First Trimester Bleeding Triage

For Educational Purpose Only

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4 weeks13 weeks
8 weeks
Heart Rate
bpm
Systolic BP
mmHg
Spotting
< 1 pad/day
Light
1–2 pads/day
Moderate
3–4 pads/day
Heavy
Soaking pads
Old/Brown
Dried blood
Pink/Watery
Fresh, dilute
Bright Red
Active bleed
Clots / Tissue
Products passed
None
Mild Cramping
Like menstrual
Severe Cramping
Worsening
Shoulder Tip Pain
Diaphragm irritation
IVF / ART Conception
+4 pts · ectopic risk
Previous Ectopic Pregnancy
+4 pts · red flag
Tubal Surgery / PID
+3 pts · ectopic risk
IUD in Situ
+3 pts · ectopic risk
Previous Miscarriage
+2 pts
Recurrent Pregnancy Loss
+3 pts · ≥2 prior losses
Known Subchorionic Hematoma
+2 pts
Coagulopathy / Anticoagulants
+2 pts
Syncope / Near-Syncope
+6 pts · hemodynamic
Peritoneal Signs
+7 pts · guarding/rigidity
Severe Dizziness
+3 pts
Fever > 38°C
+3 pts · septic risk
Decreased Fetal Movement
+2 pts
Dilated Cervical Os
+5 pts · on exam
Urgency Score
0
/ 50
Differential Diagnosis
Recommended Workup
Clinical Recommendations