Per vaginal bleeding in the exam

It is important to have a systematic way of approaching a case with per vaginal bleeding in the exam. 

Premenopausal

• embedded IUD
• lost IUD
• submucosal fibroid

Pregnancy related

• perigestational hemorrhage
• intrauterine fetal demise
• ectopic pregnancy
  • ruptured ectopic
  • cervical ectopic 
  • interstitial ectopic
  • casarian scar ectopic
• anembryonic pregnancy
• gestational trophoblastic disease
• placenta previa
• placental abruption
• retained products of conception (RPOC)

Postmenopausal

• endometrial polyp
• endometrial hyperplasia
• endometrial carcinoma