ABC of antenatal care. Vaginal bleeding in early pregnancy-II.

Bleeding drives patients to their general practitioner swiftly. Vaginal bleeding in pregnancy makes the woman think that she may be miscarrying, so this brings her even more promptly; the practitioner thence has the Causes of bleeding opportunity to diagnose the cause and start prompt management. * Abortion or miscarriage Bleeding has four known causes in early pregnancy (box). In addition, * Ectopic pregnancy bleeding occurs for no apparent reason in a large number of cases. In early * Trophoblast disease pregnancy such cases are commonly categorised as threatened miscarriage, * Lesions of cervix or vagina but this is fudging the issue for in many cases the conceptus and its future placental system are not involved; doctors should be honest and say that they do not know the cause.