Dear doc. I had normal bleeding and cramping at 8...

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Treatment of vaginal bleeding

based on what you mentioned at your question, there is vaginal bleeding with abdominal cramping and the US does not show uterine sac thus It is necessary to exclude ectopic pregnancy and diagnosis of ectopic pregnancy is by the following

• At 5 gestation age , vaginal US does not reveal pregnancy sac and the Bhcg above 1500 or 
• At 6 gestational age, the abdominal US does not reveal pregnancy sac and the Beta hcg above 6500 thus it is better to do beta hcg hormone and repeat it after 48 - 72 hours .
• Based on your scenario, it is a case of ectopic pregnancy till proven otherwise and treatment is according to patient status with methotraxate drug or surgery.

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