EARLY PREGNANCY

BLEEDING
Mrs Rama, 23 yr old home maker, wife of Mr Kumar residing
in Mylapore belonging to socioeconomic class III with
education till 10th standard and obstetric code G1P0 with
history of 10 weeks of amenorrhea

Chief complaint
Patient came to the hospital with complaints of bleeding per
vagina since last day.

History of presenting illness

Mrs Rama came with bleeding per vagina which was
moderate in quantity, red in colour associated with mild lower
abdominal pain.
No H/O clots
No H/O burning micturation
No H/O fever/chills
No H/O trauma

Obstetric history
The patient is booked and immunized at nearby PHC.
LMP- 04/03/2021
EDD- 11/12/2021
Spontaneous conception
Pregnancy confirmed by UPT at 5 weeks of gestation.
No H/O fever with rash, No H/O drug intake,
No H/O radiation exposure
Folic acid tablet taken
Dating scan done at 8 weeks

Menstrual history
Age at menarche- 12 years
4/28 cycles, regular cycle
3-4 pads changed per day
No H/O passing clots
Marietal history
Age at marriage - 22 yrs
Non consanguineous marriage
Conceived 1 yr after marriage
No H/ O OCP intake

Past history
Not a known case of diabetic, hypertension,
asthma, epilepsy, heart disease, TB
No H/O blood transfusion
No H/O previous surgery
No H/O drug or food allergy
Personal history
Consumes mixed diet
Normal bowel and bladder habits
Normal sleep pattern
Not an alcoholic/ smoker

Family history
No H/O genetic disorders in family
General examination
Patient is conscious, oriented, moderately
build and nourished.
No pallor
No icterus
No clubbing
No cyanosis
No pedal edema
No generalized lymphadenopathy

Anthropometry
Height- 157cm
Weight- 60kg. BMI- 24.3
Vitals
Temperature- Afebrile
Respiratory rate- 14 breaths/min
Pulse-80 beats /min
Blood pressure recorded in the left upper arm in
sitting position- 110/70mm Hg

Systemic examination
Respiratory system
Normal vesicular breath sounds heard
No added sounds.
CVS
S1,S2 heard. No murmurs

CNS
No focal neurological deficit

Breast and thyroid examination

Normal
Per vaginal examination
On speculum examination mild bleeding is noticed

Summary
23 yr old Mrs Rama of socioeconomic class III with
obstetric code G1P0 and history of 10 weeks of
amennorhea with LMP- 04/03/21 and EDD- 11/12/21
came with history of bleeding per vagina and mild lower
abdominal pain possibly a case of threatened abortion.
Investigations
CBC
Hemoglobin
Blood grouping and typing
Blood sugar
Urine- albumin and sugar
Urea and creatinine
LFT
RFT
USG
Management
Reassurance
Bed rest
Repeat USG after a week