EARLY PREGNANCY BLEEDING

A   40-year-old woman   (G3 P1  Ab1)    at  9   weeks’  gestation   comes   to  the

office  complaining of  vaginal bleeding.   A   urine   pregnancy   test    was positive

3   weeks   ago.    She initially   experienced breast  tenderness, though  it  has now

disappeared.    She denies  passage of  any tissue  vaginally.