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Antepartum Haemorrhage - Symptom, Causes, Treatment of Antepartum Haemorrhage

Antepartum haemorrhage is the bleeding from the vagina during the second half of pregnancy, earlier labour commences, or it can also be specify as the bleeding from the vagina afterwards 24 weeks gestation up until labour. Earlier 24 weeks, bleeding annunciate threatened or inevitable abortion ascribable pre-mature separation of the placenta from the wall of the uterus.

APH appears in 2% of pregnancies and is an essential reason of foetal and maternal death - 30% of maternal deaths are antecedent by APH, of which 50% are linked with avoidable factors. If the placenta is introduced in the normal position in the superior part of the uterus, bleeding caused by premature separation is called accidental haemorrhage that can happen from pregnancy induced hypertention (high blood pressure) or appear for no apparent reason. If bleeding is moderate there is no danger to the mother, but even a little amount can decrease the supply of oxygen and nutrients to the foetus.

Diagnosis of Antepartum Haemorrhage

  • Bloody show (benign) - most frequent cause of APH
  • Placental abruption - most general pathological cause
  • Placenta previa - second most usual pathological cause
  • Vasa previa - often elusive to analyze, often produce to fetal demise
  • Uterine rupture
  • Bleeding from the lower genital tract
    -- Cervical bleeding - cervicitis, cervical neoplasm, cervical polyp
    -- Bleeding from the vagina itself - trauma, neoplasm
  • Bleeding which may be perplexed with vaginal bleeding
    -- GI bleed - hemorrhoids, inflammatory bowel disease
    -- Urinary tract bleed - urinary tract infection

Types of antepartum haemorrhage

An antepartum haemorrhage may precipitate into one of three main categories:

Placenta praevia is a condition in which the placenta, alternatively of being linked to the upper part of the uterus, is touched to the lower part in the region of the lesser uterine segment or the cervix. Accidental haemorrhage is frequently related with pain low in the abdomen.

Accidental antepartum haemorrhage (abruptio placentae) is a comparatively infrequent condition in which the placenta is commonly implanted in the upper part of the uterus but separate from it prematurely and generally results in vaginal bleeding.

Incidental antepartum haetnorrhage is haemorrhage which appears from the venereal tract but not from the site of the placenta or its implantation. Such haemorrhage may produce from injury, infection, ulcers on the neck of the womb, polyps or, most normally, the onset of labour.

Pregnancy and Antepartum Haemorrhage

If you have any bleeding during pregnancy, communicate your doctor or go to hospital instantly. An ultrasound checkup will show whether the bleeding is unintended or referable to placenta praevia. Bleeding which appears during the ultimate 2 months of pregnancy is particularly expressive and the woman is nearly always admitted to hospital until a diagnosis of placenta praevia has been proved, or disproved by ultra-sonic scan. If an accidental haemorrhage is little and stops soon, you will normally be capable to go home, allowed your blood pressure is average and there is no continuing risk to the foetus. If placenta praevia is establish you may be considered to stay in hospital, as the bleeding is likely to recur and may be intense enough for you to necessity a blood transfusion. The aim is to defend the pregnancy until around 37 weeks.


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