antepartum haemorrhage

Question 1

define APH

Answer 1

Bleeding from the genital tracks at >24 weeks gestation

Minor haemorrhage: <50mls of blood loss
Major haemorrhage: 50-1000 mls of blood loss
Massive haemorrhage: >1000mls of blood loss, or signs of shock

Question 2

what laboratory investigations should be done for those with APH

Answer 2

Full blood count, urea and electrolytes and LFTs: helps to exclude hypertensive conditions such as HELLP or pre-eclampsia
Clotting profile
Kleihauer test
Group and save, and crossmatch

Question 3

what should be given to all those with APH within 72 hours

Answer 3

Rhesus-D negative women require anti-D prophylaxis in all cases of APH
dose determined by Kleihauer test

Question 3

what are the 3 most important causes of APH to consider

Answer 3

placenta praevia
vasa praevia
placental abruption