Antepartum Haemorrhage

Question 1

What is the definition on antepartum haemorrhage?

Answer 1

Bleeding from the genitals after 24 weeks?

Question 2

What are 3 three main causes of antepartum bleeding?

Answer 2

Placenta Praevia
Placental Abruption
Local Causes

Question 3

What are the 3 most common presenting features of placenta praevia?

Answer 3

Painless antepartum bleeding
Abnormal fetal lie
Non-engagement of the fetal presenting part

Question 4

How is placenta praevia diagnosed?

Answer 4

Using ultrasound scan and can either be major or minor depending on whether the os is covered

Question 5

What is the management for placenta praevia?

Answer 5

First examine. No foetal Heart then resuscitation

If metal heart rate then check FBC, cross match, clotting screen and US

If bleeding continues then c-section

If bleeding stops and it is >37 weeks then induced vaginal if minor or elective c-section if major

Question 6

What are the conditions associated with placental abruption?

Answer 6

Pregnancy-induced hypertension
Ecplamsia
Renal disease ±hypertension
Rapid changes in uterine size

Question 7

What can cause rapid changes in uterine size?

Answer 7

Release of polyhydramnios

Deliver of one twin

Question 8

A woman who is 34 weeks pregnant presents with vaginal bleeding which has been ongoing for an hour and is associated with abdominal pain. what is the most likely diagnosis?

Answer 8

Placental Abruption

Question 9

What is the management of a woman who has placental abruption, who is not in shock and has ongoing bleeding?

Answer 9

Cardiotocogrphy and aim for vaginal delivery if normal, id abnormal then c-section

Question 10

Give 4 causes of antepartum bleeding other than placenta praevia or abruption

Answer 10

Vasa Praevia
Cervical Carcinoma
Cervical lesions
Ruptured uterine scar

Question 11

What is cardiotocogrphy?

Answer 11

monitoring of the foetal heartbeat