Vaginal bleeding in early pregnancy- Part I

This is one of the commoner presentation to my clinic besides the general antenatal workload.

The euphoria of early pregnancy(first trimester) is sometimes interrupted by symptom of vaginal bleeding.  There is usually high anxiety level, which is only natural.   This bleeding varies from brownish discharge to fresh red bleeding. This symptom can be associated with lower abdominal cramps.  Most couple come early for consultation.  My assessment during this consultation is to attempt to ascertain the cause of vaginal bleeding and demonstrate pregnancy viability.

It is understandable that couple would want to know if  ‘the pregnancy or fetus is alright’.  However, there is no single clinical assessment, blood test or ultrasound features that provides a reliable prediction of the pregnancy outcome following such event.  The current treatment this condition remains empirical.  Most doctors advocate bedrest and hormonal support, although the evidence is lacking.

On the contrary, it is not uncommon to find a cervical polyp as the source of vaginal bleeding.  This condition can be treated with removal of the polyp to relieve the symptom. The pregnancy is usually left undisturbed.

Our clinical experience has shown that about half of the early pregnancies with complication of vaginal bleeding is associated with good prognosis.  In these cases, the vaginal bleeding stop gradually over time and the pregnancy continues to term.

Early pregnancy vaginal bleeding is common and requires immediate medical attention

See also “Pregnancy and Baby” section for Early pregnancy bleeding or  click here.


Author: Dr Ng Soon Pheng

Dr. Ng Soon Pheng MD(USM), M.Med (O&G), Fellow Reprod Medicine (Singapore), AM (Mal) Dr. Ng Soon Pheng qualified from University Kebangsaan Malaysia (UKM), Malaysia. After obtaining his post graduate degree, Dr. Ng Soon Pheng continued his clinical fellowship training in the field of IVF in Singapore. He was also the recipient of Yayasan Sultan Iskandar (Johor) Scholarship for the fellowship stint. Dr. Ng Soon Pheng has more than 10 years of working experience in the field of Obstetrics and Gynaecology in the public and university hospital, with special interests in infertility. He was an Associate Professor with the Department of O&G in Universiti Kebangsaan Malaysia (UKM) specialising in infertility. Dr. Ng Soon Pheng is currently Consultant Obstetrician and Gynaecologist with special interests in infertility at Columbia Asia Hospital - Puchong.