Evaluation of vaginal bleeding

Last reviewed: 4 Apr 2025
Last updated: 21 Nov 2024

Summary

Differentials

Common

  • Cervical cancer
  • Miscarriage
  • Cervical polyp
  • Ectropion
  • Iatrogenic
Full details

Uncommon

  • Endometrial cancer
  • Ovarian cancer
  • Vaginal cancer
  • Ectopic pregnancy
  • Placental abruption
  • Placenta previa
  • Cervicitis
  • Vaginitis
  • Sexual abuse in children
  • Neonatal uterine bleeding
  • Precocious puberty
  • Genital trauma
  • Vaginal foreign body
  • Condylomata acuminata
Full details

Contributors

Authors

Steven R. Goldstein, MD, MSCP, CCD, FACOG, FRCOG(H)

Professor

Obstetrics and Gynecology

New York University Grossman School of Medicine

New York

NY

Disclosures

SRG has been paid by Pfizer for consulting, Bayer for membership on a Data and Safety Monitoring Board, and Mylan for case adjudication. He has received royalties from Cook Medical Obstetrics and Gynecology. He was previously paid by Scynexis for participation on an advisory board.

Acknowledgements

Dr Goldstein wishes to gratefully acknowledge Dr Intisar Elnahhas and Dr Mohamed Mitwally, previous contributors to this topic.

Peer reviewers

Sarah Baxley, MD, PhD

Assistant Professor

University of Florida College of Medicine

Gainesville

FL

Disclosures

SB declares that she has no competing interests.

Sana Salih, MD

Assistant Professor

Department of Obstetrics and Gynecology

University of Wisconsin

Madison

WI

Disclosures

SS declares that she has no competing interests.

Austin Ugwumadu, PhD, FRCOG

Consultant/Senior Lecturer in Obstetrics and Gynaecology

St George's Hospital

London

UK

Disclosures

AU declares that he has no competing interests.

M. Jonathon Solnik, MD, FACOG, FACS

Associate Professor of Obstetrics & Gynaecology

Head of Gynaecology & Minimally Invasive Surgery

Faculty of Medicine at the University of Toronto

Mt. Sinai Hospital

Toronto

Canada

Disclosures

JS consults for Medtronic, Hologic, and Olympus. He is on the advisory board for Abbvie.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Full text  Abstract

National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. Aug 2023 [internet publication].Full text

American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 193: tubal ectopic pregnancy. Mar 2018 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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