492:
spontaneously within four week. Women who decide on expectant management may experience more days of bleeding and longer completion time as compared to surgical management. Serious complications of watchful waiting are rare. Effective medical management entails 200 mg of oral mifepristone (Mifeprex) followed 24 hours later by 800 mcg of vaginally administered misoprostol. Bed rest and progesterone therapy have not been shown to increase the likelihood of a viable outcome.
465:
intrauterine pregnancy is uncertain, repeat ultrasonography coupled with laboratory measurement of progesterone and/or serial hCG can be helpful. The absence of either intrauterine or ectopic pregnancy on imaging is suggestive of a complete early pregnancy loss (if the pregnancy was previously seen on imaging) or a pregnancy of unknown location (if the pregnancy was not previously seen on imaging).
444:
lightheadedness, or pelvic discomfort is associated with increased risks of ectopic pregnancy and spontaneous abortion. Discomfort in the middle of the abdomen is more closely associated with spontaneous abortion; discomfort on a side of the abdomen is more closely associated with ectopic pregnancy. Risk factors for ectopic pregnancy or spontaneous abortion should also be considered.
499:
therapy or surgery. Typically, an intramuscular injection of 50 mg per m^2 of methotrexate is given followed by close monitoring of b-hCG levels 4 and 7 days after injection. B-hCG levels should decrease by at least 15% between those two timepoints. Surgery is required for individuals who have failed
249:
is a term often used interchangeably with spontaneous abortion and miscarriage and refers to pregnancy loss during the first trimester. It is the most common cause of early pregnancy bleeding and is associated only with heavy (versus light) bleeding. However, patients typically remain hemodynamically
491:
Early pregnancy loss can be treated with watchful waiting, medication, or uterine aspiration based on shared decision-making between the mother and provider. For those with incomplete abortion, watchful waiting is the recommended method as more than 90% of these individuals will complete the process
459:
Before 10 weeks gestation, a slower than normal increase in hCG suggests early pregnancy loss or ectopic pregnancy. By approximately 10 weeks, hCG plateaus and ultrasound is preferred to determine the location of the pregnancy (i.e., intrauterine or ectopic). In the presence of prior pelvic imaging,
455:
If the person is stable and a pelvic exam is unrevealing, transvaginal ultrasonography and/or serial measurement of hCG is generally recommended to assess fetal location and viability. Reviewed data from observational studies determined that ultrasound examination and hCG concentration could replace
430:
is a rare condition that can result in bleeding from the fetoplacental circulation. Vasa praevia happens most often when the umbilical cord grows in a way that it directly enters the membrane, and therefore blood vessels that are unprotected by the umbilical cord or placental tissue can rupture and
447:
The physical examination includes assessing vital signs and performing an abdominal and pelvic examination. Signs of hemodynamic instability or peritonitis require emergent intervention. A pelvic examination may reveal non-obstetric causes of bleeding such as bleeding from the vagina or cervix. It
439:
The initial assessment of vaginal bleeding in early pregnancy must first consider hemodynamic stability and the degree of pain or bleeding. A hemodynamically unstable individual would necessitate an immediate transfer to the emergency department. It is important to recognize that women may
464:
is sufficient to assess fetal viability beginning at 10–12 weeks of gestation. Bleeding associated with an intrauterine, viable pregnancy suggests threatened early pregnancy loss. Bleeding associated with an intrauterine, nonviable pregnancy suggests early pregnancy loss. If the viability of an
443:
The initial evaluation of early pregnancy bleeding involves a history and physical examination. The relevant history includes determining the gestational age of fetus and characterizing the bleeding. Bleeding that is at least as heavy as menstrual bleeding or associated with clots, tissue,
253:
Threatened early pregnancy loss, often considered a type of early pregnancy loss, refers vaginal bleeding in the presence of an intrauterine pregnancy and a closed cervix. The presence of fetal heart rate largely determines whether the pregnancy will progress to a viable
508:
First trimester bleeding is more common than second or third trimester bleeding. First trimester bleeding may be associated with complications in later pregnancy, including placental abruption, smaller estimated fetal weight, stillbirth, and perinatal death.
