Miscarriage usually starts with a small amount of vaginal bleeding, often dark red or coffee-colored discharge, sometimes accompanied by a vague pain in the lower abdomen, which is a premonitory miscarriage. After treatment by a doctor and rest, in most cases the symptoms disappear and the pregnancy can continue. However, if the symptoms worsen, the bleeding increases, the pain in the lower abdomen is obvious, and even the vagina discharges meat-like tissue, then the miscarriage is inevitable and is called a refractory miscarriage. If the pregnancy is completely discharged, the bleeding gradually decreases, and the abdominal pain decreases, the miscarriage is complete and generally does not require special treatment. If the pregnancy is not completely discharged, bleeding is still heavy and abdominal pain is obvious, it is incomplete miscarriage, and in most cases, emergency evacuation is needed. The most dangerous cause of vaginal bleeding in early pregnancy is: ectopic pregnancy Also called ectopic pregnancy. As the name suggests, it means that the fertilized egg does not settle in the uterine lining, but in the tissue outside the lining of the uterus, and 95% of ectopic pregnancies occur in the fallopian tube. The reason why ectopic pregnancy is dangerous is because as the embryo develops, the fallopian tube cannot support the growing embryo, and the chorionic villi penetrate the wall of the fallopian tube, causing the wall to rupture, resulting in a large amount of bleeding inside the stomach, which can cause shock or even death, while the amount of vaginal bleeding at this time will still not be very large. Women who have a history of pelvic infection, have had uterine surgery, or have had tubal surgery should be even more alert. Another more dangerous cause is: hyperemesis gravidarum Most patients with hyperemesis gravidarum have intermittent small amounts of bleeding, but in between there may be repeated large bleeds many times, and sometimes blisters are found in the blood. More serious cases can cause severe vomiting of pregnancy and hypertensive disorders of pregnancy (proteinuria, hypertension, edema). The treatment is mainly purging surgery, but it is worth noting that there is a possibility that the gravidarium may undergo malignant changes and evolve into invasive gravidarium, so the mother-to-be must insist on regular review. In addition, some gynecological problems can also cause vaginal bleeding in early pregnancy, such as cervical erosion and cervical polyps. These diseases can usually be detected under careful examination by a specialist. However, bleeding caused by cervical lesions is often difficult to distinguish from bleeding caused by miscarriage, then doctors in early pregnancy will often follow the miscarriage to deal with it first, otherwise it may cause unavoidable losses. If the cervical polyp is large, consider having a minor surgery to remove the polyp during the middle trimester to avoid continued confusion. What should I do if I experience early pregnancy vaginal bleeding? If this happens to the mom-to-be, don’t be nervous, let alone panic. As soon as bleeding occurs, stop what you are doing, sit or lie down to rest, and ask a family member or coworker to contact the hospital for medical attention. A portion of patients with early pregnancy vaginal bleeding, or even most of the patients are still do not know whether the case of pregnancy irregular vaginal bleeding, this often requires urgent laboratory urine pregnancy test, if positive, further ultrasound examination, to confirm the intrauterine or ectopic pregnancy, and then further treatment, intrauterine early pregnancy miscarriage, then fertility preservation treatment, ectopic pregnancy requires hospitalization for observation or surgery. If the test is negative but more like a miscarriage or ectopic pregnancy, ultrasound and blood test for beta-HCG can be done to identify it, and the rest can be treated as menstrual disorders. Pregnant, but ultrasound finds no evidence of pregnancy Sometimes, a positive urine pregnancy test establishes pregnancy, but ultrasound finds no evidence of intrauterine pregnancy or ectopic pregnancy. What’s going on here? In most cases, it may be due to the fact that the mother-to-be has a long menstrual cycle and a shorter period of time to actually fertilize, so the embryonic sacs are smaller and cannot be detected by ultrasound. In this case, you need to rest and observe, and the ultrasound will be repeated in 5-7 days, and the growing embryo sac can usually be detected. In a few cases, the ultrasound still can not detect the embryonic sac, and then the urine becomes negative, and even menstruation, this situation is called biochemical pregnancy, in fact, can also be considered a type of complete miscarriage. What is worth keeping the pregnancy? If vaginal bleeding occurs during early pregnancy, almost all moms-to-be worry about one thing: is this baby okay? Let’s look at some of the common causes of miscarriage. Miscarriage is mainly caused by chromosomal abnormalities of the embryo, endocrine function abnormalities, infections, and immune function abnormalities. If the miscarriage is caused by chromosomal abnormality of the embryo or abnormal development of the embryo due to infection, it is usually inevitable that there will be inevitable miscarriage or the embryo stops developing, and such a baby will be eliminated naturally. If the miscarriage is caused by endocrine or immune function abnormality, or some trauma-induced miscarriage, there is no problem with the baby itself, and once the root cause of the miscarriage has been corrected, the baby can continue to be pregnant after birth control, and this kind of baby is no different from the one that has not been bled out, so there is no need to worry. Of course, if it is an ectopic pregnancy or a gravidarium, then there is certainly no way to preserve the pregnancy and further specialized treatment is required. Specifically in reality, in most cases, it is difficult to determine the specific cause of miscarriage, the doctor is usually first in accordance with the luteal insufficiency to give progesterone to protect the fetus, supplemented by rest, traditional Chinese medicine and other measures to protect the fetus. If the symptoms disappear and the ultrasound suggests that the embryo is developing well, then it can be indirectly determined that the cause of the miscarriage is due to endocrine abnormalities. Some expectant mothers with habitual miscarriages are found to have luteal insufficiency or abnormal immune function in the pre-pregnancy checkups, and they get pregnant after treatment and continue to be treated during pregnancy to preserve the fetus. The babies in these cases are no different from other babies. The mother-to-be has nothing to worry about. If after active and correct measures to preserve the fetus, it is still unavoidably miscarried, then it can indirectly indicate that this embryo is developing abnormally. Don’t be too sad when such a baby is eliminated. Clinically, we often come across a situation where the ultrasound only sees the embryonic sac, but not the embryonic buds or heart tube pulsation in more than 40 days or even more than 50 days of pregnancy. This is mostly due to the fact that the embryo has stopped developing, but of course it could also be that the actual fertilization was late, so the embryo has not yet developed a germ. If the mother-to-be is not bleeding much and there is no obvious lower abdominal pain, you can consider giving fertility preservation treatment temporarily, following up in the outpatient clinic, and usually checking the blood β-HCG and progesterone and doing an ultrasound every 5-7 days. If the blood β-HCG rises satisfactorily and the ultrasound examination reveals that the embryo sac grows, and there are also embryo buds and heart tube pulsations, then such a baby is still a good baby and can be kept on fertility preservation to continue the pregnancy. On the contrary, if the embryo stops developing it is an induced abortion and the pregnancy should be terminated by abortion. If hemorrhage and lower abdominal pain are evident during observation, the miscarriage is unavoidable and the pregnancy should also be terminated by evacuation.