What is the cause of spotting during the fifth week of pregnancy?

We all know that the early stages of pregnancy are a very critical period for women. During this period, any momentary negligence is particularly likely to cause symptoms of miscarriage. However, many women will experience spotting when they are five weeks pregnant. They don’t always know what causes it, and are always afraid that it is a threatened miscarriage. In fact, there are many reasons for spotting, and it is not necessarily caused by miscarriage. Let’s understand what is going on when you see spotting at five weeks of pregnancy?

What is the cause of spotting during the fifth week of pregnancy?

The early stages of pregnancy are the most difficult time for every expectant mother. This is not only because of early pregnancy reactions, but also because the early stages of pregnancy are a time full of danger and anxiety. In the early stages of pregnancy, it is necessary to exclude ectopic pregnancy and hydatidiform mole to ensure that the fetus is growing safely in the uterus; you must also be extra careful to nurture the fetus, for fear of missing the baby if you are not careful.

Once vaginal bleeding or a small amount of spotting is discovered in the early stages of pregnancy, pregnant mothers will panic or go directly to the hospital to get a progesterone injection to preserve the fetus. In fact, pregnant mothers do not need to panic. Vaginal bleeding is not necessarily a sign of miscarriage. Even if it is a sign of miscarriage, progesterone is not a good medicine to preserve the fetus. What should you do if you experience vaginal bleeding in early pregnancy?

Not all vaginal spotting is a precursor to miscarriage. When you experience vaginal spotting, you must first identify the cause of the spotting so that you can effectively take necessary countermeasures.

1. Spotting caused by the pregnant mother's own problems

If the pregnant mother has luteal insufficiency, cervical polyps or cervical erosion, vaginal spotting may occur in the early pregnancy. Vaginal bleeding caused by these diseases may also occur before pregnancy. Spotting caused by the pregnant mother's own problems generally does not cause serious consequences.

1. Luteal insufficiency

After the sperm and egg are fertilized, the fertilized egg must be supported by endocrine hormones in order to grow and develop normally. After fertilization, the most important hormone is progesterone. If progesterone is not secreted enough, the endometrium will be insufficiently prepared, which will hinder the implantation of the fertilized egg, so that the fertilized egg cannot implant or cannot continue to develop after implantation. Before 8 weeks of gestation, the main source of progesterone is the corpus luteum of pregnancy. After 8 weeks of pregnancy, the placenta is slowly formed, and the placental trophoblast gradually replaces the corpus luteum as the main source of progesterone. When the corpus luteum slowly atrophies and the placenta has not yet formed, it is easy to be inadequate to meet the nutritional needs of the fetus.

Vaginal spotting due to luteal insufficiency is generally a small amount of vaginal bleeding, often less than menstrual flow, and the blood is bright red. The early pregnancy still exists, the embryo and fetal heart rate are normal, and the pregnant mother sometimes has mild lower abdominal pain, back pain and a feeling of falling.

After examination, it was confirmed that the vaginal spotting was caused by luteal insufficiency. It is generally recommended to rest in bed. When going to the hospital, the doctor will usually give an injection of progesterone to correct the progesterone deficiency until the placenta is firmly formed. However, it should be noted that progesterone supplementation can only be used when luteal insufficiency is confirmed. Blind use will not only fail to protect the fetus, but large amounts of progesterone in early pregnancy may increase the risk of fetal malformation by 8 times.

Clinically, endometriosis, ovarian cysts, hyperprolactinemia, polycystic ovary syndrome, hypothyroidism, and ovulation induction therapy may all cause luteal insufficiency. If you monitor your basal body temperature before pregnancy and find that the high temperature period is less than 12 days or the temperature rise is less than 0.3 degrees, or the temperature fluctuates greatly during the luteal phase, it is often luteal insufficiency.

2. Cervical polyps

Vaginal spotting may also occur when pregnant women have cervical polyps. This type of spotting usually occurs as blood mixed in the urine or during sexual intercourse. The amount of bleeding is small, but sometimes there is repeated bleeding and increased leucorrhea. A gynecological examination may reveal polyps on the cervix.

Most cervical polyps are benign and can be left alone during pregnancy and will not affect fetal development. Resection is only necessary if recurrent bleeding occurs. Sometimes, as the pregnancy progresses, polyps will grow larger. This has no effect on pregnancy and delivery, and there is no need to use pregnancy-preserving drugs. If the polyp grows very quickly, it can be removed during pregnancy. This is all possible.

3. Cervical erosion

When the pregnant mother has cervical erosion, bleeding may also occur in early pregnancy. During pregnancy, the levels of estrogen and progesterone in the mother's body will continue to increase, cervical erosion will be significantly aggravated, and vaginal bleeding will occur. This type of bleeding is usually a small amount of bleeding or bleeding during sexual intercourse, accompanied by increased leucorrhea.

Cervical erosion is caused by long-term stimulation of chronic inflammation and does not have much impact on the fetus. Since there are contraindications to medication during pregnancy, improper use of medication may cause harm to the fetus. It is recommended to use some external medications under the guidance of a doctor and continue treatment after delivery.

