What is the differential diagnosis for intrauterine bleeding (IUB)?

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Last updated: February 11, 2025View editorial policy

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Differential Diagnosis for Intrauterine Bleed

Single Most Likely Diagnosis

  • Placenta Previa: This condition, where the placenta partially or completely covers the internal cervical os, is a common cause of intrauterine bleeding, especially in the second and third trimesters. It is often associated with painless vaginal bleeding.

Other Likely Diagnoses

  • Placental Abruption: Also known as placental abruption, this condition involves the premature separation of the placenta from the uterus. It can cause intrauterine bleeding and is often associated with painful vaginal bleeding.
  • Uterine Rupture: Although less common, uterine rupture can cause significant intrauterine bleeding, especially in women with a history of uterine surgery or previous uterine rupture.
  • Molar Pregnancy: A molar pregnancy, also known as hydatidiform mole, can cause intrauterine bleeding due to the abnormal growth of trophoblast cells.

Do Not Miss Diagnoses

  • Uterine Artery Aneurysm or Pseudoaneurysm: These vascular abnormalities can cause significant intrauterine bleeding and are often associated with a history of uterine surgery, trauma, or previous uterine artery embolization.
  • Uterine Cancer: Although rare, uterine cancer can cause intrauterine bleeding, especially in postmenopausal women.
  • Intrauterine Fetal Demise: Intrauterine fetal demise can cause intrauterine bleeding, especially if the fetus has been dead for an extended period.

Rare Diagnoses

  • Vasa Previa: This rare condition involves the fetal blood vessels crossing over or near the internal cervical os, which can cause significant intrauterine bleeding if ruptured.
  • Choriocarcinoma: A rare type of gestational trophoblastic disease, choriocarcinoma can cause intrauterine bleeding due to the abnormal growth of trophoblast cells.
  • Uterine Arteriovenous Malformation: This rare vascular anomaly can cause significant intrauterine bleeding due to the abnormal connection between uterine arteries and veins.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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