What is the difference between postpartum haemorrhage and antepartum haemorrhage?
Antepartum haemorrhage (APH) is usually defined as bleeding from the birth canal after the 24th week of pregnancy . It can occur at any time until the second stage of labour is complete; bleeding following the birth of the baby is postpartum haemorrhage.
What is the most common cause of PPH?
Uterine atony. This is the most common cause of PPH. It happens when the muscles in your uterus don’t contract (tighten) well after birth. Uterine contractions after birth help stop bleeding from the place in the uterus where the placenta breaks away.
What is the management of PPH?
Management of post-partum haemorrhage (PPH) involves the treatment of uterine atony, evacuation of retained placenta or placental fragments, surgery due to uterine or birth canal trauma, balloon tamponade, effective volume replacement and transfusion therapy, and occasionally, selective arterial embolization.
What is APH and symptoms?
Symptoms of antepartum haemorrhage (APH) consist of vaginal bleeding in late pregnancy and before delivery. Along with vaginal bleeding other symptoms may be- (a) In APH due to placenta previa, vaginal bleeding is painless, or bleeding occurs after sexual intercourse.
What are the types of APH?
Type I: the placenta is located in the lower part of the uterus but does not come close to the cervix. You can usually expect to birth vaginally with this type. Type II (or marginal) – the placenta touches but does not cover the cervix. Type III (or partial) – the placenta partially covers the cervix.
What are the two types of PPH?
There are two types of PPH. Primary postpartum hemorrhage occurs within the first 24 hours after delivery. Secondary or late postpartum hemorrhage occurs 24 hours to 12 weeks postpartum.
How can you prevent PPH?
Uterotonics (such as oxytocin and misoprostol) cause uterine contractions and have long been used to treat uterine atony and reduce the amount of blood lost following childbirth. Use of a uterotonic drug immediately after the delivery of the newborn is one of the most important interventions to prevent PPH.
What are the stages of postpartum bleeding?
You’ll go through three postpartum bleeding stages: lochia rubra, lochia serosa and lochia alba.
Which drug may be used to treat postpartum hemorrhage?
Oxytocin is the drug of choice for preventing postpartum hemorrhage because it is at least as effective as ergot alkaloids or prostaglandins and has fewer side effects.
What is the prevention of post partum haemorrhage?
The most effective strategy to prevent postpartum hemorrhage is active management of the third stage of labor (AMTSL). AMTSL also reduces the risk of a postpartum maternal hemoglobin level lower than 9 g per dL (90 g per L) and the need for manual removal of the placenta.
What are the two types of antepartum haemorrhage?
You can usually expect to birth vaginally with this type. Type II (or marginal) – the placenta touches but does not cover the cervix. Type III (or partial) – the placenta partially covers the cervix. Type IV (or complete) – the placenta completely covers the cervix.
How do you treat APH?
In general, the patient’s usual chronic medications should be continued. In the patient who has APH due to placenta previa, magnesium sulfate may be used as a tocolytic to allow the administration of betamethasone to mature the fetal lung and to allow the obstetrician to better time delivery.
What are signs of APH?
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.
How is APH diagnosed?
Ultrasound scan (USG)- Women presenting with APH should have an ultrasound scan performed to confirm or exclude placenta praevia, if the placental site is not already known. Transvaginal ultrasound is more accurate than transabdominal in diagnosing placenta previa.
What are the four T’s of postpartum hemorrhage?
As a way of remembering the causes of PPH, several sources have suggested using the “4 T’ s” as a mnemonic: tone, tissue, trauma, and thrombosis.
What is lochia rubra?
Lochia rubra is the first stage of lochia. Dark or bright red blood. Lasts for three to four days. Flows like a heavy period. Small clots are normal. Mild, period-like cramping.
What are the types of PPH?
Postpartum hemorrhage can be divided into 2 types: early postpartum hemorrhage, which occurs within 24 hours of delivery, and late postpartum hemorrhage, which occurs 24 hours to 6 weeks after delivery.