Bleeding in early pregnancy

Early pregnancy bleeding is a common phenomenon, occurring in up to one-quarter of clinically diagnosed pregnancies, encompassing in the main the different types of miscarriage and early pregnancy failure, along with ectopic pregnancies and gestational trophoblastic disease. The management of early pregnancy bleeding has been revolutionized over the past 4–5 years, from inpatient care and out-of-hours surgical treatment, to outpatient care, next-day elective surgical treatment or medical treatment. This change has principally been brought about through the use of daily early pregnancy assessment clinics, in combination with the more widespread availability and use of quantitative serum bHCG measurements and transvaginal ultrasound scanning.