Bleeding During the First Half of Pregnancy

The two diagnoses to firstly consider are ectopic pregnancy and abortion.

• In all cases of bleeding in pregnancy rapidly assess the severity of bleeding.
• In the event of heavy hemorrhage or shock or if a surgical intervention (Laparotomy etc.) is required:

Start an IV infusion of Ringer lactate; monitor vital signs (pulse, BP).

• Prepare for a possible blood transfusion (determine patient's blood group, identify blood transfusion potential donors)
• In the event of referral surgical facility, difficult transport conditions might aggravate the hemorrhage: the patient should be infused and accompanied by family members who are potential blood donors.
• Prevent or treat anemia (measure hemoglobin if possible).