The other day I met a patient who was 50+ days pregnant and experiencing vaginal bleeding, and during the exchange I realized that many moms and dads aren’t really worried about what will happen to them if they bleed vaginally, but most of all what will happen to the baby if they bleed vaginally. Here’s what happened: “Doctor, I’m 50+ days pregnant and I’ve been having vaginal bleeding, what should I do?” “Is the bleeding heavy? How many days exactly?” “It’s been coming out for four or five days now, it’s just a coffee-colored stuff on my underwear every time!” “And is there any feeling of tightness and swelling in the belly?” “There was a little bit for two days before, just a vague, tugging feeling on the sides of my belly.” “And now? Is there still any pain?” “It’s still a little bit now and then, but it’s not noticeable.” “Has an ultrasound been done?” The ultrasound sheet was presented. I looked at it and saw that the ultrasound had been done 3 days ago at an outside emergency room visit and there was a fetal heartbeat and buds. There was also blood HCG, over 30,000, and progesterone was a little over 20. “There’s no problem, your condition is quite common in early pregnancy ……” “What, isn’t there a preeclampsia?” “Well …… some vaginal bleeding in early pregnancy can be a pre-miscarriage ……” “But the progesterone is low… …” I instantly felt like the other person was not intentionally testing me~~ ⊙n⊙b Khan (being a doctor is not a good thing when you look young!) “Don’t you worry, I’ve encountered quite a lot of people in your situation, including my wife when she was pregnant, the symptoms were more obvious than yours ……” “How much did she check her progesterone?” “Since I know a lot of people get this early in pregnancy, I didn’t even consider checking her progesterone until her symptoms tended to worsen. So it just never got checked.” “Don’t be in such a hurry!” I went on to say “It is possible to bleed in a normal pregnancy, so you might want to browse this article, “Bleeding in a Normal Pregnancy Too? , which I wrote some time ago, you can go back and read it.” In fact, in the early stages of normal pregnancy, the endometrium just metaplasia, the cervix and the body of the uterus grow unevenly, the cervical canal metaplasia will be stripped bleeding, usually is your kind of out of the way, but also a little out of fresh blood. There is also a possibility that when the gestational sac is first formed, there will be some mucus and blood between the two layers of meconium on the outside of the gestational sac, and this is how the “double ring sign” is formed. When she finished reading the article, she seemed to understand. “So it’s normal, don’t we need to keep the baby?” “No, as long as the bleeding doesn’t increase, it will get better on its own.” “But I’ve been out for so long, what if it affects the baby?” I realized at once that such a small amount of coffee-colored bleeding is something that even a normal menstrual period can occasionally encounter, such as two days after your period clears, and then suddenly a little bit of coffee-colored stuff comes out again. This is also very common clinically. But most women don’t come to the doctor because of this, most women don’t worry about their body because of this bleeding, they actually worry about the baby. “It won’t affect the baby, don’t worry, as long as there’s nothing wrong with the baby itself, usually speaking.” “If it keeps bleeding like this, it won’t even affect the baby?” “It doesn’t matter, this bleeding is in fact the uterus bleeding. To be more precise, it’s the cervical canal meconium that’s bleeding. And to be more specific, it’s the cervical canal of the mom’s uterus that’s bleeding. In other words, it is the mother who is bleeding, not the child, and this has nothing to do with the child. Even if there is something wrong with the child, it is not caused by the mom’s bleeding, the two are not necessarily related.” “In other words, if the mom is bleeding, it doesn’t affect the child. But the reverse is different, if the child itself has problems. For example, if there are serious defects in the congenital chromosomes, then it’s because the embryo itself is of poor quality. Sooner or later, such embryos are miscarried. The embryo will cause the mother to bleed during the miscarriage. But this bleeding is not so simple, it is much, much bigger. There will also be symptoms corresponding to the miscarriage, such as abdominal pain and dilation of the cervical canal.” “But in this case there is something wrong with the embryo itself, and the problem with the embryo is not caused by the mom’s bleeding.” After my tireless explanation, the patient finally understood, and finally went home without giving any birth control medicine. Vaginal bleeding during pregnancy is a very common symptom. It is also a very alarming symptom for obstetricians and gynecologists. Common preeclampsia, ectopic pregnancy, hyperemesis gravidarum, placenta previa, etc., in the early stage of vaginal bleeding as the first symptom. Therefore, many obstetricians and gynecologists, when explaining this problem to their patients, start from the clinical thinking that the first thing to do is to exclude the above mentioned diseases one by one. However, these diagnoses cannot be made in a single visit and with a single symptom. Often, it is only when the disease progresses that the doctor has enough basis to make a diagnosis. As a result, most doctors think in terms of communicating with their patients on the basis of these possible diseases. For example, most doctors will tell their patients, “There is a ‘possibility’ that you are having a miscarriage,” “There is a ‘possibility’ that you are having an ectopic pregnancy,” and so on. ” and so on. Although in most cases, perhaps the doctor thinks it is unlikely. But do not say so can not ah, now the doctor-patient conflict is so intense, if you do not put the problem in place, in case of a she really is, will not get out of it? However, this way of communicating in fact, also brought anxiety to many patients. I personally believe that the diagnosis of “preterm labor” is a controversial one. If there is cervical insufficiency and contractions that should not normally occur in the middle of the pregnancy, the diagnosis of “preeclampsia” is not controversial. However, many pregnant women experience abdominal pain and vaginal bleeding in the early stages of pregnancy, especially a little vaginal bleeding and mild abdominal pain as in a normal pregnancy, in which case it is difficult to define whether it is a normal pregnancy or a true “preeclampsia”. The rate of spontaneous abortions is high in the early stages of pregnancy, but the vast majority of these miscarriages are caused by problems with the embryo, not the mother. It can be assumed then that these pregnancies are actually destined to miscarry, regardless of the mother. For those pregnancies that are destined to miscarry, it is better to say “destined to miscarry” rather than “premonitory miscarriage”. For those early pregnancies that are diagnosed with “preterm miscarriage” and successfully treated with fertility preservation, God knows whether the pregnancy was already fine, or the doctor used medication to preserve it. Vaginal bleeding has no effect on the baby, whereas a problem with the baby has an effect on the mother. The most common effect is that it causes the mom to hemorrhage during a spontaneous abortion. Of course, because of the placenta, hemorrhage, if it affects the blood supply of the fetus, it can be dangerous to the life of the fetus. But by this time, the adult’s life has been threatened first. So in that case, the focus of both the doctor and the patient’s family is no longer on the child, but on the adult. Finally, once again, vaginal bleeding is bleeding from the mother’s cervical canal, from the mother’s uterus, it’s the mother who is bleeding, not the child, and no matter how many times you bleed during your pregnancy, as long as it’s not caused by a serious other disease that causes heavy bleeding, it won’t affect the child. Even if it is going to affect, it is going to affect the adults first. When the adults don’t have enough blood circulation, not enough blood supply and oxygen supply, it will naturally affect the child.