Vaginal bleeding during pregnancy has many causes and ranges in severity from benign with normal pregnancy outcome to life-threatening for both infant and mother.
Etiology can be from...
Anytime in pregnancy: quality of pregnancy dating, context (e.g., following bowel movement, during voiding, after intercourse, drug use, or trauma including domestic violence), amount...
Treat underlying cause of bleeding, if identified.
If mother is Rh-negative, give RhoGAM to prevent autoimmunization. In late pregnancy, dose according to the amount of es...
Patient should be instructed to report any increase in the amount or frequency of bleeding and to seek immediate care if experiencing fever, diz...
Al-Ma’ani WI, Solomayer EF, Hammadeh M. Expectant versus surgical management of first-trimester miscarriage: a randomised controlled study. Arch Gyneco...
O20.9 Hemorrhage in early pregnancy, unspecified
O46.90 Antepartum hemorrhage, unspecified, unspecified trimester
O20.0 Threatened abortion
O26.859 Spotting complicating pregnancy, unspecified...
Obtain blood type and screen all women presenting with vaginal bleeding in pregnancy after 8–9 weeks' gestation and administer RhoGAM to all Rh-negative patients.
For up to 50% of early...
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Endocervical polyp. A low-power photomicrograph shows cystic endocervical glands in a chronically inflamed stroma.
Normal cervical Papanicolaou (Pap) smear. Large squamous cells from the superficial, and intermediate layers of the epithelium are illustrated. The cells have abundant cytoplasm, which varies in staining from pink to blue. The nuclei are small, and the nuclear-cytoplasmic ratio is low. The most superficial cells have pyknotic nuclei (arrows).
Normal cervical Papanicolaou (Pap) smear. Large squamous cells from the superficial, and intermediate layers of the epithelium are illustr...
<bold>(1) Gently grasp the polyp with ring forceps, apply traction, and twist until it falls off.</bold>
<bold>(2) Alternatively, a small polyp may be biopsied off with a Tischler biopsy forceps.</bold>
<bold>FIG. 8.26.</bold> Placental abruption. The edge of the placenta (P) has been elevated by the bleeding. A portion of the amnion and chorion attached to the edge appears to be floating in the uterine cavity.
<bold>FIG. 8.26.</bold> Placental abruption. The edge of the placenta (P) has been elevated by the bleeding. A portion of the...
FIG. 3.85. Recurrent cervical carcinoma with vesicovaginal fistula. Fat-suppressed, gadolinium-enhanced T1-weighted image of pelvis demonstrates enhancing infiltrating pelvic tumor (<italic>arrow</bold>) and wide communication between bladder and vagina (<italic>arrowhead</bold>) allowing passage of high signal intensity gadolinium.
FIG. 3.85. Recurrent cervical carcinoma with vesicovaginal fistula. Fat-suppressed, gadolinium-enhanced T1-weighted image of pelvis demons...
FIGURE 28.50. Trichomonas vaginalis in urine. Note the flagella and the spherical character of this parasite. These organisms are easily misdiagnosed as white blood cells. (Bright-field microscopy, 3400.)
FIGURE 28.50. Trichomonas vaginalis in urine. Note the flagella and the spherical character of this parasite. These organisms are easily m...
<bold>Figure 6.15 Atypical squamous cells of undetermined significance (ASC-US).</bold> This Pap smear shows superficial-type squamous cells with mild nuclear enlargement and hyperchromasia. These features are suggestive but not diagnostic of a low-grade squamous intraepithelial lesion.
<bold>Figure 6.15 Atypical squamous cells of undetermined significance (ASC-US).</bold> This Pap smear shows superficial-type ...
<bold>Figure 6.16 Low-grade squamous intraepithelial lesion (Pap smear).</bold> These lesions show mildly dysplastic squamous cells with nuclear enlargement, hyperchromasia, and irregular nuclear contours that are more pronounced than in Figure 6.15.
<bold>Figure 6.16 Low-grade squamous intraepithelial lesion (Pap smear).</bold> These lesions show mildly dysplastic squamous ...
