Vaginal Bleeding in Pregnancy

When presented with vaginal bleeding in pregnancy, there are several important things to enquire about:

  • Gestation:
    • If the pregnancy is <24 weeks gestation, bleeding is technically described as miscarriage
      • If painless, closed cervix and only a little bleeding: likely threatened miscarriage
      • If painful, more blood and open cervix: more likely inevitable, incomplete or complete miscarriage depending on the location of the products of conception
    • If the pregnancy is >=24 weeks gestation, this is technically antepartum haemorrhage
  • Blood loss
    • How much?  Colour?  Clots?
  • Associated symptoms
    • Pain/cramps?  Nausea?
  • Other Hx
    • Trauma?  Pre-eclampsia?  Obstetric Hx.  Hx of antenatal checks.

Examination of the pregnant abdomen

Bimanual Examination

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