Spotting During The First 20 Weeks Of Pregnancy

If you’re pregnant, you may already be aware that occasional spotting is common. However, how can you tell the difference between normal spotting and when a problem arises? We are going to dive into some of the questions you may have and hopefully provide helpful answers to put your mind at ease.


If you have experienced spotting or bleeding of any kind during the first weeks or months of your pregnancy, good chances are you were pretty unnerved and unsettled. You might have even gone to an emergency room or to your OB/GYN the moment it happened. You’re not alone. In fact, it’s totally normal to be a little anxious and unsettled if you experience spotting during your pregnancy.


In fact, according to recent statistics, nearly one-third of pregnant moms experience some sort of spotting or bleeding in their first trimester. “The vast majority of spotting is harmless,” says Alyssa Stephenson-Famy, M.D., Maternal-Fetal Medicine Specialist at the University of Washington, Seattle. However, bleeding of any kind can be a tell-tell sign of a variety of possible complications, including miscarriage, ectopic pregnancy, and placenta previa, and should never be taken lightly. 


What Causes Bleeding or Spotting In First 20 Weeks


According to the American Pregnancy Association, there are a number of possible causes of spotting or bleeding in the first half of pregnancy, including the following:


  •  – Implantation bleeding: The implanting of the egg in the lining of the uterus occurs about 4 weeks into your pregnancy as the fertilized egg attaches to the uterine wall. If you notice a small amount of bleeding within a week to 10 days after conception, implantation bleeding is likely the cause and is nothing to worry about.


  •  – Infections: Some women have cervical bleeding because of an infection, usually a sexually transmitted disease such as chlamydia. In this case, the underlying condition needs to be treated. You should see your doctor immediately to receive treatment and medications. 


  •  – Internal exam done by your obstetrician: It’s not uncommon to bleed after a Pap smear or pelvic exam, which in many practices is conducted between the sixth and twelfth week of pregnancy. Spotting may occur within 24 hours after the visit and usually goes away within a day. If it persists, you should contact your doctor immediately. 


Sometimes bleeding during the first half of your pregnancy can be a sign of a more serious condition, however, such as:


  • – Subchorionic hemorrhage, which is bleeding around the placenta. Although it is possible to continue with a normal pregnancy after this type of bleeding occurs, prompt diagnosis and treatment is essential. 


  • – Chemical pregnancy, which occurs when an egg is fertilized but never fully implants in the uterus.


  • – Miscarriage (either threatened or imminent), which is the spontaneous loss of a pregnancy in the first 20 weeks. Often, the bleeding or spotting that occurs during a miscarriage will be accompanied by other symptoms, such as cramping or abdominal pain. If any of these related symptoms occur, seek help immediately. 


  • – Ectopic pregnancy, which occurs when a fertilized egg implants somewhere other than the uterus, most often in a fallopian tube. Sometimes called a tubal pregnancy, an ectopic pregnancy cannot progress normally and may be life-threatening to the mother if left undiagnosed.


  • – Molar pregnancy, a nonviable pregnancy characterized by an abnormal growth on the placenta, and, usually, an abnormal fetus.


If you have any concerns, please don’t hesitate to reach out to our team of doctors. It’s always a good idea to be on the cautious side rather than to assume everything is as it should be and there be an underlying problem that could’ve been avoided. If you need us, give us a call or visit our website for more contact information.