What is a threatened miscarriage?
An ongoing pregnancy associated with some bleeding is called a ‘threatened miscarriage’. The first symptoms are usually vaginal bleeding with or without mild period type pain. The bleeding can occur at any time after a missed period. The amount of bleeding may vary, from just spotting, to a gush with clots.
The diagnosis of threatened miscarriage is made with the help of an ultrasound scan. A baby’s heartbeat on ultrasound is reassuring and once the heart beat is seen the risk of miscarriage decreases. Sometimes the scan may show up a small blood clot around the pregnancy sac (called a ‘subchorionic haematoma’), which identifies the source of the bleeding. A subchorionic haematoma can continue to bleed intermittently during the first trimester and usually does not cause a miscarriage. They often disappear by the second trimester.
Sometimes the scan is completely normal and a source for the bleeding is not found. It is then not possible to give an explanation as to why this bleeding occurs. In most cases the pregnancy continues safely.
Do I require another scan?
The Early Pregnancy Assessment Unit nurse/doctor will advise if you need another scan and under which circumstances to have a scan. Usually, if you have some more spotting or smearing, another scan is not required. If the bleeding stops and then returns and is more than spotting, another scan is recommended. If you have heavy bleeding (soaking a pad in under an hour), present to your nearest emergency department for assessment.
Should I rest in bed?
Although bed rest was routinely advised in the past for threatened miscarriage it did not alter the outcome of the pregnancy. There is no specific treatment to stop your bleeding.
How long will I bleed?
In most cases bleeding will settle after a few days. However, if the scan showed a subchorionic haematoma, you may have some bleeding on and off until around the second trimester. You may notice increased bleeding after going to the toilet. It is simply due to the pooling of blood in the vagina from lying down that comes out as a result of gravity. The bleeding may also increase as a result of coughing/vomiting, exercise and heavy lifting, so do not be alarmed should this occur.
Should I return to work?
Unless your work involves heavy manual labour, then going to work will not affect the outcome. If you feel that having some time off work may reassure you, then we would be happy to provide a medical certificate—please ask us.
Is it safe to have sex?
Having sexual intercourse during pregnancy does not have any adverse outcomes. However, it would be sensible to avoid sex until the bleeding has stopped for at least a week. Also, do not avoid using tampons and swimming while you are bleeding.
Early Pregnancy Assessment Unit
Level 7, Mater Mothers’ Hospitals
South Brisbane Qld 4101
Telephone: 07 3163 5132
© 2016 Mater Misericordiae Ltd. ACN 096 708 922
Mater acknowledges consumer consultation in the development of this patient information.
Last modified 05/9/2016.