Hello and thank you for your question. There are many different causes for bleeding during pregnancy, some which are serious and some which are not. But bleeding in the second trimester is usually considered abnormal until proven otherwise and may indicate a serious problem for either mother or baby.

There various causes for bleeding in the second trimester includes:

• Placenta praevia- It is a condition where the placenta is located low in the uterus and partially or completely covers the birth canal. If there is painless bleeding, you would require immediate medical attention.

• Placenta abruptio- The placenta detaches from the uterus wall before or during labor and causes bleeding between the placenta and uterus. There can be massive blood loss which may endanger both mother and baby. Other signs may include abdominal pain, clots from the vagina and back pain.

• Uterine rupture- This is a rare emergency in which the scar from a previous Caesarean section tears apart. Besides bleeding, it also causes severe abdominal pain.

• Vasa praevia- Also a rare condition, the blood vessels in the umbilical cord crosses the birth canal opening. As the vessels are very fragile, they can tear and cause severe bleeding causing the fetus to lose oxygen.

• Premature labour- Bleeding may also indicate that you are in early labour. There may be other signs such as contractions, abdominal cramps or pressure, lower back pain and vaginal discharge.

• Other causes- Cervical or vaginal injury, polyps

Other warning signs which pregnant women should be aware of are severe abdominal pain, discharge from vagina that contains tissue, dizziness or fainting, fever and chills.

In any case, please visit your doctor immediately. You will likely undergo an ultrasound scan, abdominal and vaginal examination to find out the cause of your bleeding. Do take care and all the best.

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