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Early bleeding under 6 weeks — DRCOG MCQ

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ModerateEarly PregnancyEarly bleeding under 6 weeksDRCOG

A 24-year-old woman has bleeding at 5+3 weeks by dates. She has no pain, no ectopic risk factors and is haemodynamically well. Pregnancy test is positive and examination is unremarkable. What would you advise?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Repeat a urine pregnancy test in 7 to 10 days and return if pain develops

NICE supports expectant management for women less than 6 weeks pregnant with bleeding but no pain or ectopic risk factors, with clear safety-netting and repeat pregnancy testing. Pain, ongoing bleeding or a positive repeat test should prompt reassessment. Ectopic pregnancy is uncommon in this scenario but not impossible, so safety-netting is essential. Methotrexate and surgery are not indicated from this low-risk presentation.

Reference: NICE NG126