Consider any woman of childbearing age with vaginal bleeding pregnant until proven otherwise. Initiate fluid resuscitation early in cases of orthostatic hypotension. Pelvic examination should focus on determining the source of bleeding. Chromosomal abnormalities are the most common cause of spontaneous abortion. The rate of chromosomal abnormalities increases with age, with a steep increase in women older than 35 years.
Maternal factors account for the majority of second-trimester abortions.
These factors can be divided into 4 categories. This test is qualitative and, if results are positive, quantitative. Blood type Blood type must be documented for every pregnant patient with vaginal bleeding. If Rh-negative, administer RhoGAM to prevent hemolytic disease of the newborn in this pregnancy and subsequent pregnancies. Ultrasound is used widely and is the imaging study of choice.