Light Bleeding in Early Pregnancy: Causes, Treatment & What to Expect

Question
Dear Brenda,
I am jignasa, 28 years old and 14week pregnant lady. i had just two spot of bleeding in the begining of the 7 week, but then evrything was normal. my OB gave me Jusprin 1 per a day. at the end of the 12 week again i had bleeding and it was also very light then i suddenly went to the doctor but when she was doing scanning i was bleeding more then she told me to stop jusprin and i am taking Dhuphaston 2 per day also as well as Primolute depot injection per week.

i was on the bedrest for last week now i have join work again baby is fine doctor told me that. i dont have any infection also which she did some tests too.

i am worried that weather this is normal or what ??is this happen to others also? and is there any chance in the fututre to happen this again?
i will be obliged if u will reply and will satisfy my confusion .
Thanks and regards,
Jignasa

Answer
Dear Jignasa,

I am unfamiliar with the medications you cite, but I have done some research. I am completely confused as to why Jusprin would have been ordered, since it is aspirin. If you were spotting, aspirin would have been one of the last things that I would expect to be ordered, as it can cause bleeding under any circumstances. It typically is not ordered in pregnancy anyway, unless there is an underlying disease or condition requiring it (at least in the U.S.). I am quite relieved you have stopped taking it.

The information I found on Primolut Depot is as follows:
- FDA Pregnancy Risk "Category D" drug (The U.S. Food and Drug Administration has a categorization of drug risks to the fetus that runs from "Category A" (safest) to "Category X" (known danger--do not use!). Categories are A,B,C,D, and X) Category D means that there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (for instance, if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).
- Suggested association with congenital defects when used in pregnancy including: central nervous system, cardiac defects, cataract, ambiguous genitalia of both male and female fetuses, limb defects.
- Exposure to estrogen-progesterone causes developmental changes in the psychosexual performance of boys (less heterosexual experience, fewer masculine interests).

Duphaston is essentially a synthetic progesterone. There are no known harmful effects when this medicine is used during pregnancy. Progesterone is often used in pregnancy when the woman's progesterone levels are too low and the doctor is afraid it is not high enough to support/maintain the pregnancy. Progesterone is an essential hormone during pregnancy. Some of its important functions are:
-Helps to regulate the menstrual cycle.
-Prepares the lining of the uterus for implantation.
-Keeps the lining of the uterus thick which is necessary for a successful pregnancy.
-Produces a rise in temperature after ovulation, which remains until menstruation occurs.
-Creates a nutrient rich environment for the baby by increasing glycogen and arterial blood to the lining of the uterus.
-Keeps the uterus from having contractions.
-Causes the cervix to thicken and create a mucous plug which prevents bacteria from entering the uterus.

However, please note that in March 2008: The manufacturer is withdrawing this medicine from the market for commercial reasons. If you regularly take this medicine you should make an appointment with your doctor to discuss alternative treatments. You should not abruptly discontinue progesterone supplementation during pregnancy. It will need to be discontinued gradually.

As for the bleeding, vaginal bleeding can occur frequently in the 1st trimester of pregnancy and may not be a sign of problems. Bleeding can be a sign of miscarriage but does not mean that miscarriage is imminent. Studies show that anywhere from 20-30% of women experience some degree of bleeding in early pregnancy. Approximately half of pregnant women who bleed do not have miscarriages.

Unless you begin to experience cramping (like strong menstrual cramps) and/or clots or tissue passing with heavier bleeding, I would not be overly concerned. Please be aware that you should never wear a tampon or introduce anything else into the vaginal area such as douche or sexual intercourse if you are currently experiencing bleeding. It is also useful to wear a pad or pantiliner so that you can accurately judge the amount of spotting/bleeding.

I hope this has helped you and answered your question. Obviously, there are differences between treatment methods and medications used in different countries. All I can really do is tell you what the standard of care tends to be here where I am. It may be different where you are. I wish you well.

Brenda