Bleeding in 2nd trimester

Question 1

Causes of bleeding in 2nd trimester

Answer 1

• Onset of labour
• Placental bleeding (placenta previa)
• Abruption
• Cervical polyp, cancer, ectropion
• Cervical incompetence
• Infection

Question 2

Cervical incompetence

Answer 2

Painless dilatation of the cervix
- May result in a spontaneous mid trimester birth
- Often no preceding cramps or pain

Question 3

Management of cervical incompetence

Answer 3

• Swabs to rule out infection
• Urine c/s to rule out infection
• Emergency cerclage may be necessary if still viable
• Cerclage for future pregnancies (Cervical length monitoring from 14 weeks, remove at 36 weeks)

Question 4

Onset of labour

Answer 4

Stage 1
Painful regular contractions resulting in progressive cervical dilatation