Single most likely diagnosis
- Trauma to the vulva or vagina: This is the most likely diagnosis given the history of a fall, which could have caused direct injury to the external or internal genitalia, leading to bleeding.
Other Likely diagnoses
- Uterine rupture (in pregnant women): A fall could potentially cause enough trauma to rupture the uterus, especially if the woman is pregnant, leading to vaginal bleeding.
- Placental abruption (in pregnant women): Trauma from a fall could also cause the placenta to separate from the uterus, leading to bleeding.
- Cervical or vaginal laceration: The fall could result in a laceration of the cervix or vagina, which would cause bleeding.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ectopic pregnancy: Although less common, an ectopic pregnancy could rupture due to the trauma from the fall, leading to severe internal bleeding.
- Uterine perforation: This could occur if an intrauterine device (IUD) is dislodged or if there is a pre-existing uterine anomaly, and the fall causes a perforation, leading to bleeding.
Rare diagnoses
- Coagulopathy: A rare possibility is that the fall triggered or exacerbated an underlying coagulation disorder, leading to vaginal bleeding.
- Tumor or vascular malformation: Although rare, a pre-existing tumor or vascular malformation in the genital tract could bleed due to the trauma from the fall.