Early pregnancy bleeding
| Early pregnancy bleeding | |
|---|---|
| Other names | First trimester bleeding, hemorrhage in early pregnancy |
| Specialty | Obstetrics |
| Complications | Hemorrhagic shock[1] |
| Causes | Ectopic pregnancy, threatened miscarriage, pregnancy loss, implantation bleeding, gestational trophoblastic disease, polyps, cervical cancer[1][2] |
| Diagnostic method | Typically includes speculum examination, ultrasound, hCG[1] |
| Treatment | Depends on the underlying cause[1] |
| Frequency | ~30% of pregnancies[1] |
Early pregnancy bleeding (also called first trimester bleeding) is vaginal bleeding before 13 weeks of gestational age.[1][2] Early pregnancy bleeding is common and can occur in up to 25% of pregnancies. Many individuals with first trimester bleeding experience no additional complications. However, 50% of pregnancies with first trimester bleeding end in miscarriage.[3][4]
Common causes of early pregnancy bleeding include miscarriage, ectopic pregnancy, and subchorionic hematomas. Other causes include implantation bleeding, gestational trophoblastic disease, cervical changes, or infections.[1] Assessment of first trimester bleeding includes history and physical exam (including speculum examination), imaging using ultrasound, and lab work such as beta-hCG and ABO/Rh blood tests.[1]
Treatment depends on the underlying cause.[1] Emergent management is indicated for patients with significant blood loss or hemodynamic instability. Anti-D immune globulin is usually recommended in those who are Rh-negative.[5] Early pregnancy loss can be treated with expectant management, medication, or surgical intervention.[6] Ectopic pregnancy can be treated with medication or surgical management, although emergent intervention is needed if the pregnancy has ruptured.[7]
- ^ a b c d e f g h i Breeze, C (May 2016). "Early pregnancy bleeding". Australian Family Physician. 45 (5): 283–6. PMID 27166462.
- ^ a b Stables, Dorothy; Rankin, Jean (2010). Physiology in Childbearing: With Anatomy and Related Biosciences. Elsevier Health Sciences. p. 423. ISBN 978-0702044113.
- ^ Cite error: The named reference
:72was invoked but never defined (see the help page). - ^ Deutchman, M; Tubay, AT; Turok, D (1 June 2009). "First trimester bleeding". American Family Physician. 79 (11): 985–94. PMID 19514696.
- ^ Coppola, PT; Coppola, M (August 2003). "Vaginal bleeding in the first 20 weeks of pregnancy". Emergency Medicine Clinics of North America. 21 (3): 667–77. doi:10.1016/S0733-8627(03)00041-5. PMID 12962352.
- ^ Cite error: The named reference
:0was invoked but never defined (see the help page). - ^ Hendriks, Erin; Rosenberg, Rachel; Prine, Linda (2020-05-15). "Ectopic Pregnancy: Diagnosis and Management". American Family Physician. 101 (10): 599–606. ISSN 1532-0650.