Bleeding
Vaginal bleeding in the first trimester is not an uncommon occurrence, happening in approximately 25% of all pregnancies. Of that 25%, 50% will miscarry. If the patient is stable and fetal heart tones are detected (as early as 10 weeks with a Doppler), then cautious reassurance and waiting are an appropriate approach.
There are multiple criteria including ultrasound and the beta subunit of human chorionic gonadotropin, which will help the clinician establish a diagnosis from among the many potential causes of first trimester bleeding. These causes include threatened abortion, spontaneous abortion, incomplete abortion, septic abortion, and ectopic pregnancy. Other causes include less acute diagnoses like gestational trophoblastic disease. |