260:
refers to a pregnancy outside the uterus, commonly in the fallopian tube. It is a less common but more serious cause of early pregnancy bleeding. Ectopic pregnancies can rupture, leading to internal bleeding that can be fatal if
431:
lead to bleeding. Another common source of bleeding can be due to abnormal development of the embryo. The most common early fetal abnormality is abnormal number of chromosomes causing loss of the pregnancy and bleeding.
307:
that be either cancerous or non-cancerous. This cause is extremely rare with non-cancerous gestational trophoblastic neoplasia found in 23 to 1,299 cases per 100,000 pregnancies and cancerous forms with a 10-fold lower
1606:
Coomarasamy, Arri; Devall, Adam J.; Cheed, Versha; Harb, Hoda; Middleton, Lee J.; Gallos, Ioannis D.; Williams, Helen; Eapen, Abey K.; Roberts, Tracy; Ogwulu, Chriscasimir C.; Goranitis, Ilias (2019-05-09).
398:
bleeding, which may arise from many causes including fibroids, polyps, warts, tumors, vaginitis, or trauma. Importantly, these causes may co-occur with other causes of early pregnancy bleeding.
344:
refers to the placenta or fetal blood vessels, respectively, covering or being located close to the opening of the uterus. More than half of women affected by placenta praevia (51.6)% have
1762:
Bever, Alaina M.; Pugh, Sarah J.; Kim, Sungduk; Newman, Roger B.; Grobman, William A.; Chien, Edward K.; Wing, Deborah A.; Li, Hanyun; Albert, Paul S.; Grantz, Katherine L. (June 2018).
334:
Pregnancy loss refers to death of the fetus at any time during pregnancy. Pregnancy loss most commonly occurs during the first trimester, when it is referred to as early pregnancy loss.
267:
involves a small amount of bleeding that may occur 10 to 14 days after implantation of the fertilized egg. However, there is little evidence to support the existence of such bleeding.
920:
Altieri, Andrea; Franceschi, Silvia; Ferlay, Jacques; Smith, Jennifer; La
Vecchia, Carlo (November 2003). "Epidemiology and aetiology of gestational trophoblastic diseases".
1028:
Ruiter, L.; Kok, N.; Limpens, J.; Derks, J. B.; de Graaf, I. M.; Mol, Bwj; Pajkrt, E. (July 2016). "Incidence of and risk indicators for vasa praevia: a systematic review".
223:(0 to 14 weeks gestational age). Bleeding in the second trimester (12 to 24 weeks gestational age) is less common. About 15% of those who realize they are pregnant have a
456:
pelvic examination in the initial evaluation of early pregnancy bleeding. Transvaginal ultrasound is frequently used in the evaluation of bleeding in early pregnancy.
426:
or a lesion in the cervix or vagina. In the earlier stages of pregnancy, the cervix can be vulnerable to bleeding as new blood vessels are being grown.
388:
Iatrogenic causes, or bleeding due to medical treatment or intervention, such as sex steroids, anticoagulants, or intrauterine contraceptive devices.
422:
Early pregnancy bleeding is usually from a maternal source rather than a fetal one. The maternal source may be a disruption in the vessels of the
760:
American
College of Obstetricians Gynecologists' Committee on Practice Bulletins—Gynecology (November 2018). "ACOG Practice Bulletin No. 200".
1494:"Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial)"
1288:
Hendriks, Erin; MacNaughton, Honor; MacKenzie, Maricela
Castillo (February 2019). "First Trimester Bleeding: Evaluation and Management".
1114:
814:; Olshan, A. F.; Jonsson Funk, M. L.; Hartmann, K. E. (2009). "Association Between First-Trimester Vaginal Bleeding and Miscarriage".
