First trimester bleeding. Occurs in 20 to 40% of pregnancies Differential diagnosis:Ectopic pregnancyThreatened or inevitable miscarriageMolar pregnancyPregnancy implantationUterine, cervical or vaginal lesions . Evaluation of first trimester bleeding. Confirmation of the pregnancy urine pregnancy testEstablishment of the estimated gestational agePhysical examVital signs (hypotension, tachycardia)Abdominal exam Signs of peritonitis measurement of the fundus if palpable abdominall23
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