Dear patient, i understand your concerns about vaginal bleeding while pregnant in the first trimester. There are three main reasons for vaginal spotting during this period of pregnancy. 1- threatened abortion, incomplete abortion or complete abortion. 2- ectopic pregnancy 3- molar pregnancy. since an ultrasound scan was done and didn t show anything in the uterus then we are sure this is not molar pregnancy since it will show easily on ultrasound. we are left with either threatened abortion with early pregnancy that cannot be detected by ultrasound, a complete abortion, or ectopic pregnancy. in order to make the difference between these three entities we have to do a serum beta hcg level and repeat it in 48 hours. if it is doubling it means that you have a viable pregnancy and this was a threatened abortion and hence it is recommended to start on progestins supplementation like duphaston. if there is decrease in the level of beta hcg then this an actual abortion and if the ultrasound of the uterus shows it is empty then it s a complete abortion. and finally if there is an increase in the level without doubling of serum beta hcg then there is a chance this might be an ectopic pregnancy. you have to know that at a level of 2000 serum beta hcg , a gestational sac should be seen by transvaginal ultrasound. i recommend you to do the serum beta hcg level and repeat it in 48 hours to have an answer to your question. one last thing, if your blood group rhesus is negative and your husband is rhesus positive a type and screen should be done and if indirect coombs is negative then you must take 50 mcg of rhogam. best regards