1st trimester bleeding

Question 1

• leading cause of 1st trimester pregnancy-related death
• most women have no identifiable risk factor
• transvaginal ultrasound and serial bHCG required for diagnosis
• clincial signs/sx: cervical motion tenderness, unilateral pelvic or lower abdominal pain, amenorrhea

Answer 1

Ectopic Pregnancy

Question 2

• commonly presents with vaginal bleeding in early pregnancy
• increased risk at extremes of maternal age and previous molar pregnancy
• dx: ultrasound and pathology
• tx: aspiration and serial bHCG for at least 6 mos
• CM: painless vaginal bleeding, preeclampsia before 20 weeks & hyperemesis gravidarum

Answer 2

Gestational trophoblastic disease

(also known as molar pregnancy)