Related Subjects:
|Antepartum haemorrhage
|Postpartum haemorrhage
|Acute Haemorrhage
The most important causes of APH are placenta praevia and placental abruption, although these are not the most common. See link to RCOG guidance below.
About
Incidence
Causes of uterine bleeding in pregnancy
Placenta praevia Seen in 1 in 200 pregnancies and causes painless vaginal bleeding which contrasts with Placental abruption which causes vaginal bleeding and Pain. Placenta praevia can be graded into major and minor depending on whether the placenta overlies the internal os.
Placental abruption The most predictive historical fact is abruption in a previous pregnancy. Always ask about headache, blurred vision and abdominal pain and consider preeclampsia. Placental abruption is due to detachment of the placenta from the uterus with maternal blood loss. The blood may remain localised "concealed" or pass via the os and becomes a "revealed" haemorrhage
Vasa Praevia Rare seen in 1 in 2500. Fetal blood vessels cross over the membranes in advance of the presenting part. Can lead to fetal loss from exsanguination at the time of membrane rupture. May be PV bleeding. May be detectable with doppler USS. Needs prompt CS.
Other A Circumvallate placenta and Other non uterine - cervicitis, cervical polyp, cervical carcinoma
Unknown In 50% of cases no cause is found however there is still an increased risk of perinatal mortality
Clinical
Assessing severity
Investigations
Management
Delivery
Complications for Mother
Complications for Fetus
References
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Antepartum haemorrhage
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