I remember the first time I experienced spotting during pregnancy. My heart dropped and my mind automatically jumped to the conclusion I was miscarrying, but spotting during pregnancy is actually quite common. In fact, around 20 percent of women experience it during the first 12 weeks of pregnancy.
Note: If you are not sure if you are pregnant, and curious if what you are seeing is your period, implantation bleeding, or pregnancy spotting, you may find my post on what looks like a period while pregnant more helpful. This post is more aimed at spotting after a confirmed pregnancy in the first trimester. Bleeding during pregnancy in later trimesters is covered here.
Common causes of spotting during pregnancy:
Cervical changes: During pregnancy the cervix becomes soft and blood flow is increased. This can make your cervix more prone to minor damage. Things such as sex, dilation or position checks, PAP smears, and even excessive physical activity which may have triggered small contractions can cause spotting during pregnancy. You should always mention any bleeding to your doctor, but know that short term spotting is not often a cause for concern, especially if it was just once and after an activity that may have affected your cervix.
Infection: Infections that may cause inflammation to the cervix or vaginal canal can also cause spotting during pregnancy. These may include common infections during pregnancy include yeast infections and bacterial vaginosis as well as sexually transmitted diseases such as herpes, gonorrhea, and chlamydia. Spotting accompanied by foul smelling discharge, itching, skin rashes or warts may be a good tip off this is what you’re dealing with, though not all infections present with symptoms.
Sub chronic Hematoma: A sub chronic hematoma is a pocket of blood or blood clot within the uterine wall. This cause of spotting during pregnancy might sound a bit scary, but in most cases sub chronic hematomas are minor and resolve on their own. Bleeding from a hematoma may be as light as spotting or heavy with clots depending on severity. Ultrasound is often used to confirm and determine that severity.
Ectopic pregnancy: Sadly, there are a few causes of spotting during pregnancy that are bad news. Ectopic pregnancy, where the baby has implanted somewhere outside of the uterus such as the fallopian tube, is one of those causes. Ectopic pregnancy can cause long-term fertility issues and even be life threatening, so the earlier it is discovered the better. Symptoms of ectopic pregnancy in addition to spotting may include severe cramping, abdominal pain, light headedness and a pregnancy test that is positive, then negative.
Molar Pregnancy: Keeping up with those bad news causes of spotting during pregnancy, molar pregnancy occurs when tissue (a tumor) begins to grow within the uterine wall causing a positive pregnancy test. Molar pregnancies are rare and caused by chromosomal abnormalities within the fertilized egg. In addition to spotting, symptoms may include severe nausea or vomiting, high blood pressure, measuring large (rapid uterine growth), passing of cysts, and occasionally pelvic pain or pressure.
Miscarriage: Finally, spotting during pregnancy can indeed be caused by miscarriage, whether missed or impending. Keep in mind that in almost all cases, nothing was done to cause or can be done to prevent early miscarriage. The most common cause is chromosomal abnormality.