What causes spotting, bleeding and right abdominal cramping during a pregnancy?
Patient: I am 4 weeks pregnant.  Yesterday I started bleeding bright red. Not a lot just a bit of spotting. I had no pain or discomfort. Now I am passing dark brown blood. I have a small cramp in my lower right side. I am 35 years old, I have had 2 healthy pregnancies in the past and never miscarried before. Could I be miscarrying and what should I do? Doctor: Hello, and I hope I can help you today.Unfortunately your symptoms are consistent with miscarriage, and because you are having pain on one side- there is also a possibility of a tubal pregnancy (unless you already had an ultrasound that saw the pregnancy in your uterus)Either way, you need an urgent medical evaluation.  The most efficient way to do this- and get all the tests you need right away; including a blood test for the hormone level of your pregnancy and a pelvic ultrasound- is to go to a local emergency room.  I am sorry that the prognosis of this pregnancy looks bleak, but nothing can be done to prevent miscarriage once the body has started the process.  At the age of 35, one in 7 pregnancies will miscarry.  So I hope you get a proper evaluation of your condition soon, and if this pregnancy is not viable, still, the greatest chance is that everything will be fine if you try to conceive again afterward.I hope I was able to answer your question and that this information was helpful.Best wishes, Dr. Brown