Bleeding while pregnant

Patient

Q: Hi my name Is Alexis, I'm 20 year old. I'm pregnant for the second time. First time I got pregnant I miscarried. Started bleeding and then that led to the horrible cramps. Now I'm only about two weeks and this morning I woke up with bright red blood in my panties. I went to my obgyn but it's to soon to see anything on the ultrasound so she took some blood and I go back Tuesday for the results. Later this afternoon I started seeing clots but it's only when I go to the restroom and pee. It was lots of clots. And then the next pee I took nothing was there. And then I felt it go on the pad as just blood. And then soon after I took a nap I peeded again and it's bright red and tiny pieces of clots. I'm really scared and I don't know what to do or think! I need help or advice on what someone thinks it is. I'm having no stomach pain once so ever and feel like I could run a mile so please give me some answers? Thanks}

Doctor

A:   Hello,
Thanks for contacting askthedoctor.com for an opinion.
Having gone through the details of your history, it is assumed that you have already undergone a urine pregnancy test or a serum beta hcg test to confirm pregnancy. If you are sure about the gestational period of 2 weeks , which is actually too small a gestation for having been picked up on transvaginal ultrasound.

I understand your concern is bleeding in form of clots, which in a case of pregnancy is not a healthy sign . Firstly , it is always better to confirm a pregnancy and its location. Also it is a good practice to perform an ultrasound to rule out a developing ectopic pregnancy if the uterus is found empty and bleeding per vaginum is noticed.

there could be various reasons for bleeding during early pregnancy namely abortion, implantation bleed, or luteal phase defect due to decreased serum progesterone.

I suggest you should wait for the blood reports to analyse the blood serum hcg levels probably conducted by your physician to establish viability of pregnancy and a probable follow up after 2 days again with same test to analyze the rise or fall of hcg levels. If there is a rise of 66.3 % from the previous value then the pregnancy is considered viable. However the period of gestation is actually too small to make a working diagnosis.
I suggest you visit your physician if the bleeding is not controlled for an ultrasound and if need be evacuation of products if its an incomplete abortion.

I hope i have answered your queries in detail.
wishing you good health,
regards

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