Table: Some Causes and Features of Vaginal Bleeding During Early Pregnancy

Some Causes and Features of Vaginal Bleeding During Early Pregnancy

Cause	Common Features*	Diagnostic Approach†,‡
Pregnancy-related (obstetric) disorders
An ectopic pregnancy Ectopic Pregnancy Ectopic pregnancy is attachment (implantation) of a fertilized egg in an abnormal location, such as the fallopian tubes. In an ectopic pregnancy, the fetus cannot survive. When an ectopic pregnancy... read more (an abnormally located pregnancy—not in its usual place in the uterus)	Sometimes only slight vaginal bleeding Abdominal or pelvic pain that Is often sudden and constant Begins in a specific spot Is sometimes slight Usually tenderness when the pelvic examination is done If the ectopic pregnancy has ruptured, fainting, light-headedness, or a racing heart	A blood test to measure a hormone produced by the placenta (human chorionic gonadotropin, or hCG) Ultrasonography of the pelvis Sometimes laparoscopy (insertion of a viewing tube through an incision in the abdomen) or laparotomy (surgery involving an incision into the abdomen)
A miscarriage Miscarriage A miscarriage is the loss of a fetus before 20 weeks of pregnancy. Miscarriages may occur because of a problem in the fetus (such as a genetic disorder or birth defect) or in the woman (such... read more that Has occurred or is occurring May occur (threatened abortion)	Vaginal bleeding, sometimes with passage of tissue from the pregnancy Crampy pain in the pelvis and throughout the abdomen	Sometimes a doctor’s examination alone Usually tests as for ectopic pregnancy
Septic abortion Miscarriage A miscarriage is the loss of a fetus before 20 weeks of pregnancy. Miscarriages may occur because of a problem in the fetus (such as a genetic disorder or birth defect) or in the woman (such... read more (infection of the contents of the uterus)	Fever and chills Constant, severe abdominal pain, Abnormal vaginal discharge Vaginal Discharge A discharge from the vagina may occur normally or may result from inflammation of the vagina (vaginitis), often due to an infection. The genital area (vulva)—the area around the opening of the... read more that may look like pus and may be foul-smelling Often in women who have had an intentional abortion (often done by untrained practitioners or by the women themselves)	Ultrasonography of the pelvis Cultures of samples taken from the cervix
A hydatidiform mole Molar Pregnancy A molar pregnancy (hydatidiform mole) and other types of gestational trophoblastic disease are growth of an abnormal fertilized egg or an overgrowth of tissue from the placenta. Women with a... read more (abnormal placental growth with or without a fetus due to an abnormally fertilized egg) or another form of gestational trophoblastic disease	A uterus that is larger than expected No heartbeat or movement detected in the fetus (or no fetus) Sometimes high blood pressure, swelling of the feet or hands, severe vomiting, or passage of tissue that resembles a bunch of grapes	Tests as for ectopic pregnancy A biopsy if no pregnancy is seen in the uterus
Rupture of a corpus luteum cyst (which develops in the structure that releases the egg after the egg is released)	Abdominal or pelvic pain that Begins in a specific spot Sometimes causes nausea and vomiting Usually begins suddenly Most common during the first 12 weeks of pregnancy	Tests as for ectopic pregnancy
Disorders unrelated to the pregnancy
Vaginitis Overview of Vaginal Infections In the United States, vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year. Vaginal infections are caused by microorganisms... read more (inflammation of the vagina, often due to infection)	Only spotting or slight bleeding Vaginal discharge Sometimes pain during sexual intercourse, pelvic pain, or both	Testing for sexually transmitted diseases using samples taken from the cervix
Cervicitis Cervicitis Cervicitis is inflammation of the cervix (the lower, narrow part of the uterus that opens into the vagina). It may be caused by an infection or another condition. Cervicitis is often caused... read more (infection of the cervix)	Only spotting or slight bleeding Sometimes tenderness when the pelvic examination is done, abdominal pain, or both	Testing for sexually transmitted diseases using samples taken from the cervix
Polyps Polyps of the Cervix Cervical polyps are common fingerlike growths of tissue that protrude into the passageway through the cervix. Polyps are almost always benign (noncancerous). Cervical polyps may be caused by... read more (fingerlike growths) in the cervix, which are usually benign	Slight bleeding No pain Polyps sometimes seen protruding from cervix	A doctor’s examination alone Follow-up visits to further evaluate the polyps
Injury	A tear in the cervix or vagina Possibly due to a procedure such as amniocentesis Amniocentesis Prenatal diagnostic testing involves testing the fetus before birth (prenatally) to determine whether the fetus has certain abnormalities, including certain hereditary or spontaneous genetic... read more	A doctor's examination alone
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present.
† Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing.
‡ A urine pregnancy test is typically done if women have had only a home pregnancy test. Because an ectopic pregnancy can be very dangerous, tests are done to check for ectopic pregnancy in most pregnant women with vaginal bleeding unless symptoms clearly point to another disorder.