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Vaginal Bleeding

Vaginal Bleeding is a topic covered in the 5-Minute Emergency Consult.

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  • Common presenting complaint to EDs
  • Most cases have benign etiology
  • Some patients may have potentially life-threatening conditions
  • Key principles in evaluating women with vaginal bleeding:
    • Any woman capable of childbearing might be pregnant
    • Menstrual and sexual histories do not rule out pregnancy


  • Early pregnancy:
    • Ectopic pregnancy (occurs in 2% of pregnancies)
    • Abortion:
      • Threatened, incomplete, complete, missed, inevitable, septic
    • Molar pregnancy
    • Trauma
  • Later pregnancy:
    • Placenta previa
    • Placental abruption
    • Molar pregnancy
    • Labor
    • Trauma
  • Immediate postpartum period:
    • Postpartum hemorrhage
    • Uterine inversion
    • Retained placenta
    • Endometritis
  • Dysfunctional uterine bleeding (DUB)
  • Structural abnormalities:
    • Uterine fibroids
    • Cervical/endometrial polyps
    • Pelvic tumors
  • Atrophic endometrium:
    • Most common cause of postmenopausal bleeding
  • Rare for systemic disorders to present solely with vaginal bleeding:
    • Von Willebrand disease
    • Idiopathic thrombocytopenic purpura
  • Trauma
  • Foreign bodies
  • Infections

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Rosen, Peter, et al., editors. "Vaginal Bleeding." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding.
Vaginal Bleeding. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding. Accessed April 24, 2019.
Vaginal Bleeding. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding
Vaginal Bleeding [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Vaginal Bleeding ID - 307053 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -