Vaginal Bleeding
Basics
Description
Description
- 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
Etiology
PREGNANT PATIENTSEtiology
- Early pregnancy:
- Ectopic pregnancy:
- Occurs in 2% of pregnancies
- Abortion:
- Threatened, incomplete, complete, missed, inevitable, septic
- Molar pregnancy
- Trauma
- Ectopic pregnancy:
- Later pregnancy:
- Placenta previa
- Placental abruption
- Molar pregnancy
- Labor
- Trauma
- Immediate postpartum period:
- Postpartum hemorrhage
- Uterine inversion
- Retained placenta
- Endometritis
- Abnormal uterine bleeding (formerly dysfunctional uterine bleeding)
- 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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Citation
Schaider, Jeffrey J., et al., editors. "Vaginal Bleeding." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding.
Vaginal Bleeding. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding. Accessed December 10, 2024.
Vaginal Bleeding. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307053/all/Vaginal_Bleeding
Vaginal Bleeding [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 10]. 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
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T1 - Vaginal Bleeding
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ED - Shayne,Philip,
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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PB - Lippincott Williams & Wilkins
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DB - Emergency Central
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