in a given pregnancy.

Three or more miscarriages warrant more investigation. These may include an abnormal shape to the inside of the womb, some autoimmune conditions and balanced rearrangements of the mother or fathers’ chromosomes. Your GP or gynaecologist can assist you with these follow up tests.

Finally, miscarrying a wanted pregnancy can be a profoundly sad event for the woman and the couple and in some cases sets in train an ongoing depressive reaction. It is important to talk about these feelings with those close to you and your family doctor. Sympathetic counseling or speaking with others can help to relieve the sense of isolation that can become overwhelming.

IMPORTANT POINTS

These scans can be done abdominally or transvaginally depending on how early the pregnancy is.

You will be advised which is appropriate when you attend for your scan. A transvaginal scan is performed gently and no harm will be done to your baby.

The probe is covered with a sterile disposable sheath and the ultrasound transmitted to the baby is no stronger than that done through the abdomen. By being closer however the smaller structures of an early pregnancy are more easily seen.