When bleeding happens, it is frightening. Am I losing the baby? is bound to be the biggest fear in early pregnancy. Bleeding in early pregnancy does not usually mean miscarriage, but it can be one of the early signs that the pregnancy is not going well.

How can I tell what is going to happen?

There are two different ways to investigate bleeding in early pregnancy.

When bleeding happens very early, hormone levels can be measured and followed to help determine if things are going well. HCG and Progesterone levels can be checked in your blood, and if the level of progesterone and the increase in HCG levels is normal, your pregnancy is probably doing well. HCG levels in early pregnancy should double about every three days.

When can we see the baby on sonogram?

The pregnancy sac can be seen before the baby.

When HCG levels are greater than 1500, Dr. Daum should be able to see the sac with transvaginal sonograms. If the sac is not visible at this hormone level, the possibility of an ectopic (tubal) pregnancy must be considered. If the sac is seen in the uterus, the baby and a heartbeat should be able to be seen by about 6 1/2 weeks from the last period. Seeing the heartbeat usually means that things will be OK.

How will I know the danger is over?

When the baby's heartbeat is seen, everyone can breathe a little easier. Miscarriages usually happen before 10 weeks of pregnancy, and are very unusual after 12 weeks.

When bleeding happens and the heartbeat is there, more frequent sonograms may be done to make sure the baby is growing normally. When bleeding stops and the pregnancy reaches 9 to 10 weeks, usually the danger is past.

Why do miscarriages happen?

Most early miscarriages happen because something went wrong with the combination of the sperm and the egg.

The majority of first trimester miscarriages contained an abnormal number of chromosomes. Normal pregnancies have 46, but miscarried pregnancies may have 45, 47, broken chromosomes, or completely duplicated sets. Health problems and severe illness can be related to miscarriage, but are not common. Most losses are random events and not related to your feelings, stress, or physical activity.

Unless you have had multiple miscarriages in a row, your risk of miscarriage in your next pregnancy should not increase. Have faith, things should go well next time.