A pregnant woman presents with intermittent rectal bleeding. What could be the cause, what are the appropriate investigations and when should these investigations be carried out?
Angela, a 28-year-old woman who is 14 weeks pregnant, presents to her GP with a two-month history of intermittent rectal bleeding. Over this period she has been passing bright blood on to her toilet paper, and at times into the toilet bowl. In addition, her stools are looser than in the past and she reports occasional urgency. There has been no abdominal pain or weight loss. Her general health is good and she is not taking any regular medications. There is no relevant family history.
Does Angela require investigation at this stage or can this be deferred until after her baby is born?