Antepartum hemorrhage

Question 1

define antepartum hemorrhage ?

Answer 1

bleeding from the genital tract > 24 weeks

Question 2

3 major causes of antepartum hemorrhage

Answer 2

placenta previa
placenta abruption
local causes (unknown)

Question 3

initial investigations for antepartum hemorrhage?

Answer 3

1. FBC
2. group and crossmatch
3. Keihauer test
4. coagulation
5. monitor fetus - ultrasound, umbilical artery doppler, CTG

Question 4

Management of Antepartum hemorrhage ?

Answer 4

1. resuscitation: IV line, FBC, group and crossmatch, coagulation, give steroids, if bleeding doesn’t stop get ready to go to theatre to deliver
2. admission
3. anti-D immunoglobulin

Question 5

what are the grades of placenta previa?

Answer 5

1. grade 1: into the lower uterine segment
2. lower uterine segment and at the edge of cervical os
3. extending partway across the cervical os
4. grade 4: extending fully across the cervical

Question 6

what do you do if there is intrauterine demise?

Answer 6

vaginal delivery

Question 7

what do you do if the fetus is in distress?

Answer 7

LSCS