Viable Intrauterine Pregnancy

Bleeding or spotting in pregnancy is common, especially during the first 12 weeks

and doesnt necessarily mean that you are miscarrying or that you will miscarry. So if
you have bleeding or spotting, you may still go on to have a healthy pregnancy.
Theres a heartbeat, but Im still bleeding
If the scan does pick up a heartbeat and the baby appears to be the right size
according to your dates, this can be very reassuring, even if you are still bleeding.
Research has shown that if you see a heartbeat on ultrasound the chances of the
pregnancy continuing are high.
Unfortunately things can still go wrong and sadly sometimes do, however the risk of
miscarriage decreases as the weeks go by, and you will have another scan at 12-14
weeks in the Antenatal Clinic to check your babys growth.
What if I continue to bleed or it gets heavier?
You may continue to bleed or it may stop and start again. We need to give your body
time to allow this pregnancy to develop and hope that it continues to grow the way
we would like. It may be that your bleeding has nothing to do with your baby. Women
who are not pregnant can have bleeding. Heavier or prolonged bleeding needs to be
checked in case it is coming from the cervix (where we take your smear tests from)
or is due to infection. It is important to make sure we dont keep checking the baby
and miss the opportunity to check you. Please see your GP if your bleeding stops
and starts, or is continuous.
Why did the scan not show the reason for my pain/bleeding?
Ultrasound scans dont normally find any reason for bleeding or pain. We dont even
know that the pain or bleeding is due to the pregnancy. Pain could be caused by
reasons such as constipation, urine infection or other surgical conditions such as
appendicitis. The pain you have been feeling may be the normal stretching pains that
happen in pregnancy due to the uterus (womb) growing. It would be helpful if you try
regular paracetamol for a day or so to see if this eases your pain. Do not take more
than it says on the package. If your pain does not settle, or worsens despite taking
paracetamol, please see your GP for further assessment.
Why have you not stopped my pain/bleeding at this appointment?
Unfortunately we cant stop a woman bleeding in pregnancy, or stop a miscarriage, if
that is what is going to happen. However as previously mentioned, most pregnancies
go on to develop completely normally. Your symptoms may already have stopped or
will stop in the next few days. Some women continue to spot/bleed through their
pregnancy.

What do I need to do now?

Book with your midwife for normal antenatal care. She will arrange for your next scan
at 12-14 weeks, and this is when you will be given an expected due date
Reference number: FPH 251
Clinical Business Unit: Family and Public Health
Department: Gynaecology
Author: Laura Rutherford
Review date: March 2017

Continue to take 400mcg folic acid daily. If your bmi is over 30 speak to your midwife
as you may need a higher dose
Take 10mcg vitamin D daily
Do not drink alcohol for 3 months speak to your midwife if this is difficult for you to
do
Binge drinking of 7.5 units or more at once may harm your baby
Stop or reduce smoking speak to your midwife if you would like support to do this
See your GP if you have any other medical conditions that may affect your
pregnancy such as diabetes or epilepsy
If your bleeding continues after 14 days, please contact us for a further review

Do I need to come to hospital if I have more bleeding or pain?

You do not need to come to hospital if you have more bleeding or pain, unless it is
very heavy or you feel unwell. We would suggest that if you need 2 thick sanitary
pads per hour for 2 hours then you should have an assessment in hospital.
Unfortunately we cannot stop your bleeding but it is important to keep you safe and
as comfortable as possible
Would you scan me again if I have more bleeding?
The doctors would carry out the best investigations for your symptoms, although this
wouldnt necessarily be a scan. It is important that your GP checks you (as
previously mentioned) to see there is no other reason why you are bleeding. The
doctor may want to check if your cervix is open, or monitor your level of bleeding.
You may need a blood test if you are feeling unwell. A second scan checks the size
of the baby and compares it to previous measurements. Usually there needs to be
around 14 days between scans so that any measurements can be helpful in
checking development.
Contact Details
The Early Pregnancy/Emergency Gynaecology Unit
Womens Outpatient Department, Peterborough City Hospital, Edith Cavell
Campus, Bretton Gate, Peterborough, PE3 9GZ
Telephone 01733 673758
www.peterboroughhospitals.co.uk
Monday-Friday 0800 -1800
Saturday/Sunday 0800 - 1200
Outside these hours please go to A&E if you need emergency attention

Reference number: FPH 251

Clinical Business Unit: Family and Public Health
Department: Gynaecology
Author: Laura Rutherford
Review date: March 2017