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Causes of gynecologic bleeding include trauma from penetrating injury or sexual assault, a ruptured ectopic pregnancy, internal injuries from a blow to the abdomen, particularly during pregnancy, placental abruption , and uterine cancer.
Bleeding in quantities greater than six ounces (half a can of soda) from the groin that does not slow or stop will generally require some diagnostic explanation. In many cultures the patient may attempt to hide her injuries out of embarrassment or fear.
In the urban setting, call for help immediately. Apply direct pressure to the outside of the vaginal cavity. Do not attempt to pack the vaginal cavity with cotton or any other item or object.
If this is the result of giving birth; the infant, if alive, should be given to suck. This should cause the flow of blood to stop.
In wilderness first aid, immediate evacuation is indicated.
Transport immediately to hospital care. Follow local protocols.
Treatment depends on diagnosis and may include coagulants, muscle agents, blood transfusion and immediate abdominal surgery.
See also: Medical emergency