Antepartum Haemorrhage

Question 1

Antepartum haemorrhage describes any vaginal bleeding during what period of time?

Answer 1

24 weeks until delivery

Question 2

Which type of antepartum haemorrhage is this describing: separation of the placenta from the uterine wall before delivery?

Answer 2

Placental abruption

Question 3

Which type of antepartum haemorrhage is this describing: a placenta either partially or wholly covering the cervix?

Answer 3

Placenta praevia

Question 4

Which type of antepartum haemorrhage is this describing: a placenta that is abnormally adherent to the myometrium, usually at the site of the scar from a previous C-section?

Answer 4

Placenta accreta

Question 5

Which type of antepartum haemorrhage is this describing: bleeding from foetal vessels?

Answer 5

Vasa praevia

Question 6

How is placenta accreta managed?

Answer 6

C-section, usually with hysterectomy

Question 7

Which types of antepartum haemorrhage are painful?

Answer 7

Placental abruption and uterine rupture

Question 8

Which is the only type of antepartum haemorrhage not to cause maternal haemodynamic compromise?

Answer 8

Vasa praevia

Question 9

Which is the only type of antepartum haemorrhage not to cause foetal distress?

Answer 9

Placenta praevia

Question 10

Foetal compromise and maternal collapse disproportionate to the degree of blood loss visible is a common sign of which type of antepartum haemorrhage?

Answer 10

Placental abruption

Question 11

A tense and tender uterus is most suggestive of which type of antepartum haemorrhage?

Answer 11

Placental abruption

Question 12

How is placental abruption managed?

Answer 12

Resuscitation, stabilisation and delivery

Question 13

Before any examination can proceed in a women with antepartum haemorrhage, what investigation must be done? This is to rule out what condition?

Answer 13

Ultrasound to rule out placenta praevia

Question 14

How is a uterine rupture managed?

Answer 14

Emergency C-section

Question 15

How is vasa praevia managed?

Answer 15

Emergency C-section

Question 16

Once the mother’s condition has been stabilised, how is the foetus monitored?

Answer 16

CTG

Question 17

What investigation and intervention is required for Rhesus negative women who have an antepartum haemorrhage?

Answer 17

Kleihauer test and anti-D

Question 18

If significant antepartum haemorrhage occurs before 35 weeks, what additional medication is given in case delivery is required?

Answer 18

Corticosteroids

Question 19

Antepartum haemorrhage with abdominal pain, maternal haemodynamic compromise and foetal distress is most suggestive of which two diagnosis?

Answer 19

Placental abruption and uterine rupture

Question 20

Antepartum haemorrhage with maternal haemodynamic compromise but no abdominal pain and no foetal distress is most suggestive of what diagnosis?

Answer 20

Placenta praevia

Question 21

Antepartum haemorrhage with foetal distress but no abdominal pain or maternal haemodynamic compromise is most suggestive of what diagnosis?

Answer 21

Vasa praevia