Antepartum haemorrhage Flashcards
What is antepartum haemorrhage?
Bleeding during pregnancy after 24 weeks from genital tract
What are causes of antepartum haemorrhage?
Placental abruption
Placenta praevia
Vasa praevia
Cancer
Trauma
What are risk factors for placental abruption?
Previous abruption
Pre-eclampsia
Fetal growth restriction
Advanced age (>40yrs)
Smoking
Cocaine and amphetamines
What is delivery for minor placenta praevia?
vaginal birth if >2cms from os
What is deliver for major placenta praevia?
caesarean due to high risk of bleeding
What are praevia risk factors?
Uterine Abnormalities
Multiparity
Multiples (twins, triplets, etc.)
Uterine Scarring (previous CS or other surgery)
In vitro fertilization
What is vasa praevia?
Fetal vessels run unsupported in membranes, near cervix
May tear/rupture with cervical dilatation
Risk of fetal bleeding and anaemia
What is major bleeding volume?
> 200mls
What are the degrees of haemorrhage? What is the management for each?
SPOTTING – usually managed conservatively at home after assessment
MINOR (<100mls)
Assess and likely home if well
MAJOR
CM blood
What are maternal complications of APH?
- Anaemia
- Shock
- Renal failure
- DIC
- Postpartum haemorrhage
- Blood transfusion
- More surgery
- Hysterectomy
- Psychological effects
What are fetal complications of APH?
- Prematurity (iatrogenic and pathological)
- Fetal compromise
- Fetal anaemia
- Fetal death
- Fetal growth restriction
