Expert: Lawrence Jay Rappaport <B>M.D.</B> - 10/8/2005
Question -------------------------
Followup To
Question -
Hello, I am 22 years old and I am pregnant with my first child. My last normal menstrual period was in the second week on July. I began bleeding the second week of August and It has continued up until now (Oct. 1st)
I live in Canada and the obstetrician informs me that they do not see anyone until the 16th week.
They tell me that if I have heavy bleeding I should go to the ER. I have had heavy bleeding on numerous occassions, however, I have only visited the ER three times.
Yesterday was the third time that I visited the ER and I had my sixth ultrasound today. The Doctor told me that he was going to set me up with an appointment to see a gynecologists and from the ultrasound pictures he seems to be unsure as to where the bleeding is coming from.
Today he said that there might be a hole in the sac and he also said sometimes you can bleed because I could be having problems with the placenta, but it started so early on that It might be something else.
My concern right now is that if there is a hole in the sac, what does this mean for the baby and I?
and what are other possible reasons for the bleeding? I would really appreciate your Expert Opinion on this. It seems like nobody is really telling me anything for the moment.
Thank-you in advance for your time.
Sincerely,
Maria Cruz
Answer -
There are several reasons to have bleeding in early pregnancy. Early bleeding, such as you described starting four weeks after your last perid, could be a miscarriage or evidence of a "blighted ovum" (sponatneous abortion). You can also have some bleeding due to a "subchorionic hematoma" which is a sequestration of blood in the folds of the developing placenta. A subchorionic bleed usually will nto cause any ill effects with the pregnancy or the baby, but can be frustrating due to constant bleeding until around 15 weeks gestation. You did not mention the results of the six u ltrasound exams you had. By now (October 1), you should be 11 weeks pregnant (from the first day of your last period). and a sonogram should show a fetus, a fetal heartbeat, and a gestational sac. If there is no fetus or fetal heartbeat by 11 weeks, it sounds like a missed abortion or miscarriage. If there is adeuqate growth, it may be fine. If there is an empty gestational sac you may have miscarried. I don't know what your sonographer meant by saying that there may be a hole in the sac. If the fetus is identified and is growing, it is still a viable pregnancy. If there is no fetal heartbeat at this time, it is a non-viable pregnancy. We usually start to see patients at 8 weeks from their last period in the U.S. If there is heavy bleeding, you should see a gynecologist right away.
Hello, I have not yet received the call from the gynecologist that I was told was supposed to call me shortly to schedule an appointment. I don't know what to do anymore, I have tried calling all the Doctors that I can and everyone just tells me to wait for my appointment or call the obstetrician and bug him to take me in sooner.
I have just read something regarding chlamydia and bleeding. I am afraid I might have this std or something close or like it. I have not yet been tested for std's since I have been pregnant! In my last check-up they told me I had chlamydia, however my fiancee was told that he did not have anything which made us wonder but I still took the pills that were given to me and went in for a follow up and they told me I was ok.
The thing here is that I had not been with anyone else since the check up that I had previous to that one. On the check-up previous to the one on which they told me that I had chlamydia they told me that I had abnormal cells and they had me tested for cervical cancer. They took two samples of tissue from my cervix (i believe) and then I was told that I ok.
My concern here is that everytime that I have gotten checked they always say I have abnormal cells and they have told me two different things both times even though I had not been with anyone else (and I truly belive that my fiancee has not either since we have been together).
What type of complications can something like this or similar to this have for my baby. I am almost at the 12 week point and I am still bleeding? I still have no definite answers from the Doctors and I am still waiting and bugging anyone I can for help. I was having excessive bleeding last night but I did not bother to go to the ER this time since they always kind of blow me off and tell me to call my Doctor, who tells me to go to the ER or to call my obstetrician, and an obstetrician who tells me that I have to wait until I am 16 weeks.
I am going crazy, Can you help me understand this if this is possible?
Thank you so much in advance for your time
Answer Unless you are bleeding very, very heavily, with cramps, you do not have to go to the ER. It is common for you to have a "subchroionic bleed" within the folds of the developing placenta. The bleeding should stop by 16 weeks gestation. Chlamydial infection will not cause bleeding. Chlamydia infections can be a cause of infertility, but if you did become pregnant, obviously that is not a problem. The mild abnormal PAP smears you had will not cause bleeding and can be addressed after the baby is born. YOu will need another PAP smear when you go for your first visit. If it is normal, you have nothing to worry about. Just wait for the appointment with your doctor at 16 weeks. if, on the other hand, you start to bleed very heavily with cramping, go to the ER and get another sonogram. If the baby is still growing, relax and don't worry.
