Spotting in Early Pregnancy: Causes, Concerns & When to See a Doctor

Question
Hi Dr. Rappaport.  I'm 36 and this is my first pregnancy. I'm 10 and a half weeks pregnant.  This week, I've been experiencing some spotting and light bleeding (very light).  It's continued now for 3 days.  I have no cramping, pain, fever, etc.  Nothing else is wrong.  My first prenatal appointment is just over a week away.  Should I go to the hospital before that, or should I just keep track of what is happening to tell the ob-gyn next week?  What could this spotting be?  Thanks in advance.

Answer
Bleeding or spotting at 10 weeks gestation can be due to a "subchorionic bleed" which is a sequestration of blood within the folds of the developing placenta. It usually dissipates on its own and has no effect on the pregnancy. HOwever, you can also have some bleeding due to an impending or threatened miscarriage, which can occur ini 15-20% of every pregnancy. Usually there is heavy bleeding along with cramps. If you have any doubt, a sonogram can reassure you as to the status of the fetus and may show where the bleeding is coming from. The recommended time to have your first obstetrican visit is 8 weeks after your last period. If you are bleeding heavily, go to the ER.