Bleeding/pain during pregnancy

Question 1

Diifferential Diagnosis of Bleeding +/- pain during pregnancy(according to trimesters)

Answer 1

First Trimester:

Threatened miscarriage: Bleeding with or without mild cramping, but the cervix remains closed.
Miscarriage: Bleeding with abdominal or pelvic pain, passage of tissue/clots, and the cervix may be open.
Ectopic pregnancy: Abnormal implantation of the embryo outside the uterus, typically causing abdominal pain and bleeding. It can be life-threatening and requires immediate medical attention.
Molar pregnancy: Abnormal growth of placental tissue, leading to bleeding and potentially severe nausea or vomiting.
Cervical polyp: A benign growth on the cervix that can cause bleeding during pregnancy.
Infections: Such as bacterial vaginosis or pelvic inflammatory disease, which can lead to bleeding.

Second and Third Trimesters:

Placenta previa: The placenta partially or completely covers the cervix, leading to painless bleeding.
Placental abruption: Premature separation of the placenta from the uterine wall, often associated with sudden onset of intense pain and bleeding.
Preterm labor: Contractions before 37 weeks of pregnancy accompanied by bleeding.
Uterine rupture: A rare but serious condition where the uterus tears, leading to severe pain and bleeding.
Cervical changes: Such as cervical ectropion, cervical polyps, or cervical infection, which can cause bleeding during pregnancy.
Vasa previa: Fetal blood vessels run over the cervix, which can rupture and cause bleeding.
Uterine fibroids: Non-cancerous growths in the uterus that may cause bleeding or pain.

*24 weeks pregnant w/ bleeding: start fluid, labs, blood. Give steroids for 48
hours so the lungs develop, give rhogam if necc, then deliver

**28 weeks pregnant: deliver