Bleeding during early pregnancy
The common causes of bleeding during the fist and second trimesters are miscarriage, ectopic pregnancy, placental causes (placenta praevia, placental detachment), vaginal or cervical infections, polyps and trophoblastic disease (hydatid mole). Acute referral to a gynaecology outpatient clinic is needed if profuse bleeding or severe pain occurs. Acute referral to a prenatal clinic is needed irregular or painful contractions occur, the cervix is dilated or shortened the presenting part is low in the delivery channel, the membranes bulge out and blood and mucus are present.
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