gynecology and obstetrics
Vaginal Bleeding During Late Pregnancy
Key Points
All patients with vaginal bleeding during late pregnancy require IV access for fluid or blood resuscitation, as well as continuous maternal and fetal monitoring. A digital cervical examination is contraindicated in evaluation of bleeding during late pregnancy until placenta previa and vasa previa are excluded. In placental abruption, vaginal bleeding may be absent if blood is concealed between the placenta and uterine wall. Suspect uterine rupture in women with a history of cesarean delivery or other uterine surgery. Vaginal bleeding may be mild despite maternal hypotension. 