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What Causes Bleeding In A 4 Weeks Pregnant Woman?

Posted on Tue, 31 May 2016

Question: Hello
I am 4 weeks 5 days pregnant. I am bleeding from last 8 days. It started with spotting on 18 of feb which is my regular period date. I went to c my Gp on 21 of feb. she took my blood and the report showed my HCG level is 26.2 i also had an ultrasound which didnot show any sac but endometrium thickness was 19 mm. 2 days ago i passed a clot with heavy bleeding. I rushed to emergency they also tested my blood and hcg level was 89. Dr said everthing is fine and reffered me to early pregnancy unit. Now i have an appointment with them on tuesday next week. Iam really stressed about whats going on inside me.could you please give me an idea whats the reason for this?

Answered by Dr. Deepti Verma (26 minutes later)

Brief Answer:
Repeat ultrasound after 2 weeks

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
Bleeding in early pregnancy can be due to threatened or missed abortion, subchorionic haemorrhage, or idiopathic( no cause is found).
If the beta hCG levels are on increasing trend, then spontaneous or missed abortion is ruled out.
You should take rest and take progesterone support in the form of tablets or injections to make the uterine environment more favourable for the pregnancy, and get a repeat ultrasound after two weeks to assess the viability of pregnancy.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (2 minutes later)

Could it be a ectopic pregnancy. I am so scared of that?

Thank you soo much for your answer. I have some other concers as well. Is my hcg level too low for this stage. And when the gestational sac is visible. If it is sub chorionic heammorhage. Is there any treatment available?

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
Ectopic pregnancy is ruled out in ultrasound

Detailed Answer:
Hi dear,
Ectopic pregnancy is diagnosed in a transvaginal ultrasound.
Treatment is available for subchorionic haemorrhage in the form of progesterone tablets or injections and hCG injection.
Hope you found the answer helpful.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (26 minutes later)

Thanks what are the signs of ectopic pregnancy?

Are these visible in 4 week ultrasound

Answered by Dr. Deepti Verma (2 minutes later)

Brief Answer:
Detailed answer below

Detailed Answer:
Hi dear, the signs of ectopic pregnancy are dizziness, pain in lower abdomen, spotting.
E Ectopic pregnancy can be visible in a transvaginal ultrasound at 4-5 weeks of pregnancy.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (20 minutes later)

Thanks but in my scan it was jus thick endometrium and no sac, no pelvic fluid and no adenexal mass. I am worried because my sac was not visible. Dr couldnt completely ruled out ectopic. But i dont have any symptom u have mentioned. I just have bleeding with some deep red clot.

And i have very dull periods like pain on left side of abdomen

Answered by Dr. Deepti Verma (1 hour later)

Brief Answer:
Repeat ultrasound

Detailed Answer:
Hi dear, you should get a repeat transvaginal ultrasound after two weeks to confirm.
Regards
Dr Deepti Verma
OBGYN

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar