Vaginal bleeding in a pregnant 32-year-old woman

Physical Examination

  • General appearance: Appears well and in no distress.

  • Vital signs:
  • Temperature: 37° C
  • Pulse: 88 beats/min
  • BP: 118/64 mm Hg
  • Respirations: 20/min

  • Skin: No petechiae, ecchymoses, or other lesions.

  • HEENT: No scleral icterus or signs of bleeding.

  • Pulmonary: Lungs clear

  • Cardiovascular: Mild tachycardia; regular rhythm, no murmurs, rubs, or gallops.

  • Gastrointestinal: Gravid abdomen, fundal height normal for dates. Uterus normal tone, nontender.

  • Genitourinary: Scant dried brown blood at the introitus. On speculum exam, a few milliliters of dark red blood are present in the vaginal vault. The cervix appears approximately 1-cm dilated, no active bleeding. Bimanual examination not done.