What is antepartum haemorrhage?
Antepartum haemorrhage (APH) is defined as bleeding from or in to the genital tract, occurring from 24+0 weeks of pregnancy and prior to the birth of the baby. The most important causes of APH are placenta praevia and placental abruption, although these are not the most common.
What are the signs and symptoms of antepartum haemorrhage?
It presents classically with vaginal bleeding, abdominal pain, uterine contractions and tenderness. On clinical examination, the uterus is irritable, with increased baseline tone. There may be evidence of fetal distress. In severe cases, the mother may show cardiovascular decompensation with evidence of hypovolaemia.
What is the importance of antepartum haemorrhage in obstetrics?
Antepartum hemorrhage is one of the major complication. Antepartum haemorrhage is an obstetric emergency contributing to a significant amount of perinatal & maternal morbidity and mortality.
What are the risk factors of APH?
In this study, the factors found to be risk factors of antepartum hemorrhage were maternal age, previous history of cesarean section, and previous history of abortion.
What is the meaning of PPH?
Postpartum hemorrhage (also called PPH) is when a woman has heavy bleeding after giving birth. It’s a serious but rare condition. It usually happens within 1 day of giving birth, but it can happen up to 12 weeks after having a baby.
What is the management of antepartum hemorrhage?
The initial emergency management of antepartum haemorrhage Assess the condition of the fetus. If the fetus is viable but distressed, an emergency delivery is needed. Diagnose the cause of the bleeding, taking the clinical findings into account and, if necessary, the results of special investigations.
What are the treatment of antepartum haemorrhage?
However, surgery for the treatment of PPH is usually emergent and cannot wait for several hours. Elective: Surgery for treatment of APH can be elective for cases of placenta previa or vasa previa with minimal pre-delivery bleeding and no evidence of fetal stress. Surgery for treatment of PPH is not elective.
How do you manage APH?
Principles of management of APH
- evaluate a woman with an APH.
- be aware of the differential diagnoses.
- diagnose a placenta praevia.
- diagnose and manage placental abruption.
- manage both conditions safely.
- counsel a woman on the recurrence risks.
Who define PPH?
Definition and Prevalence Postpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean. 1. Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss.
What are the 4 causes of PPH?
The causes of postpartum hemorrhage are called the four Ts (tone, trauma, tissue and thrombin). The most common causes of PPH are: Uterine atony: Uterine atony (or uterine tone) refers to a soft and weak uterus after delivery.
What are the 4 main causes of PPH?
Tone: Uterine atony (70% of PPH worldwide) Trauma: Genital tract trauma. Tissue: Retained products of conception (POC) Thrombin: Coagulopathy.
What are the 5 main causes of postpartum hemorrhage?
What causes postpartum hemorrhage?
- Placental abruption. The early detachment of the placenta from the uterus.
- Placenta previa. The placenta covers or is near the cervical opening.
- Overdistended uterus.
- Multiple pregnancy.
- Gestational hypertension or preeclampsia.
- Having many previous births.
- Prolonged labor.
- Infection.
What causes haemorrhage?
Injuries, such as cuts or puncture wounds, bone fracture or traumatic brain injury. Violence, such as a gunshot or knife wound, or physical abuse. Viruses that attack the blood vessels, such as viral hemorrhagic fever.
What are the 4 T’s of PPH?
What is antepartum hemorrhage (APH)?
INTRODUCTION: Antepartum hemorrhage (APH) is defined as bleeding from or in to the genital tract, occurring from 24+0 weeks of pregnancy and prior to the birth of the baby.
What causes antepartum haemorrhage in pregnancy?
Causes of antepartum haemorrhage The causes of APH are: Extraplacental bleeding: From sites other than the placental surface, including cervical lesions, e.g., trauma, cancer of the cervix, cervical polyps; vaginal lesions, genital tears/lacerations (rare), and infections; and vulvoperineal tears (rare).
Is antepartum hemorrhage due to placental abruption most prevelant?
Antepartum hemorrhage due to placental abruption was most prevelant due to the fact that strict adherence to PPH management protocols and routine active management of third stage of labor prevents PPH in patients delivered at our hospital.
Which tests are used to diagnose antepartum haemorrhage?
Vasa praevia: This is a rare cause of antepartum haemorrhage in which the umbilical cord is inserted into placental membranes with blood vessels traversing and presenting over the internal cervical ( velamentous insertion of the umbilical cord). Others: Ultrasound, which offers a high degree of diagnostic accuracy in antepartum haemorrhage