Vaginal bleeding in pregnancy (greater than 20wks): Difference between revisions
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==Background== | ==Background== | ||
[[File:Pregnancy timeline.png|thumb|Timeline of pregnancy, including (from top to bottom): Trimesters, embryo/fetus development, gestational age in weeks and months, viability and maturity stages.]] | |||
[[File:Bumm 123 lg - Copy.jpg|thumb|Estimated gestational age based on physical exam.]] | |||
*Do NOT perform digital exam in patients who present with vaginal bleeding when >20 weeks pregnant | *Do NOT perform digital exam in patients who present with vaginal bleeding when >20 weeks pregnant | ||
*Only 20% of miscarriages occur after the first trimester | *Only 20% of miscarriages occur after the first trimester | ||
Revision as of 17:24, 4 December 2024
Background
- Do NOT perform digital exam in patients who present with vaginal bleeding when >20 weeks pregnant
- Only 20% of miscarriages occur after the first trimester
Clinical Features
Maternal vitals and labs in pregnancy
- Vaginal bleeding
- Uterine fundus palpable above umbilicus
Differential Diagnosis
Vaginal Bleeding in Pregnancy (>20wks)
- Emergent delivery
- Placental abruption
- Placenta previa
- Vasa previa
- Uterine rupture
- Preterm labor
- Vaginal trauma
- Placenta accreta
- Intrauterine fetal demise
Evaluation
Workup
- Pregnancy test (urine or serum)
- Hemoglobin (CBC or POC)
- Consider type & screen