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Abnormal vaginal bleeding
- Ectopic pregnancy
- Hormonal abnormalities (including idiopathic menorrhagia)
- Gynaecological cancer
Clinical and Associated Features
- Miscarriage - often asymptomatic but bleeding, lower abdominal pain plus absence of symptoms of pregnancy are suggestive
- Ectopic pregnancy - bleeding, lower abdominal pain, dysuria, pain on bowel movement
- Idiopathic menorrhagia - common and a diagnosis of exclusion
- Cancer - post-coital bleeding, intermenstrual bleeding (between periods), dyspareunia, sometimes lower abdominal pain
- placental abruption - contractions, abdominal pain and tenderness, occasionally bleeding
- placenta praevia - usually found incidentally on routine USS or with profuse, sudden bleeding after 28 weeks.