Clinical Assessment and Risk Stratification

When assessing a patient with vaginal bleeding, there are 2 essential questions to be asked immediately which will drastically alter your assessment and management:4

  1. Is she haemodynamically stable?
  2. Is she pregnant?

If she is stable and non-pregnant proceed with routine history and examination. Vaginal bleeding in non-pregnant women is rarely life-threatening,13 but if the patient is unstable, proceed with resuscitation in parallel to assessment. If she is pregnant, your assessment and management change depending on gestation and presentation but this is beyond the scope of this session.

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