Bleeding in pregnancy
Recognise a potentially unstable patient and arrange prompt obstetric or gynaecological help.
Clinical learning outcomes: Awaiting named clinical review.
What you should learn
- Assess pain, bleeding and physiological stability without delaying escalation.
- Consider ectopic pregnancy and explain why pregnancy stage changes the pathway.
Recognise and explain
- Early-pregnancy guidance does not cover every cause of later-pregnancy bleeding.
On your placement
Agree the activity and supervision with the clinical team. For patient-facing learning, seek permission and respect the patient’s comfort and care needs.
- Take a sensitive history, including gestation and associated symptoms.
- Review observations and discuss immediate investigations with a clinician.
- Observe how consent, privacy and chaperoning are arranged for any necessary examination.
Observe and understand
- Observe senior resuscitation and specialist examination or treatment; do not undertake cervical procedures independently.
Observation does not establish competence to perform these activities.
The reading and case below concern early pregnancy. Later-pregnancy bleeding needs the local obstetric emergency pathway.
Start here
MLA: pregnancy history
Ask about the pregnancy, symptoms and the patient’s concerns.
MLA: explaining a diagnosis and uncertainty
Practise acknowledging uncertainty and explaining the next step sensitively.
Current guidance
NICE NG126: ectopic pregnancy and miscarriage
Focus on symptoms, initial assessment and referral in early pregnancy; use the obstetric pathway for later-pregnancy bleeding.
GMC decision making and consent
Use the sections on sharing information, consent and capacity to discuss a patient encounter with your supervisor.
Discuss
Pain and bleeding in early pregnancy
Separate urgent ectopic-pregnancy concern from stable bleeding, while explaining uncertainty and organising dependable follow-up.
On your next shift
Ask how the team chose between the early-pregnancy and obstetric emergency pathways.
How this relates to GMC graduate outcomes and the MLA
These are St Emlyn’s learning connections, not a claim that this page covers every national requirement.
Presentations and conditions: Abnormal vaginal bleeding; Bleeding antepartum.
Clinical and professional capabilities: Assessment and clinical reasoning; Recognising limits and seeking help.
St Emlyn’s interpretation of relevant GMC graduate outcomes and MLA themes; these are summary labels, not official topic codes or a complete curriculum.
Explore the student placement programme
Student practice and graduate expectations
About this resource and its review
A St Emlyn’s guide to learning Emergency Medicine during undergraduate placements. It is not an official medical-school or GMC curriculum. Your medical school’s curriculum and assessment requirements take precedence.
National foundations: GMC Outcomes for Graduates, the practical-skills supplement and the MLA content map applying from September 2026.
Framework checked: 8 October 2026. This is a source check, not clinical sign-off.
Clinical learning outcomes: awaiting named clinical review.
The four learning routes are St Emlyn’s groupings. The six interconnected MLA domains remain part of the official content map.