From the Guidelines
Spotting at 6 months of pregnancy can be a sign of a serious condition and requires immediate medical evaluation. If you experience spotting at 6 months pregnant, you should contact your healthcare provider promptly for assessment, as it may indicate conditions such as placenta previa, placental abruption, or preterm labor 1. The color, amount, and accompanying symptoms of the spotting are crucial in determining the severity of the condition - bright red bleeding, heavy flow, or spotting accompanied by cramping, back pain, or contractions are particularly concerning signs.
When you call your provider, be prepared to describe the color and amount of blood, any accompanying symptoms, and recent activities. It is essential to avoid using tampons, having sexual intercourse, or douching while experiencing spotting, and instead, use a pad to monitor the amount of bleeding 1. While waiting for medical advice, rest and stay hydrated.
Some studies suggest that transvaginal US is frequently necessary for evaluation of painful vaginal bleeding, especially if transabdominal US is inconclusive or inadequate 1. Additionally, women diagnosed with placenta previa after 28 weeks’ gestation are at risk for spontaneous labor and should avoid moderate to vigorous physical activity (MVPA), but maintain their activities of daily living and low-intensity activity (ie, walking) 1.
Key points to consider when experiencing spotting at 6 months of pregnancy include:
- Contact your healthcare provider promptly for evaluation
- Avoid using tampons, having sexual intercourse, or douching
- Use a pad to monitor the amount of bleeding
- Rest and stay hydrated while waiting for medical advice
- Be prepared to describe the color and amount of blood, any accompanying symptoms, and recent activities when calling your provider. Remember that many women who experience spotting in the second trimester go on to have healthy pregnancies, but proper medical evaluation is essential to ensure both maternal and fetal wellbeing 1.
From the Research
Spotting at 6 Months of Pregnancy
Spotting at 6 months of pregnancy can be a cause for concern, and it is essential to understand the potential risks and complications associated with it.
- Spotting can be a symptom of placenta previa, a condition where the placenta covers the cervix, which can lead to bleeding and other complications 2, 3.
- Placenta previa is a significant cause of maternal morbidity and mortality, and it is crucial to diagnose and manage it properly 4.
- Women with placenta previa are at increased risk of preterm birth, and the risk of preterm birth is higher for women with placenta previa than for those with low-lying placenta 5.
Risk Factors and Complications
Several risk factors can increase the likelihood of spotting at 6 months of pregnancy, including:
- Prior cesarean delivery
- Advanced maternal age
- Smoking
- Placenta accreta spectrum (PAS) disorders
These risk factors can lead to complications such as:
- Maternal morbidity and mortality
- Preterm birth
- Low birth weight
- Neonatal intensive care unit admission
Management and Prevention
Proper management and prevention of spotting at 6 months of pregnancy are critical to reducing the risk of complications.
- Planned cesarean delivery is recommended for women with placenta previa that persists into the late third trimester 2.
- Pelvic rest may be recommended for women with placenta previa or low-lying placenta, but its effectiveness in preventing preterm birth is unclear 6.
- Intramuscular progesterone, cervical cerclage, and pessary may be beneficial in preventing preterm birth, but more research is needed to confirm their effectiveness 5.