Vaginal bleeding in a pregnant 32-year-old woman

Review of Systems

  • General: She reports appropriate weight gain this pregnancy. She has felt fatigued for the past few weeks but has been able to do her normal duties at work. No recent injuries or falls.

  • Skin: No rash or easy bruising or bleeding.

  • HEENT: No bleeding from nose or gums.

  • Pulmonary: No shortness of breath.

  • Cardiovascular: No palpitations; no chest pain.

  • Gastrointestinal: No nausea, vomiting, abdominal pain, or cramping.

  • Genitourinary: No dysuria, urgency or frequency.

  • Musculoskeletal: No swelling or pain in extremities or joints.

  • Neurologic: Noncontributory

  • Obstetric: G3P1011 No other episodes of vaginal bleeding during this pregnancy. Had routine ultrasonography at 20 weeks which she was told was normal. She is unsure of her Rh status.

  • Psychiatric: Noncontributory