Bleeding during pregnancy (aka threatened miscarriage), is bleeding in the first 2 trimesters (weeks 0-28), specifically, 24 weeks (i.e seen during pregnancy prior to viability), and has yet to be assessed further.
Patient information
What is a threatened miscarriage?
It's bleeding that we think is more likely to be caused by a miscarriage, than by another cause, because it's happened so early in a pregnancy. It doesn't cover the entire 1st 2 trimesters, but extends up to 24 weeks.
Cause
Physiological, including:
Implantation bleeding, which is spotting within the first 6-12 days after you conceive, as the fertilized egg implants itself in the lining of the uterus
Rupture of a small vein on the outer rim of the placenta
Spotting
Miscarriage → strong cramps. It has a risk of 24% with heavy 1st trimester bleeding, compared to 12% in pregnancies without any 1st trimester bleeding
Ectopic pregnancy → pain in the lower abdomen. Commonly in the tube, and may lead to bleeding, internally, that could be fatal if untreated. It is found in 6% with heavy bleeding and an obstetric U/S of pregnancy of unknown location (no visible intrauterine pregnancy)
Molar pregnancy → rapid enlargement of the uterus
Vaginal bleeding (see page) for non-pregnant reasons (e.g. STI, sexual intercourse, pap test)
Gestational trophoblastic neoplasia
Chorionic hematoma
Lower genitourinary tract causes, including:
Vaginal bleed
Cervical bleed
Patient information
What's the cause of bleeding in early pregnancy?
It's not a good thing. Yes, you can sometimes get normal bleeding, but it's very early on. It can mean the death of bub, called a miscarriage. It can be a pregnancy outside the womb. It can be that there is no bub, but it's an abnormal tissue growth. Cancer. Occasionally, you can get bleeding that is not pregnancy related, due to bleeding from the vagina or cervix too.
Ix
Hx, including:
ABC's/vitals → bleeding
Amount of bleeding → spotting may be physiological
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