<bold>Figure 6.17 High-grade squamous intraepithelial lesion (Pap smear).</bold> The dysplastic cells seen in the center show a high nuclear-to-cytoplasmic ratio.
<bold>Figure 6.17 High-grade squamous intraepithelial lesion (Pap smear).</bold> The dysplastic cells seen in the center show ...
<bold>Figure 6.18 High-grade squamous intraepithelial lesion (Pap smear).</bold> A cluster of overlapping, markedly dysplastic cells forms a sheet. Note single, severely dysplastic cells.
<bold>Figure 6.18 High-grade squamous intraepithelial lesion (Pap smear).</bold> A cluster of overlapping, markedly dysplastic...
Sites of ectopic pregnancy.
<bold>FIG. 20.6.</bold> Diagrammatic representation of various degrees of placental a uption: preplacental or subamniotic (between amnion and chorion), marginal or subchorionic (between placenta and mem anes), and retroplacental (between placenta and myometrium).
<bold>FIG. 20.6.</bold> Diagrammatic representation of various degrees of placental a uption: preplacental or subamniotic (bet...
Chlamydial mucopurulent cervicitis.
Herpes simplex cervicitis.
Strawberry cervix associated with trichomoniasis.
Cervical Polyp A polyp typically develops in the endocervical canal and may protrude visibly at the cervical os. It is soft, red, and rather fragile. Cervical polyps are benign.
Cervical Polyp A polyp typically develops in the endocervical canal and may protrude visibly at the cervical os. It is soft, red, and rath...
Pap smear 1. Close up view of cross section of upper vagina and cervix with applicator inserted into the endocervical canal. Arrows indicate a clockwise rotation to obtain sample.
Pap smear 1. Close up view of cross section of upper vagina and cervix with applicator inserted into the endocervical canal. Arrows indic...
Pap smear 2. Close up view of cross section of upper vagina and cervix with wooden or plastic spatula pressed against cervix, longer end introduced slightly into os. Arrow indicates rotation to obtain ectocervical sample.
Pap smear 2. Close up view of cross section of upper vagina and cervix with wooden or plastic spatula pressed against cervix, longer end i...
<bold><italic>Figure 21-12</bold> Pap smears. A:</bold> Normal. Large, flat cells with small nuclei. <bold>B:</bold> Dysplasia. Large, dark nuclei indicate damaged DNA; cytoplasmic halo indicates human papillomavirus (HPV) effect. <bold>C:</bold> Malignant. Compact cells with huge, irregular, dark nuclei indicate malignancy.
<bold><italic>Figure 21-12</bold> Pap smears. A:</bold> Normal. Large, flat cells with small nuclei. <bold>B...
<bold><italic>Figure 21-9</bold> Ectropion ("erosion") of the cervix.</bold> Endocervical glandular epithelium has reappeared in the transformation zone in an adult woman. The rough, red appearance led early observers to believe it involved ulceration (erosion of the mucosa) and inflammation, hence the common clinical name, "cervical erosion."
<bold><italic>Figure 21-9</bold> Ectropion ("erosion") of the cervix.</bold> Endocervical glandular epithelium has...
<bold><italic>Figure 6-16</bold> Pap smear of the cervix.</bold> Many normal cells are present, which have small, uniform nuclei. Also present are clumps of malignant cells, which have large, dark nuclei.
<bold><italic>Figure 6-16</bold> Pap smear of the cervix.</bold> Many normal cells are present, which have small, ...
Figure 20.3. The relation between vaginal bleeding and abruptio placentae.
Microsurgery for ectopic pregnancy - Ectopic pregnancy is treated by making a linear salpingotomy incision over the ectopic on the antimesosalpingeal surface of the tube and gently removing the conceptus by irrigation and counterpressure on the sides of the tube
Microsurgery for ectopic pregnancy - Ectopic pregnancy is treated by making a linear salpingotomy incision over the ectopic on the antimes...