Bleeding in early pregnancy is a common occurrence. Some form of bleeding complicates at least a quarter of clinically diagnosed pregnancies. The different types of miscarriage and early pregnancy failure, along with ectopic pregnancies and gestational trophoblastic disease account for the bulk of early pregnancy bleeding problems. The management of early pregnancy bleeding has been overhauled, moving away from in-patient care and out of hours surgical treatment, to out-patient care with same or next day elective surgical treatment or alternatively, medical and conservative management options. This change has been principally brought about through the establishment of early pregnancy assessment clinics run on a daily basis, in combination with the more widespread availability and use of quantitative serum beta human chorionic gonadotrophin (bHCG) measurements and transvaginal ultrasound scanning.
ABSTRACT