Gynaecology & Obs » Pregnancy, Labour

Bleeding in late pregnancy

Most common reasons for bleeding are bleeding associated with onset of labour, contractions and opening of the cervix, bleeding caused by recent pelvic examination post-coital bleeding, cervical polyp, trauma, vaginitis, placenta praevia and premature detachment of the placenta. A careful history is important. Avoid bimanual examination; only carry out a speculum examination if necessary. Check the state of the foetus: verify the presence of heart sounds either with a Doppler or an ultrasound. If the bleeding is heavy, insert an intravenous cannula and promptly send the patient by ambulance, accompanied by an escort, to a hospital.

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