Bleeding in early pregnancy

Bleeding in early pregnancy is common

Early pregnancy bleeding is bleeding within 1st 20 weeks

About 20 % to 40 % women report bleeding during the 1st trimester

Most episodes are short lived

Causes of 1st trimester bleeding- 10 % to 57 % miscarriage- ectopic 1 % to 2 %

Peak incidence 6th-7th week

Heavy bleeding is less common

Gestational age

When did it start

Provoked ( for e.g after sexual intercourse )

Constant or intermittent

Fresh blood , dark or clots

Amount of blood ( ask how many pads changed )

Pain - location , character etc ( shoulder tip pain may suggest intra-abdominal bleeding )

Any loss of tissue

Symptoms suggesting anaemia as syncope , chest pain , SOB

Risk factors ectopic pregnancy

Symptoms suggestive of UTI

Vaginal discharge ( ? STI risk / history )

Trauma

Obstetric history

Previous problems ( bleeding , miscarriage , ectopic , PID )

Associated medical problems ( uncontrolled diabetes , clotting disorders , thyroid disease , HIV )

Fertility problems ( ? normally conceived pregnancy )

Previous treatment / interventions

Cervical smears.

Obtain BP , pulse , temp

HD unstability ( young women with adequate physiological reserve may suffer significant blood...