The fourth week of pregnancy, abdominal pain and bleeding may be caused by the first sign of miscarriage, ectopic pregnancy, grapes and other factors, need to rest in a timely manner, birth control, or surgery. 1.aura miscarriage: four weeks pregnant with a vague pain in the abdomen and bleeding is considered to be aura miscarriage, early pregnancy is prone to appear, usually first rest, observe whether the symptoms are relieved. If the rest can not be relieved, you need to inject progesterone and other drugs to protect the fetus, the use of drugs need to be guided by a doctor. 2. Ectopic pregnancy: four weeks of pregnancy, abdominal pain and bleeding may be ectopic pregnancy, ectopic pregnancy can not continue pregnancy, the need for timely termination of pregnancy through surgery. 3. Grape fetus: four weeks of pregnancy, abdominal pain and bleeding may be a grape fetus, grape fetus also need to terminate the pregnancy, to remove the intrauterine tissue in a timely manner, and then to do the operation of the uterus. The first thing you need to do is to go to a regular hospital for a detailed examination and targeted treatment.