1549:
Schreiber, Courtney A.; Creinin, Mitchell D.; Atrio, Jessica; Sonalkar, Sarita; Ratcliffe, Sarah J.; Barnhart, Kurt T. (2018-06-07).
476:
Women with significant first-trimester bleeding (more than spotting) should have a red blood cell antibody screen. Women who are
759:
500:
or have contraindications to methotrexate therapy, are experiencing significant blood loss, or have signs of ectopic rupture.
239:
The differential diagnosis depends on whether the bleeding occurs in the first trimester or in the second or third trimesters.
1325:"Review article: the use of pelvic examination within the emergency department in the assessment of early pregnancy bleeding"
300:
610:
744:
170:
74:
354:
involves the separation of the placental lining from the uterus of the mother. It occurs most commonly around 25
1635:
355:
190:
139:
103:
965:"Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis"
1820:
1382:"Ectopic pregnancy and miscarriage: diagnosis and initial management: summary of updated NICE guidance"
1715:"Placental abruption: epidemiology, risk factors and consequences: Placental abruption, epidemiology"
823:
488:. Those with significant blood loss who become hemodynamically unstable require rapid intervention.
1872:
827:
294:
165:, and pregnancy loss. Most miscarriages occur before 12 weeks gestation age. Other causes include
1437:"Outcome of expectant management of spontaneous first trimester miscarriage: observational study"
963:
Fan, Dazhi; Wu, Song; Liu, Li; Xia, Qing; Wang, Wen; Guo, Xiaoling; Liu, Zhengping (2017-01-09).
406:
47:
481:
449:
345:
209:
162:
66:
734:
656:
Coppola, PT; Coppola, M (August 2003). "Vaginal bleeding in the first 20 weeks of pregnancy".
600:
264:
166:
70:
1877:
976:
374:
refers to an ectopic pregnancy that occurs in the ovary, cervix, or intra-abdominal cavity.
246:
182:
95:
8:
402:
382:
351:
980:
736:
Professional
Paramedic, Volume II: Medical Emergencies, Maternal Health & Pediatrics
1836:
1796:
1763:
1744:
1583:
1526:
1417:
1362:
1164:
1139:
1079:
Brenner, Paul (September 1996). "Differential diagnosis of abnormal uterine bleeding".
1061:
1005:
964:
793:
485:
461:
440:
suffer significant blood loss before any signs of hemodynamic instability are evident.
385:, which is vaginal bleeding after sexual intercourse that can be normal with pregnancy.
270:
201:
147:
1469:
1092:
933:
669:
1848:
1840:
1801:
1783:
1736:
1731:
1714:
1695:
1687:
1648:
1640:
1588:
1570:
1531:
1513:
1474:
1456:
1421:
1409:
1401:
1354:
1346:
1341:
1324:
1305:
1297:
1243:
1235:
1204:
1169:
1151:
1096:
1053:
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1010:
992:
945:
937:
902:
894:
848:
785:
777:
740:
712:
704:
673:
635:
606:
572:
371:
328:
257:
228:
158:
143:
89:
62:
52:
35:
1748:
1366:
1065:
797:
1832:
1791:
1775:
1726:
1679:
1630:
1620:
1578:
1562:
1521:
1505:
1464:
1448:
1393:
1336:
1196:
1159:
1088:
1037:
1000:
984:
929:
884:
769:
665:
337:
205:
200:
it should be removed. For those in whom the pregnancy is intrauterine and who have
1779:
1493:
1492:
Trinder, J; Brocklehurst, P; Porter, R; Read, M; Vyas, S; Smith, L (2006-05-17).
773:
361:
220:
178:
174:
151:
82:
78:
1509:
840:
811:
691:
Hendriks, Erin; MacNaughton, Honor; MacKenzie, Maricela
Castillo (2019-02-01).
