9 - Obs - APH - Background + Less common causes of APH

Question 1

APH =?

Answer 1

bleeding from genital tract after 24 weeks

Question 2

Causes of APH - Common ? (3)

Answer 2

undetermined origin
placental abruption
placenta praevia

Question 3

Causes of APH - rarer (4)

Answer 3

incidental genital tract pathology (gynae bleeding)
uterine rupture
vasa praevia
placenta praevia

Question 4

Bleeding of undetermined origin.

When APH is ? and ? but placenta not ?, can be hard to find cause. ??? of little diagnostic use, many episodes likely to be minor ?– no such thing as a ‘heavy show’. manage as such.

Answer 4

small 
painless
praevia
USS
abruptions

Question 5

Ruptured Vasa Praevia

Occurs when fetal ? ? runs in membranes in front of ? part. Rare, but occur when ? ? attached to membranes rather than ? (velamentous insertion). Can rarely be detected on ???. When membranes rupture ? may rupture too w ? fetal bleed. 1/5000 pregs. ?, moderate pv bleed at amniotomy or ?
rupture of membranes, accompanied by severe fetal ?. C section often ? ? ? to save fetus.

Answer 5

blood vessel
presenting
umbilical cord
placenta
USS
vessel
massive
painless
spontaneous
distress
not fast enough

Question 6

Uterine Rupture

V occasionally occurs ? labour in women w ? or ?
abnormal uterus.

Answer 6

before
scarred
congen

Question 7

Bleeding of Gynae origin

? Ca can present in preg. If ?
overdue, woman with small recurrent or ??? should have ?. Cervical ?, ? and vaginal ?
may also be seen but bleeding not usually due to those.

Answer 7

cervical
smear
PCB
colposcopy
polyps
ectropions
lacerations