Emergency department patient with chief complaint of vaginal bleeding

GA: gauge; IV: intravenous; HCG: human chronic gonadotropin; OB: obstetrics; GYN: gynecology; US: ultrasound; IUP: intrauterine pregnancy; PUL: pregnancy of unknown location.

* Iron supplementation may be indicated for some anemic patients. Patients requiring a transfusion require an expeditious workup to determine the cause, and close follow-up. Refer to specific UpToDate topics covering causes of vaginal bleeding.

¶ For a complete discussion of the evaluation and diagnostic approach to vaginal bleeding in the premenarchal patient, refer to UpToDate topics and graphics on the evaluation of vulvovaginal bleeding in children and adolescents.