OB/GYN Issues

Vaginal Bleeding

Bleeding from lower (vulva, vagina, cervix) or upper genital tract (uterus)

Etiologies

  • Premenopausal
    • Not pregnant: menses, lower tract (trauma, STI, cervical dysplasia/cancer), & abnormal uterine bleeding (polyp, adenomyosis, leiomyoma, hyperplasia/cancer, coagulopathy, ovulatory dysfunction, endometrial, & iatrogenic)
    • Pregnant
      • 1st trimester: threatened abortion, spont. abortion (missed, incomplete, or complete), ectopic preg, molar preg (partial/complete hydatidiform mole)
      • 2nd or 3rd trimester: preterm labor/labor, placenta previa, placental abruption
  • Postmenopausal: atrophy, polyp, leiomyoma, endometrial hyperplasia/cancer

History & exam

  • Age, menopausal status, gestational age if preg, volume & duration current bleeding