Bloody show (patient information)
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Synonyms and Keywords: Vaginal bleeding in pregnancy; Maternal blood loss

# Overview
Vaginal bleeding in pregnancy is bleeding coming through the vagina during pregnancy, for any reason.

# Considerations
- Up to 10% of women have vaginal bleeding at some time during their pregnancy, especially in the first 3 months (first trimester).
- Bleeding is even more common with twins.

# What causes Vaginal bleeding in pregnancy?
- During the first 3 months, vaginal bleeding may be a sign of a miscarriage or ectopic pregnancy. See the doctor right away.
- During months 4 - 9 bleeding may be a sign of:
- Abruptio placentae
- Miscarriage
- Placenta previa
- Vasa previa
- Other possible causes of vaginal bleeding during pregnancy:
- Early labor (bloody show)
- Ectopic pregnancy
- Infection of the cervix
- Trauma to the cervix from intercourse (small amount of bleeding)
- Other diseases and medications can cause bleeding during pregnancy. The causes may differ depending on your age.
- Characteristics of the bleeding can indicate its causes. These include:
- Length of bleeding
- Quality (light or heavy bleeding, with or without pain)
- What makes the bleeding better
- What makes the bleeding worse

# When to seek urgent medical care?
Contact your health care provider if:
- There is a chance of miscarriage.
- You have any vaginal bleeding during pregnancy. Treat this as a potential emergency.
- You have vaginal bleeding and have placenta previa (get to the hospital right away).

# Diagnosis
- Your health care provider will get a medical history and will perform a physical examination.
- The doctor may ask you the following questions:
- Time pattern:
- Have you had bleeding before during this pregnancy?
- When did the bleeding begin?
- Has it been constant since the beginning of the pregnancy?
- How far along is the pregnancy?
- When was your last menstrual period?
- Quality:
- How much are you bleeding?
- Do you have cramping or abdominal pain?
- Aggravating factors:
- Have you been injured, such as in a fall?
- Have you had changes in physical activity?
- Have you been under extra stress?
- Did the bleeding occur during or after sexual intercourse?
- Relieving factors: Does rest reduce or stop the bleeding?
- Other:
- What other symptoms do you have?
- Do you have a fever?
- Do you have an illness?
- Do you have pain in your abdomen?
- Are you weak or very tired?
- Are you fainting or dizzy?
- Do you have nausea, vomiting, or diarrhea?
- Are there changes in urination?
- Are there changes in bowel movements?
- Have you felt the baby move?
- Other important information:
- Is there an IUD in place?
- What medications are you taking?
- Have you had previous problems during a pregnancy?
- Have you had sexual intercourse recently?
- Tests that may be performed include:
- Blood tests
- Ultrasound of the pelvis
- Pregnancy ultrasound

# Treatment options
- Your doctor may recommend:
- For an infection of the vagina or cervix: antibiotics that are safe for the baby.
- For bleeding caused by an ectopic pregnancy: surgery or medical treatment to remove the growing embryo and control or prevent internal bleeding.
- For a miscarriage:
- antibiotics to fight infection
- blood transfusions for severe blood loss
- possible dilation and curettage or medication may be needed to help complete the miscarriage and stop bleeding.
- For vaginal bleeding caused by placenta previa:
- bed rest in the hospital, at least until the bleeding stops.
- cesarean section if it is close to the delivery date, or if the bleeding is severe.
- if the baby is premature when bleeding occurs, steroids may be recommended to help speed fetal lung maturity.
- Home care:
- Avoid sexual intercourse until you know the cause of the bleeding.
- Drink only fluids if the bleeding and cramping are severe.
- If a miscarriage occurs, expect a small amount of vaginal bleeding for up to 10 days after. Avoid using tampons for bleeding during pregnancy and for 2 to 4 weeks after miscarriage.
- Medication is usually not necessary. Don't take any medication without talking to your doctor.

# Where to find medical care for Vaginal bleeding in pregnancy?
Directions to Hospitals Treating Vaginal bleeding in pregnancy

# Prevention
To help prevent a miscarriage or other problems during pregnancy:
- Avoid smoking and using drugs of any kind, including alcohol.
- Eat a well-balanced diet.
- Get regular medical checkups.
- Take prenatal vitamins (or vitamins high in folic acid) before and after getting pregnant.

# Source