title: Vaginal bleeding in the first 20 weeks of pregnancy.
abstract: The first and foremost diagnosis to exclude in the pregnant patient presenting with vaginal bleeding is ectopic pregnancy. Once ectopic pregnancy is ruled out, miscarriage should be considered as a clinical spectrum. Its management is directed according to the integrity of the internal cervical os and patient hemodynamic status. Treatment with anti-D immune globulin is warranted for all Rh-negative patients. Urgent obstetric consultation is necessary for most miscarriage presentations.
authors.affiliation: Department of Emergency Medicine, Brookhaven Memorial Hospital, 101 Hospital Road, East Patchogue, NY 11772, USA.
authors.forename: Paolo T
authors.initials: PT
authors.lastname: Coppola
authors.forename: Marco
authors.initials: M
authors.lastname: Coppola
mesh_terms: D000022:Abortion, Spontaneous / Q000145:classification / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D003937:Diagnosis, Differential; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011271:Pregnancy, Ectopic / Q000175:diagnosis; D012307:Risk Factors; D009626:Terminology as Topic; D016216:Ultrasonography, Prenatal; D014592:Uterine Hemorrhage / Q000209:etiology*; D014594:Uterine Neoplasms / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human