First trimester bleeding is bleeding that occurs before the 12th week of pregnancy. They can be due to 3 conditions, which in order of frequency are: miscarriages, ectopic pregnancies (or extrauterine gestations) and hydatidiform mole.
- Miscarriages
- also known as first-trimester miscarriages. They are defined as the termination of pregnancy before 12 weeks. Miscarriages are very common (10-20% of pregnancies) and most occur before 10 weeks.
- Ectopic pregnancy
- Extrauterine pregnancies are pregnancies that are not in the uterine cavity. The incidence is usually 11 per 1000 pregnancies and 95% of cases are usually found in the fallopian tube.
- Hydatidiform mole
- is a group of diseases resulting from abnormal growth of the placenta with the potential to invade the uterus and sometimes even metastasise. It is a very rare entity, occurring in 1-3 out of 1000 pregnant women.
In all three cases, it is important to take a good medical history, perform an examination, ultrasound diagnosis and, on occasion, hormonal determination of β-HCG.
Hyperemesis gravidarum is a complication of the more commonly known nausea and vomiting of pregnancy. Nausea and vomiting usually occur in 50-90% of pregnancies, while hyperemesis occurs in only 0.5-2% of pregnant women. In hyperemesis, vomiting is constant throughout the day and makes it impossible for the pregnant woman to eat. This leads to weight loss, dehydration and alterations in body salts.
It is important that when a pregnant woman has bleeding during the first trimester, she should go to the emergency room. Similarly, if she is pregnant and vomiting prevents her from eating and/or drinking water.
