###Human: Do mild cramps, bleeding and lower back pain indicate miscarriage? ###Assistant: Hi. The symptoms you are experiencing come under category of threatened abortion. The clinical diagnosis of threatened abortion is presumed when a bloody vaginal discharge or bleeding appears through a closed cervical os during the first half of pregnancy. Risk of threatened abortion progressing to abortion is substantially reduced when fetal cardiac activity is seen on ultrasound; which is true in your case and is a reassuring fact. This bleeding is not an implantation bleeding. The implantation bleeding happens between 7-10 days after ovulation when baby is burrowing in endometrium which is actually before diagnosis of pregnancy or before a woman misses her period. Placenta takes over progesterone production between 7-11 weeks. But it is just a shift in hormone production and not associated with bleeding. As described above, you have a fair chance of continuing pregnancy (if not already lost), because of heart activity seen on ultrasound. Cramps during pregnancy (unless due to bowel/bladder disturbances) are not normal and indicate threat to pregnancy. Cramps do not always indicate impending miscarriage. Acetaminophen can be taken for relief of cramps; better medicine is injection of Progesterone along with antispasmodics. Aspirin rarely aggravates bleeding and can be continued despite bleeding in most cases. Progesterone when taken orally is less effective than vaginal progesterone, only exception being Hydrogesterone which is effective orally. Normally in such cases we start injection Progesterone 100 mg intramuscularly on alternate days, but there is insufficient evidence to support and refute its effectiveness. In most cases, such bleeding happens due to chorioamniotic separation or subchorionic bleeding that is bleeding between baby and uterine wall. If cause is immunological, abortion may happen with intrauterine demise of baby or it may start with bleeding; both are possible. So, summarizing facts in your case,