Ante and postpartum haemorrhage

Question 1

Definition of antepartum haemorrhage?

Answer 1

Bleeding > 24 weeks

Question 2

Routine follow-up for patients with placenta praevia on routine 18-20 week scan?

Answer 2

Follow-up examination at 32 weeks

Question 3

How does placenta praevia present?

Answer 3

Painless bleeding

Question 4

Management of placenta praevia?

Answer 4

C-section if major placenta praevia; may be able to attempt vaginal delivery with minor placenta praevia

Question 5

Constant lower abdominal pain + PV bleeding + “woody” uterus

Answer 5

Placental abruption

Question 6

Commonest cause of uterine rupture in labour/third trimester?

Answer 6

Dehiscence of C-section scars

Question 7

Four main causes of primary post-partum haemorrhage?

Answer 7

Four Ts- tone (uterine atony), tissue (retained products), trauma, thrombin (clotting disorders)

Question 8

Management of primary PPH?

Answer 8

Ergometrine 0.5mg IV

Question 9

Management of secondary PPH?

Answer 9

Admit to obstetrics if shocked

May be able to manage conservatively with Abx