TOMORROW'S PRESENTATION Early Preg. Hem.

Department of Obstetrics and Gynaecology

Vaginal bleeding occurs in 20‑30% of pregnancies up to 20 weeks and can lead to serious complications such as hemorrhagic shock, ectopic pregnancy, and spontaneous abortion. The document outlines the major etiologies, including ruptured ectopic pregnancy, corpus luteum cyst, spontaneous abortion, gestational trophoblastic disease, and implantation bleeding. It details a systematic diagnostic approach using history, physical examination, ultrasonography, and hCG measurement. Management recommendations are tailored to severity and cause, ranging from expectant care to surgical intervention, methotrexate therapy, and Rh immunoglobulin administration. Key clinical pearls on hemodynamic instability, infection, and urgent referral are highlighted.