Vaginal bleeding (main): Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
===Non-Pregnant=== | |||
{{VB DDX nonpregnant}} | {{VB DDX nonpregnant}} | ||
===Pregnant <20 Weeks=== | |||
{{VB DDX less than 20}} | {{VB DDX less than 20}} | ||
===Pregnant >20 Weeks=== | |||
{{VB DDX greater than 20}} | {{VB DDX greater than 20}} | ||
Revision as of 18:45, 12 September 2014
Background
Differential Diagnosis
Non-Pregnant
Nonpregnant Vaginal Bleeding
Systemic Causes
- Cirrhosis
- Coagulopathy (Von Willebrand disease, ITP)
- Group A strep vaginitis (prepubertal girls)
- Hormone replacement therapy
- Anticoagulants
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Hypothyroidism
- Polycystic Ovary Syndrome
- Secondary anovulation
Reproductive Tract Causes
- Adenomyosis
- Atrophic endometrium
- Dysfunctional uterine bleeding
- Endometriosis
- Leiomyoma (Fibroid)
- Foreign Body
- Infection (vaginitis, PID)
- IUD
- Neoplasia (especially in women >45 years old or in younger women with other risk factors)
- Vaginal Trauma
Pregnant <20 Weeks
Vaginal Bleeding in Pregnancy (<20wks)
- Ectopic pregnancy
- Subchorionic hematoma
- First Trimester Abortion
- Complete Abortion
- Incomplete Abortion
- Inevitable Abortion
- Missed Abortion
- Septic abortion
- Threatened Abortion
- Gestational trophoblastic disease
- Consider when pregnancy-induced hypertension is seen before 24 wks of gestation
- Heterotopic pregnancy
- Implantation bleeding
- Molar pregnancy
- Non-pregnancy related bleeding
- Cervicitis
- Fibroids
- Implantation bleeding
Pregnant >20 Weeks
Vaginal Bleeding in Pregnancy (>20wks)
- Emergent delivery
- Placental abruption
- Placenta previa
- Vasa previa
- Uterine rupture
- Preterm labor
- Vaginal trauma
- Placenta accreta
- Intrauterine fetal demise
Workup
See individual notes:
- Vaginal Bleeding (Non-Pregnant)
- Vaginal Bleeding Pregnant (less than 20wks)
- Vaginal Bleeding Pregnant (greater than 20wks)
- Post-Partum Hemorrhage