Will spotting during early pregnancy mean miscarriage?

Because the older generation lacks certain cultural knowledge, most of them are superstitious, or they never look at different things differently, but generalize. We all know that pregnancy will cause many uncomfortable symptoms. If it is a normal phenomenon, we don’t need to make a fuss about it. But if it reaches a serious level, we should not be careless, because it involves life safety issues and there is no time to lose. Many people say that spotting in the early stages of pregnancy is a sign of miscarriage. Is it really as people say? Will spotting in early pregnancy lead to miscarriage? Let’s take a look at what’s going on:

Early pregnancy bleeding is a very common phenomenon during pregnancy, a physiological phenomenon.

It is true that in some special cases, such as "ectopic pregnancy" and "spontaneous abortion", vaginal bleeding may occur. However, normal pregnancy can also present with vaginal bleeding. On the contrary, because normal pregnancies are so common, vaginal bleeding should be seen in the vast majority of normal pregnancies. Whether it is an ectopic pregnancy or a miscarriage, the essential problem of bleeding during pregnancy lies in the endometrium. Remember that bleeding during pregnancy is you who is bleeding, not the baby. Even if there is bleeding, as long as you have ruled out ectopic pregnancy and the fetal heart rate is fine, there is no need to worry.

The endometrium is in a continuous proliferation process after the end of menstruation, and the spiral arteries in the endometrium develop further after ovulation. If pregnancy is not occurring, these small blood vessels spasm about two weeks after ovulation, causing the endometrium to fall off along with these blood vessels, and menstruation occurs. If you are pregnant, the endometrium continues to proliferate after the embryo implants. These blood vessels become the main channel for supplying nutrients, and the blood vessels also proliferate rapidly. During embryonic development, the endometrium proliferates synchronously and evenly, but some small blood vessels rupture during the proliferation process.

Or the endometrium may develop unevenly and asynchronously as a whole, which may be the cause of bleeding during pregnancy. Of course, these bleeding may also come from polyps in the cervix. Although the blood comes out of the vagina, it may come from the endometrium, the cervix, or the vagina. It just won’t come from the embryo. Where is the blood in the embryo?

Vaginal bleeding caused by the process of embryo expulsion after fetal arrest should be larger than normal vaginal bleeding during pregnancy, and white decidua (i.e. endometrium) may be discharged in the blood. During normal pregnancy, the amount of bleeding is usually less, sometimes there is bleeding, sometimes there is no bleeding, or sometimes there is a little more.

Ectopic pregnancy will also cause vaginal bleeding because the embryo is implanted in the fallopian tube, so the trophoblast cells produced by the embryo during development are not as abundant as those produced in the uterine cavity. Therefore, HCG grows slowly, so the stimulation of the corpus luteum is insufficient, the estrogen and progesterone levels are often low, and insufficient estrogen and progesterone can be produced to support the endometrium, so there is a risk of vaginal bleeding. But don't think that vaginal bleeding from ectopic pregnancy is because blood from the fallopian tube has flowed out of the uterine cavity.

Bleeding during pregnancy caused by uterine polyps is ultimately caused by the problem of the endometrium. Because these polyps grow on the endometrium.

Bleeding during pregnancy is a very common phenomenon. Some of it is abnormal, but I think most of it is physiological. We cannot generalize that there should be no bleeding during pregnancy. Perhaps doctors and pregnant women do not want to see bleeding. It is a normal phenomenon that everyone's legs will go weak when seeing themselves bleeding. I don’t want everyone to still worry after excluding ectopic pregnancy, seeing the fetal heart rate, and seeing that hormone test indicators are all normal. Family members in particular should give more comfort to pregnant women instead of worrying more than they do.

Let’s talk about the relationship between spontaneous abortion and vaginal bleeding. Let's assume that the embryo stops developing due to its own abnormalities (fetal development arrest is also known as spontaneous abortion), but humans have not yet invented artificial abortion (curettage to be more precise), does that mean the embryo will remain in the uterine cavity forever? This is possible, but most of the time it should be able to be discharged naturally. During the natural expulsion of the embryo from the body, there will definitely be bleeding as the endometrium is shedding, which is the same as the shedding of the endometrium during menstruation.

Therefore, please note: bleeding occurs because the embryo has stopped developing and a miscarriage has occurred, not because of bleeding that the fetus has stopped developing or a miscarriage has occurred. Bleeding during pregnancy can be the result of spontaneous abortion rather than the cause of it. But what do we see without ultrasound? Vaginal bleeding followed by spontaneous abortion, thus forming an inadvertent causal relationship between bleeding and spontaneous abortion for thousands of years.

The time sequence of spontaneous abortion is: embryo arrest → vaginal bleeding → spontaneous abortion

Vaginal bleeding during pregnancy is a common phenomenon of pregnancy, and the bleeding itself has nothing to do with spontaneous abortion. If pregnancy-preserving drugs are used after bleeding during pregnancy, those pregnant women who originally had a physiological phenomenon will continue their pregnancy, while those patients who already had a dead fetus in utero will inevitably have a spontaneous abortion, thus creating the illusion that some patients succeed in preserving their pregnancy while others fail.