410:
1609:"A Randomized Trial of Progesterone in Women with Bleeding in Early Pregnancy"
1551:"Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss"
1436:
1188:
473:
The management of early pregnancy bleeding depends on its severity and cause.
1866:
1844:
1787:
1691:
1644:
1574:
1517:
1460:
1452:
1405:
1350:
1301:
1239:
1208:
1155:
1049:
996:
941:
898:
781:
708:
626:
Deutchman, M; Tubay, AT; Turok, D (1 June 2009). "First trimester bleeding".
1381:
1223:
1041:
889:
872:
692:
1805:
1740:
1699:
1667:
1652:
1592:
1550:
1535:
1478:
1413:
1380:
Webster, Katie; Eadon, Hilary; Fishburn, Sarah; Kumar, Geeta (2019-11-13).
1358:
1309:
1247:
1173:
1057:
1014:
949:
906:
852:
789:
716:
677:
639:
576:
496:
427:
341:
312:
Obstetric causes of second/third trimester bleeding include the following:
1852:
1683:
1625:
1608:
1566:
1100:
477:
316:
224:
213:
197:
1200:
1138:
Derbala, Yasmine; Grochal, Frantisek; Jeanty, Philippe (January 2007).
186:
99:
40:
1397:
988:
1821:"Vaginal bleeding and adverse reproductive outcomes: a meta-analysis"
290:
1764:"Fetal Growth Patterns in Pregnancies With First-Trimester Bleeding"
242:
Obstetric causes of first trimester bleeding include the following:
196:
Treatment depends on the underlying cause. If tissue is seen at the
274:
135:
423:
278:
602:
Physiology in
Childbearing: With Anatomy and Related Biosciences
378:
Other causes of early pregnancy bleeding include the following:
395:
391:
365:
304:
286:
282:
1548:
1491:
324:
320:
1287:
1030:
919:
690:
368:
tears during childbirth or, less commonly, during pregnancy.
181:. Tests to determine the underlying cause usually include a
146:
may occur. Concern for shock is increased in those who have
1605:
1379:
348:. Vasa praevia occurs in about 0.6 per 1000 pregnancies.
30:
First trimester bleeding, hemorrhage in early pregnancy
1027:
693:"First Trimester Bleeding: Evaluation and Management"
1137:
1819:Ananth, Cande V.; Savitz, David A. (January 1994).
625:
1761:
563:Breeze, C (May 2016). "Early pregnancy bleeding".
157:Common causes of early pregnancy bleeding include
1636:20.500.11820/491f0b87-4acb-4869-a058-79104059ce8c
1189:"Genetic and Nongenetic Causes of Pregnancy Loss"
1864:
1187:Simpson, Joe Leigh; Carson, Sandra Ann (2013).
655:
1719:Acta Obstetricia et Gynecologica Scandinavica
1186:
1081:American Journal of Obstetrics and Gynecology
598:
1818:
962:
658:Emergency Medicine Clinics of North America
319:refers to the passage of a small amount of
873:"Vaginal bleeding in very early pregnancy"
839:Mouri, Michelle; Rupp, Timothy J. (2020),
732:
1795:
1730:
1634:
1624:
1582:
1525:
1468:
1340:
1163:
1004:
888:
838:
651:
649:
605:. Elsevier Health Sciences. p. 423.
558:
556:
554:
552:
550:
548:
546:
544:
542:
234:
1712:
1665:
870:
594:
592:
590:
588:
586:
540:
538:
536:
534:
532:
530:
528:
526:
524:
522:
219:About 30% of women have bleeding in the
212:is usually recommended in those who are
1322:
1078:
733:Beebe, Richard; Myers, Jeffrey (2010).
599:Stables, Dorothy; Rankin, Jean (2010).
1865:
1283:
1281:
1279:
1277:
1221:
1193:The Global Library of Women's Medicine
646:
619:
562:
452:suggestive of an incomplete abortion.
