Vaginal Bleeding in Very Early Pregnancy

Abstract

Although heavy alcohol use over an extended time is known to impair fetal growth, the effects, if any, of light or moderate consumption are not clear. This study examined drinking patterns on term small-for-gestational-age (SGA) births, with particular attention to binge drinking in the 3 months before pregnancy and the last 3 months of pregnancy. Data on 50,461 women who delivered singleton full-term infants (37-42 weeks gestation) were obtained from the Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Questionnaires were mailed 2 to 6 months after delivery, and nonrespondents were interviewed by phone. The study population was predominantly white, 18 to 34 years of age, had 12 or more years of education, was married, and did not smoke in late pregnancy. Light drinkers took 3 or fewer drinks in an average week, whereas moderate consumption was defined as 4 to 13 drinks and heavy drinking as 14 or more drinks per week on average. Binging was defined as taking 5 or more drinks in one sitting. Close to half the women reported drinking just before pregnancy, 94% of them at a light level. In the last trimester, fewer than 1% of all women and 18% of heavy drinkers binged. SGA births were more common in moderate or heavy prepregnancy drinkers than in light drinkers or nondrinkers. No such association was evident, however, for drinking in the last trimester. Although women who binged at either time were not significantly likelier to deliver an SGA infant, those binging in late pregnancy were 20% more likely to do so. After adjusting for confounding variables, women who were light or moderate drinkers before pregnancy were somewhat less likely to deliver an SGA infant, although the difference was not significant. Women who drank lightly or moderately in late pregnancy were not prone to have an SGA birth. At all levels of alcohol use the risk of an SGA birth was greater for bingers, but this was significant only for heavy drinkers. The lower risk of SGA birth found in some women who drink might be related to vascular effects of alcohol, or to dietary differences between women who drink before pregnancy or in late pregnancy and those who do not. A prospective study would clarify the observations made in this population of parturients. ABSTRACTVaginal bleeding in early pregnancy could be mistaken for menstruation, and it could lead to errors in estimating gestational age, especially in pregnancies that end in miscarriage. This prospective study examined patterns of vaginal bleeding in 151 healthy women whose pregnancies lasted at least 6 weeks beyond the last menstrual period (LMP). The participants collected daily urine samples that were assayed for human chorionic gonadotropin and kept a diary of vaginal bleeding as well as sexual intercourse. Early vaginal bleeding was defined as bleeding lasting a day or longer between conception and follow up, which extended through week 8 after the LMP in nearly all cases. Early vaginal bleeding was described by 9% of women. Typically, it was light and required only 1 or 2 ...

Patterns and Predictors of Vaginal Bleeding in the First Trimester of Pregnancy

“…Gestational age dating was verified by ultrasound, and a validation substudy of ongoing pregnancies in RFTS 1 found that the average difference between gestational age based on self-reported LMP and ultrasound was less than one day (20). Based on these results, it is unlikely that many women misdate their pregnancy by mistaking early pregnancy bleeding for their LMP, consistent with the results of a previous study (10). We found little evidence that cyclic, menstrual-like bleeding occurs during the first trimester.…”

“…Only three reports have attempted to systematically describe early pregnancy bleeding patterns (5, 8, 10). These studies are limited by small sample (10), observation through only the eighth week of gestation (10), and recruitment and data collection late during pregnancy (5, 8).…”

“…These studies are limited by small sample (10), observation through only the eighth week of gestation (10), and recruitment and data collection late during pregnancy (5, 8). The latter two studies do not provide detailed information on first-trimester bleeding and exclude miscarriages (5, 8).…”

Vaginal bleeding in early pregnancy and preterm birth: systemic review and analysis of heterogeneity

“…Thus “cases” should be individuals with preterm birth, as opposed to vaginal bleeding, and a true “case control study” of vaginal bleeding and preterm birth would identify subjects with and without preterm birth and then compare their incidence of prior vaginal bleeding, as opposed to the other way around. Although it is possible to perform a case control study with vaginal bleeding constituting the “case”, such a study would be one that identified risk factors for the outcome of bleeding [23]. Studies that identified subjects with vaginal bleeding, matched them to subjects without bleeding and then determined the subsequent obstetrical outcomes would be better described as utilizing a “sample of convenience”.…”

Can I get pregnant from oral sex? Sexual health misconceptions in e-mails to a reproductive health website

“…Implantation bleeding was hypothesized by Speert and Guttmacher in 1954 [33], but a recent study of vaginal bleeding patterns in early pregnancy found “no support for the hypothesis that implantation can produce vaginal bleeding” [34]. Like the notion that pre-ejaculatory fluid can cause pregnancy, the idea of implantation bleeding seems to have been introduced by the medical profession itself.…”