How is hemorrhage assessed in the evaluation of suspected early pregnancy loss?

Updated: Nov 05, 2018
  • Author: Slava V Gaufberg, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Assess the intensity of hemorrhage. External bleeding may not accurately reflect total hemorrhage. The patient, especially in the supine position, may collect large amounts of blood in the vagina with minimal external bleeding. Similarly, a large quantity of retained blood may be present in the uterine cavity and, in the case of ectopic pregnancy, in the peritoneal cavity. Therefore, never rely on the external examination to assess the rate of hemorrhage in patients with vaginal bleeding. Always perform a pelvic examination to look for blood collection in the vagina, disproportionately tender uterus, and signs of peritoneal irritation.

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