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Miscarriage Awareness


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Threatened Miscarriage

What is a threatened miscarriage?

The term ‘threatened miscarriage’ can induce feelings of confusion, anxiety, and fear. It is a term used to describe when there is vaginal bleeding in early pregnancy, usually before 20 weeks, but the pregnancy is still viable.1,2

Although this can be an unsettling experience, it is relatively common, occurring in about 15–25% of all pregnancies.3,4 Of these, about half will miscarry,2 therefore, many women and birthing people with early pregnancy bleeding go on to have a healthy pregnancy. Over 90% of pregnancies with a foetal heartbeat and bleeding in the first trimester do not miscarry.3 However, any bleeding, with or without pain, should be evaluated by a healthcare professional to check the viability of the pregnancy.

Bleeding in the first trimester

Vaginal bleeding in the first trimester of pregnancy is more common than people believe. Up to a quarter of women and birthing people will experience this complication and have a healthy pregnancy.1

Possible reasons for bleeding in pregnancy include:

Implantation<sup>1</sup>

Implantation1

Light spotting may occur when the fertilised egg attaches to the uterine lining usually around the time of an expected period.
Chorionic haematoma<sup>1</sup>

Chorionic haematoma1

A collection of blood that forms between the pregnancy sac and the wall of the uterus. It is the most common cause of bleeding within the first trimester.
Cervical changes

Cervical changes

Increased blood flow to the cervix during pregnancy can cause mild bleeding, often after sexual intercourse or pelvic exams.1 Cervical polyps or cervical lesions, which are commonly found in women of childbearing age, may also cause vaginal bleeding.5
Cervical ectropion (or erosion)<sup>6</sup>

Cervical ectropion (or erosion)6

A benign and harmless condition where there is a delicate and inflamed area on the outer surface of the cervix. It occurs when cells that are normally located on the inside of the cervix (glandular cells) present on the outside. This is a common condition triggered by the hormonal changes associated with pregnancy and does not put you any greater risk of miscarriage, but may result in some bleeding.
Infection<sup>1</sup>

Infection1

Some vaginal or cervical infections may cause irritation and bleeding during pregnancy. Your health care provider will be able to provide suitable antibiotics that are safe to use in pregnancy.
Coagulation (bleeding) disorders<sup>7</sup>

Coagulation (bleeding) disorders7

Bleeding due to a coagulation disorder is rare, but women and birthing people with a coagulation disorder, such as Von Willebrand’s disease, are at a higher risk for bleeding during pregnancy.
Ectopic pregnancy<sup>8,9</sup>

Ectopic pregnancy8,9

A serious condition where the fertilised egg implants outside the uterus, most often in a fallopian tube.8,9 Symptoms can include one-sided pain, shoulder pain, dizziness, and vaginal bleeding.9
Miscarriage<sup>10</sup>

Miscarriage10

The most common serious cause of first-trimester bleeding. Often accompanied by cramping, abdominal pain, or passage of tissue.

Although bleeding is common in early pregnancy, it should always be investigated. If you are experiencing these symptoms, your healthcare provider will refer you for an ultrasound scan to check the viability of the pregnancy. If the pregnancy is still in the early stages (before 6 weeks), the baby may be too small to detect a heartbeat. In this scenario, a follow-up scan will be offered after 7–14 days.1

Some women and birthing people may continue to experience bleeding throughout their pregnancy. However, if bleeding symptoms persist, speak with your healthcare provider for advice.

If you have been diagnosed with a threatened miscarriage within the first trimester, and have had miscarriages in the past, talk with your healthcare provider about further examinations and possible treatment options, which in some cases can help support an ongoing pregnancy.11

Remember that any medicine may have side-effects. Talk to your healthcare provider for more information

Seek urgent medical help if:12

You start bleeding very heavily and soaking through two or more sanitary pads within one hour, or start passing large blood clots
You experience severe stomach pain that does not get better with pain relief
Pain in the shoulder tip
You feel faint or dizzy
You start to feel unwell with diarrhoea and vomiting