Antepartum Haemorrhage Flashcards
Define antepartum haemorrhage (APH)
Bleeding from or into the genital tract from 24 weeks fo pregnancy to birth
What causes APH?
Placenta previa, abruption, show,cervicitis or uterine scar disruption
What are the complications associated with APH?
Anemia, PPH, infection, IUD, preterm delivery,, neonatal anemia or fetal hypoxia
How would you manage an APH?
Catheterise, fluid balance, haemotologist, blood products and a EMCS
Define placent previa
Placenta inserts wholly/in part into the lower segment of uterus
What are the different types of placenta previa (define them)?
Total= placenta completely covers internal OS
Partial= placenta covers internal OS when closed but not when dilated
Marginal= placenta reaches but does not cover OS
Low lying= placenta encroaches on lower segment
How would you manage a placenta previa?
No VE’s, call for help, left lateral, Obs, USS, IV access
What are some causes of placenta previa?
Endometrial scarring, increased placental mass, impeded endometrial circulation
What are the risk factors of placenta previa?
Previous CS, increased parity, smoking, increased maternal age and multiples
What are the signs of placenta previa?
Bleeding, Abdo pain, uterine activity, fetal distress, hypertonic uterus
What are the risk factors for placenta abruption?
Pre-eclampsie, FGR, non-vertex presentation, Low BMI, Multiparity, increased age or domestic abuse
How would you manage placenta abruption?
Call for help, OBs, No VE’s, IV access, fluid balance, catheterise
Define uterus rupture
Rupture of unscarred uterus or dehiscence of previous scar
What are the types of uterine rupture (define them)?
Complete= full thickness of uterine wall and pelvic peritoneum Incomplete= myometrium but not pelvic peritoneum
What are some causes of uterine rupture?
Uterine surgery, oxytocin, increased parity, trauma, prolonged labour or hypertonic uterus
