Bleeding in early and late pregnancy
Vaginal bleeding during pregnancy is always a cause for concern, for both the woman and her doctor. As the pregnancy advances, the clinical significance of the bleeding increases. It may, in addition to threatening the pregnancy, eventually also cause maternal morbidity and even mortality. The woman should be reassured about the well-being of the fetus or fully informed as to the possible complications. As soon as the fetus is viable or nearly viable, it is very important to pinpoint the optimal time of delivery. Valuable gestational age will be lost by doing an unnecessarily early delivery; on the other hand, a severe haemorrhage may cause fetal death if distress is not detected in time. All related factors have to be evaluated carefully, in order to make the best possible decision about the management of the pregnancy.