Blood in vomit during pregnancy: what it can mean and what to do

Contact local emergency services or go to the nearest emergency department now. Do not drive yourself if you feel faint, weak, confused or short of breath.

Fresh bleeding may look bright red, while blood partly changed by stomach acid may look brown, black or like coffee grounds. Both appearances need assessment. Blood in vomit is different from blood that is coughed up and from vaginal bleeding, but tell the clinician if you are unsure where it came from.

Forceful or repeated vomiting can irritate the food pipe or cause a small tear near the stomach. Other possibilities include inflammation, an ulcer, or blood swallowed from a nose or mouth bleed. Oesophageal and stomach cancers can present with vomiting blood, but many non-cancer causes are possible and an examination is needed to identify the source.

Seek emergency assessment even if the bleeding has stopped or only appeared as streaks. If possible, note the colour and approximate amount, whether vomiting was forceful, and whether you also have black stools, abdominal pain, dizziness or reduced urination. A photograph may help if taking one does not delay care.

Bring your maternity records and a list of medicines, supplements and allergies. Avoid taking a new medicine for pain, nausea or indigestion until a clinician or pharmacist confirms it is suitable in pregnancy. If you become drowsy or vomit again while waiting for help, lie on your side and have someone stay with you.

Call local emergency services immediately for a large amount of blood, repeated bloody vomit, coffee-ground material, black sticky stools, severe abdominal or chest pain, fainting, confusion, breathlessness, pale or clammy skin, a racing heartbeat, or difficulty staying awake. These can accompany significant blood loss or another serious problem.

Persistent vomiting with inability to keep fluids down, very dark urine or much less urination also needs urgent pregnancy care because dehydration may develop. The hospital team may check your pulse and blood pressure, test blood and urine, give fluids or anti-sickness treatment, and investigate the digestive tract while considering the pregnancy.

Ask what source of bleeding is suspected, whether dehydration or anaemia was found, and which tests are being considered. Clarify which anti-sickness and acid-reducing medicines you should use, what you can drink or eat, and which changes mean you should return to emergency care.