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Hum. Reprod. Advance Access published online on October 27, 2006
Human Reproduction, doi:10.1093/humrep/del417
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received June 29, 2006
Revised September 21, 2006
Accepted September 27, 2006

Article

Bleeding following pregnancy loss before 6 weeks’ gestation

J.H.E. Promislow 1 *, D.D. Baird 2, A.J. Wilcox 2, and C.R. Weinberg 3

1 Social and Scientific Systems, NC, USA
2 Epidemiology Branch, NC, USA
3 Biostatistics Branch, National Institute of Environmental Health Sciences, Durham, NC, USA

* To whom correspondence should be addressed.
J.H.E. Promislow, E-mail: promisl1{at}niehs.nih.gov


  Abstract

BACKGROUND: Pregnancy loss before 6 weeks’ gestation is common, but little has been reported about the associated bleeding. We compared women’s bleeding following a pregnancy loss before 6 weeks’ gestation with their typical menstruation. METHODS: Women provided daily urine samples while trying to become pregnant and recorded the number of pads and tampons used each day. Thirty-six women had complete bleed data for a loss before 6 weeks’ gestation and one or more non-pregnant cycles. RESULTS: Mean bleed length following a pregnancy loss was 0.4 days longer than the woman’s average menstrual bleed (P = 0.01), primarily because of more days of light bleeding. Although there was no overall increase in the total number of pads plus tampons used, women with losses bled less than their typical menses following pregnancies of very short duration and more than usual for the pregnancies lasting the longest. CONCLUSIONS: Overall, the bleeding associated with pregnancy loss before 6 weeks’ gestation is similar to menstrual bleeding and unlikely to be recognized as pregnancy loss. The intriguing finding that pregnancies of very short duration were associated with less bleeding than the woman’s typical menses might reflect endometrial factors associated with loss.

Keywords: pregnancy loss/menses/bleed length/spontaneous abortion.
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