434:
1825:Paediatric and Perinatal Epidemiology
1434:
1275:
1273:
1271:
1269:
1267:
1265:
1263:
1261:
1259:
1257:
583:
519:
216:. Occasionally, surgery is required.
1323:Isoardi, Katherine (December 2009).
728:
726:
303:, which refers to pregnancy-related
301:Gestational trophoblastic neoplasia
231:occurs in under 2% of pregnancies.
13:
1837:10.1111/j.1365-3016.1994.tb00436.x
1254:
495:Ectopic pregnancy is treated with
417:
405:bleeding, which may result from a
142:. If the bleeding is significant,
14:
1889:
1713:Tikkanen, Minna (February 2011).
739:. Cengage Learning. p. 704.
723:
364:is when the muscular wall of the
289:. It occurs in about 3.1% of all
171:gestational trophoblastic disease
75:gestational trophoblastic disease
1732:10.1111/j.1600-0412.2010.01030.x
1666:Barnhart, Kurt T. (2009-07-23).
1342:10.1111/j.1742-6723.2009.01227.x
293:and is the most common cause of
1812:
1755:
1706:
1672:New England Journal of Medicine
1659:
1613:New England Journal of Medicine
1599:
1555:New England Journal of Medicine
1542:
1485:
1428:
1373:
1316:
1215:
1180:
1131:
1107:
1072:
1021:
956:
913:
864:
503:
113:Depends on the underlying cause
1329:Emergency Medicine Australasia
832:
804:
753:
684:
409:(UTI), strenuous exercise, or
1:
1093:10.1016/s0002-9378(96)80082-2
934:10.1016/s1470-2045(03)01245-2
871:Harville, E.W. (2003-09-01).
670:10.1016/S0733-8627(03)00041-5
512:
468:
281:, a membrane surrounding the
1780:10.1097/AOG.0000000000002616
1144:Journal of Prenatal Medicine
828:10.1097/AOG.0b013e3181b79796
774:10.1097/aog.0000000000002899
7:
1768:Obstetrics & Gynecology
1510:10.1136/bmj.38828.593125.55
1228:Australian Family Physician
1115:"Bleeding During Pregnancy"
816:Obstetrics & Gynecology
762:Obstetrics & Gynecology
565:Australian Family Physician
10:
1894:
1224:"Early pregnancy bleeding"
1222:Breeze, Carol (May 2016).
372:Nontubal ectopic pregnancy
208:is generally appropriate.
1290:American Family Physician
847:, StatPearls Publishing,
810:Hasan, R.; Baird, D. D.;
697:American Family Physician
628:American Family Physician
460:fetal heart tracing with
273:is the pooling of blood (
117:
109:
88:
58:
46:
34:
26:
21:
1453:10.1136/bmj.324.7342.873
1435:Luise, C. (2002-04-13).
346:bleeding before delivery
327:resulting from labor or
295:first trimester bleeding
132:first trimester bleeding
128:Early pregnancy bleeding
22:Early pregnancy bleeding
1042:10.1111/1471-0528.13829
407:urinary tract infection
482:anti-D immune globulin
450:products of conception
448:may also show visible
235:Differential diagnosis
210:Anti-D immune globulin
163:threatened miscarriage
67:threatened miscarriage
1684:10.1056/nejmcp0810384
1626:10.1056/NEJMoa1813730
1567:10.1056/nejmoa1715726
890:10.1093/humrep/deg379
841:"Threatened Abortion"
265:Implantation bleeding
167:implantation bleeding
148:loss of consciousness
71:implantation bleeding
922:The Lancet. Oncology
247:Early pregnancy loss
183:speculum examination
154:, or shoulder pain.
96:speculum examination
1668:"Ectopic Pregnancy"
1504:(7552): 1235–1240.