2. Bloody Shower Caused by Embryonic Development Problems

If the spotting is caused by the embryo itself, the situation will be more serious and pregnant mothers need to pay great attention to it.

1. Ectopic pregnancy

This is a situation that no pregnant mother wants to see. The fatal part of ectopic pregnancy is the intra-abdominal bleeding after rupture. Relatively speaking, if the rupture happens early and the blood vessels are not very thick, the danger is not very great. However, if the rupture happens after 8 weeks, it can be severe, with sudden abdominal pain, pale complexion, and a continuous drop in blood pressure, which is very dangerous.

Therefore, every pregnant mother must do a transvaginal ultrasound about 40 days after menstruation to see whether the gestational sac is in the uterus and rule out ectopic pregnancy. A preliminary diagnosis can also be made through progesterone and HCG. If the progesterone level is less than 15ng/ml and the hCG doubling time is prolonged, then it is very likely an ectopic pregnancy. After being diagnosed with ectopic pregnancy, it should be treated as soon as possible. In the early stages, medication or ultrasound-guided puncture treatment can be used. If you go to the hospital and are diagnosed with ectopic pregnancy around 8 weeks, you often have to undergo surgery immediately. Of course, a better way is preventive measures, that is, to ensure that the fallopian tubes are unobstructed when trying to conceive.

2. Hydatidiform mole

It usually occurs between 8 and 12 weeks of pregnancy. Hydatidiform mole is not a true embryo. The specific cause is unknown, but it is probably related to fertilization defects. It is more common in couples who have been exposed to reproductive and embryotoxic substances, or pregnant women who are too young or too old.

The early pregnancy reactions of hydatidiform mole come early and violently. The uterus grows faster than that of normal pregnant women, the belly is larger than that of normal pregnant women, the HCG value is much higher than normal, and there is continuous vaginal bleeding and abdominal pain. No embryo can be seen on B-ultrasound, and there is no heartbeat. There are grape-like cysts in the uterus.

If it is a hydatidiform mole, you need to be hospitalized for uterine cleaning and thorough curettage. In severe cases, the uterus may need to be removed. Because some patients with this disease will undergo malignant transformation, that is, malignant hydatidiform mole, you need to go to the hospital for quantitative HCG measurement every week after curettage, once every half a month after 3 months, and then once a month until it drops to normal levels. Those with a tendency to malignant transformation may require chemotherapy, surgery, etc. After the condition returns to normal levels, they should still follow the doctor's orders for regular follow-up and strict contraception for at least 2 years. Whether they can continue to conceive depends on the doctor's comprehensive analysis.

3. Subchorionic blood clot

If the chorion that wraps the fetus separates slightly from the uterine wall, a blood clot will form on the outside, causing bleeding. At this time, the nutritional supply required by the embryo will also be affected. Since it is formed by coagulation in the uterus, it is brown in color and the amount of bleeding varies.

For bleeding caused by chorionic villus separation, a small amount of bleeding can be stopped by resting quietly and lying in bed, which has basically no effect on the fetus. Once long-term and continuous heavy bleeding occurs, and large blood clots are detected through B-ultrasound examination, it is possible that the chorion will fall off. The patient should be immediately hospitalized for rest and receive treatment to reduce uterine contractions under the guidance of a doctor.

4. Spontaneous abortion

This is a problem that many pregnant mothers worry about. The bleeding from a spontaneous abortion is initially a small amount of vaginal bleeding. Depending on the amount of bleeding and the time it accumulates in the vagina, the color may be bright red, pink, or dark brown. Sometimes there is mild lower abdominal pain, a feeling of falling during fetal movement, and mild back pain and abdominal distension.

For spontaneous abortion, many pregnant mothers and doctors habitually use progesterone to preserve the fetus, which is not a wise choice. Because there are many reasons for spontaneous abortion, the blind use of progesterone has no practical effect on spontaneous abortion caused by reasons other than progesterone deficiency. Moreover, large amounts of progesterone in early pregnancy may actually "increase the risk of fetal malformation by 8 times."

At the same time, nurturing life itself is a process of survival of the fittest. If there is a problem with the embryo itself, the embryo will be eliminated after developing to a certain extent, and miscarriage usually occurs in about two months. Early miscarriage is almost always caused by defects in the fertilized egg, which leads to abnormal fetal development. It is often unavoidable and there is no need to preserve the fetus. When an embryo dies in the womb, it is often accompanied by vaginal bleeding.

When a miscarriage is confirmed through B-ultrasound, blood tests, etc., a doctor needs to deal with it in a timely manner to clean up the residue in the uterus. For those who have had a miscarriage, the embryonic tissue should be sent for examination to determine whether there are chromosomal abnormalities.

The above is an introduction to what causes spotting at five weeks of pregnancy. After understanding it, we know that there are many reasons caused by spotting at five weeks of pregnancy. First of all, pregnant mothers must find out whether it is a problem with themselves or the fetus that causes this phenomenon, and make timely adjustments, go to the hospital for regular check-ups, and do not take medication blindly.