FREQUENCY AND SIGNIFICANCE OF BLEEDING IN EARLY PREGNANCY

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Abstract
Single vaginal smears, taken at random from 68 women between the 33rd and 60th days of pregnancy (menstrual dates), contained red blood cells in 12 cases. Microscopic bleeding from the uterus probably occurs more frequently and it may occasionally assume macroscopic proportions, even simulating a menstrual flow. This is the most likely explanation of the occasional disparity between the calculated duration of pregnancy and a disproportionately large fetus. In another series of 225 consecutive patients who did not abort 21.8% reported macroscopic vaginal bleeding between conception and the 196th day of pregnancy. In 8%, the bleeding began on or before the 40th day of pregnancy in the absence of any visible lesion of the cervix and it was interpreted as a physiological response to implantation. Physiological bleeding of early pregnancy is distinguished from the bleeding of abortion by the usual association of abortion with a greater flow of blood, the brown-black color of the initial vaginal discharge of blood, uterine cramps, and the absence of nausea.

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