1201:10.3843/GLOWM.10319
981:2017NatSR...740320F
486:RhD isoimmunization
435:Diagnostic approach
403:genitourinary tract
383:Postcoital bleeding
352:Placental abruption
152:shortness of breath
138:before 14 weeks of
121:~30% of pregnancies
94:Typically includes
969:Scientific Reports
877:Human Reproduction
480:are usually given
462:Doppler sonography
356:weeks of pregnancy
271:Chorionic hematoma
202:fetal heart sounds
69:, pregnancy loss,
1619:(19): 1815–1824.
1561:(23): 2161–2170.
1447:(7342): 873–875.
1398:10.1136/bmj.l6283
989:10.1038/srep40320
329:cervical weakness
258:Ectopic pregnancy
229:Ectopic pregnancy
159:ectopic pregnancy
144:hemorrhagic shock
125:
124:
90:Diagnostic method
63:Ectopic pregnancy
53:Hemorrhagic shock
16:Medical condition
1885:
1857:
1856:
1816:
1810:
1809:
1799:
1774:(6): 1021–1030.
1759:
1753:
1752:
1734:
1710:
1704:
1703:
1663:
1657:
1656:
1638:
1628:
1603:
1597:
1596:
1586:
1546:
1540:
1539:
1529:
1489:
1483:
1482:
1472:
1432:
1426:
1425:
1377:
1371:
1370:
1344:
1320:
1314:
1313:
1285:
1252:
1251:
1219:
1213:
1212:
1184:
1178:
1177:
1167:
1135:
1129:
1128:
1126:
1125:
1111:
1105:
1104:
1076:
1070:
1069:
1036:(8): 1278–1287.
1025:
1019:
1018:
1008:
960:
954:
953:
917:
911:
910:
892:
883:(9): 1944–1947.
868:
862:
861:
860:
859:
836:
830:
808:
802:
801:
768:(5): e197–e207.
757:
751:
750:
730:
721:
720:
688:
682:
681:
653:
644:
643:
623:
617:
616:
596:
581:
580:
560:
338:Placenta praevia
323:or blood-tinged
206:watchful waiting
198:cervical opening
19:
18:
1893:
1892:
1888:
1887:
1886:
1884:
1883:
1882:
1873:Human pregnancy
1863:
1862:
1861:
1860:
1817:
1813:
1760:
1756:
1711:
1707:
1664:
1660:
1604:
1600:
1547:
1543:
1490:
1486:
1433:
1429:
1378:
1374:
1321:
1317:
1286:
1255:
1220:
1216:
1185:
1181:
1136:
1132:
1123:
1121:
1113:
1112:
1108:
1077:
1073:
1026:
1022:
961:
957:
928:(11): 670–678.
918:
914:
869:
865:
857:
855:
837:
833:
809:
805:
758:
754:
747:
731:
724:
689:
685:
654:
647:
624:
620:
613:
597:
584:
561:
520:
515:
506:
471:
437:
420:
418:Pathophysiology
362:Uterine rupture
237:
221:first trimester
179:cervical cancer
140:gestational age
83:cervical cancer
17:
12:
11:
5:
1891:
1881:
1880:
1875:
1859:
1858:
1811:
1754:
1725:(2): 140–149.
1705:
1678:(4): 379–387.
1658:
1598:
1541:
1484:
1427:
1372:
1335:(6): 440–448.
1315:
1296:(3): 166–174.
1253:
1234:(5): 283–286.
1214:
1179:
1130:
1106:
1087:(3): 766–769.
1071:
1020:
955:
912:
863:
831:
822:(4): 860–867.
812:Herring, A. H.
803:
752:
745:
722:
703:(3): 166–174.
683:
645:
634:(11): 985–94.
