What could bleeding during early pregnancy mean?

Bleeding in early pregnancy is always worrying, but it's also surprisingly common. There can be several possible reasons.

• In the very early stages of pregnancy, as the fertilised egg implants there can be a day or two of light bleeding. Later, as the placenta embeds in the uterine lining, it causes slight bleeding. Sometimes a woman will experience 'breakthrough' bleeding.

• Pregnancy hormones cover up a woman's usual hormonal cycle, but variations in those normal cycles still go on. Some women notice bleeding at around the time they would usually have had a period as a result of this 'background' variation in hormonal levels. Occasionally women will experience a cervical erosion (a softening of the cervix), which can cause bleeding in early pregnancy.

• Bleeding can also signal a molar pregnancy -- a relatively rare condition in which abnormalities in the fertilised egg at conception make it impossible for the embryo to develop or survive.

• Bleeding can also be associated with a vaginal or cervical infection (such as a yeast infection or bacterial vaginosis) or a polyp (a benign growth) and can also occur after intercourse.

Sometimes it's not possible to decide what has actually caused minor bleeding.
Do I need to see a doctor?
It's worth talking to your doctor about any bleeding in pregnancy.
Often light spotting is not considered a major problem. But spotting or fresh bleeding, especially if it's accompanied by abdominal pain or cramping, needs immediate attention. It may be the sign of:

• a miscarriage

• an ectopic pregnancy (where the embryo implants in the fallopian tube rather than the womb)

• in later pregnancy, a problem with the placenta.

Having had some bleeding in early pregnancy, it's natural to feel concerned. Call your doctor who will be able to check things out for you now and throughout the pregnancy. Be specific about your symptoms. Do tell your doctor:

• if the discharge was light pink, brown or bright red

• if the flow was light, heavy or accompanied by clots or tissue

• if you experienced pain, dizziness, fever or chills

• if you have had to use sanitary napkins to soak the discharge, do let your doctor know how many.

All this information provides a fairly good indication of how heavy or light the bleeding has been, and your doctor will be able to advise you accordingly.