APH - Antepartum Haemorrhage Flashcards
After how many weeks gestation does APH occur?
24 wks
How is APH categorised?
Spotting
Minor <50ml
Major 50-1000ml
Massive >1000ml, or signs of shock
Note this is different to PPH
What must be remembered to be given and tested in Rhesus -ve mothers?
Kleihauer test - quantify how much foetal blood has mixed with mothers blood
Anti-D prophylaxis
What is meant by the term ‘concealed blood’?
Bleeding that has occurred into the uterus when the cervical os is shut -> “revealed bleeding” is insufficient to quanitify the patients signs and symptoms
What is the main symptom of placental abruption?
CONTINUOUS abdo pain
Woody hard and tender abdo
What is the most common cause of APH?
Placental abruption
How do you diagnose placental abruption?
Clinical diagnosis
Along with a trans abdo US
Baby’s who’s mums have placental abruption need to be delivered preterm. What must be given antenatally to help babies lungs?
STEROIDS - help mature foetal lungs
How do you manage mums with APH?
ABCDE
Resus mum
Deliver baby
What is a Couvelaire uterus?
Haematoma bruised uterus can be found with mothers with placental abruption
What is the difference between low-lying uterus and placenta praevia?
Low lying within 20mm of cervical os
Placenta praevia - covering cervical os
What condition presents with ‘woody’ uterus and what does this mean?
Hard uterus in which you can’t feel the foetal parts
Placental abruption
26wk Woman presents with spotting sometimes triggered by sex. She has no other symptoms.
What is the gold standard for diagnosis?
What MUST NEVER be done before ruling out this condition?
TVUS
Digital vaginal examination - can irritate the placenta overlying the cervical os
Placental previa
How are babies delivered with placenta preavia?
Planned C-section
What form of investigation is used to ascertain severity of placental accerta?
MRI