618:
612:978-0702044113
611:
582:
517:
516:
514:
511:
505:
502:
470:
467:
436:
433:
419:
416:
415:
414:
411:bladder cancer
399:
389:
386:
376:
375:
369:
359:
349:
335:
332:
310:
309:
298:
277:) between the
268:
262:
255:
251:
236:
233:
150:, chest pain,
123:
122:
119:
115:
114:
111:
107:
106:
92:
86:
85:
60:
56:
55:
50:
44:
43:
38:
32:
31:
28:
24:
23:
15:
9:
6:
4:
3:
2:
1890:
1879:
1876:
1874:
1871:
1870:
1868:
1854:
1850:
1846:
1842:
1838:
1834:
1830:
1826:
1822:
1815:
1807:
1803:
1798:
1793:
1789:
1785:
1781:
1777:
1773:
1769:
1765:
1758:
1750:
1746:
1742:
1738:
1733:
1728:
1724:
1720:
1716:
1709:
1701:
1697:
1693:
1689:
1685:
1681:
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1140:"Vasa previa"
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130:(also called
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48:Complications
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1831:(1): 62–78.
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1122:. Retrieved
1119:www.acog.org
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571:(5): 283–6.
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504:Epidemiology
497:methotrexate
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428:Vasa praevia
421:
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342:vasa praevia
311:
287:uterine wall
241:
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127:
126:
1878:Miscarriage
1150:(1): 2–13.
484:to prevent
478:Rh-negative
317:Bloody show
291:pregnancies
225:miscarriage
214:Rh-negative
27:Other names
1867:Categories
1124:2022-09-18
858:2020-03-15
845:StatPearls
513:References
469:Management
308:incidence.
285:, and the
261:untreated.
187:ultrasound
100:ultrasound
41:Obstetrics
1845:0269-5022
1788:0029-7844
1692:0028-4793
1645:0028-4793
1575:0028-4793
1518:0959-8138
1461:0959-8138
1422:208019482
1406:0959-8138
1392:: l6283.
1351:1742-6723
1302:1532-0650
1240:0300-8495
1209:1756-2228
1156:1971-3282
1050:1471-0528
997:2045-2322
975:: 40320.
942:1470-2045
899:1460-2350
782:0029-7844
709:1532-0650
118:Frequency
110:Treatment
36:Specialty
1806:29742672
1749:10871832
1741:21241259
1700:19625718
1653:31067371
1593:29874535
1536:16707509
1479:11950733
1414:31722871
1367:42681031
1359:20002713
1310:30702252
1248:27166462
1174:22470817
1066:43666201
1058:26694639
1015:28067303
950:14602247
907:12923154
853:28613498
798:13149908
790:30157093
717:30702252
678:12962352
640:19514696
577:27166462
396:cervical
275:hematoma
254:outcome.
136:bleeding
1853:8153019
1797:6223322
1584:6437668
1527:1471967
1165:3309346
1101:8828559
1006:5220286
977:Bibcode
424:decidua
392:Vaginal
279:chorion
250:stable.
1851:
1843:
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401:Lower
366:uterus
305:tumors
283:embryo
189:, and
177:, and
175:polyps
79:polyps
59:Causes
1745:S2CID
1418:S2CID
1363:S2CID
1062:S2CID
794:S2CID
325:mucus
321:blood
1849:PMID
1841:ISSN
1802:PMID
1784:ISSN
1737:PMID
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993:ISSN
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938:ISSN
903:PMID
895:ISSN
849:PMID
786:PMID
778:ISSN
741:ISBN
713:PMID
705:ISSN
674:PMID
636:PMID
607:ISBN
573:PMID
1833:doi
1792:PMC
1776:doi
1772:131
1727:doi
1680:doi
1676:361
1631:hdl
1621:doi
1617:380
1579:PMC
1563:doi
1559:378
1522:PMC
1506:doi
1502:332
1498:BMJ
1465:PMC
1449:doi
1445:324
1441:BMJ
1394:doi
1390:367
1386:BMJ
1337:doi
1197:doi
1160:PMC
1089:doi
1085:175
1038:doi
1034:123
1001:PMC
985:doi
930:doi
885:doi
824:doi
820:114
770:doi
766:132
666:doi
394:or
340:or
191:hCG
104:hCG
65:,
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