Antepartum haemorrhage (Complete) Flashcards
(12 cards)
Define antepartum haemorrhage
Vaginal bleeding that occurs between the 24th week of pregnancy and birth.
What differential conditions should always be considered in women presenting with antepartum haemorrhage?
Placental abruption
Placenta praevia
Vasa praevia
Genitral tract trauma/malignancy
STI
Uterine rupture
Inheritted bleeding disorders
Gestational trophoblastic disease
Cervical ectropion
Key clinical features of placental abruption
Vaginal bleeding
Abdominal pain
Uterine tenderness and rigidity (‘Woody’ uterus)
Key clinical features of placental praevia
Painless and bright red vaginal bleeding
Key clinical features of vasa praevia
Vaginal bleeding
Abnormal foetal heart patterns
Key clinical features of genital tract trauma
Recent trauma hx of injury
Vaginal bleeding
Pelvic pain
Key features of genital tract infections
Vaginal bleeding
Fever
Vaginal discharge
Pelvic pain
Key features of uterine rupture
Sudden and severe adominal pain
Vaginal bleeding
Signs of shock
Key features of inheritted bleeding disorders
Personal or family history of bleeding disorders
Key features of gestatonal trophoblastic disease
Vaginal bleeding
Elevated b-hCG
Uterine fundus size larger than expected given gestational date
Key features of cervical ectropion
Post-coital vaginal bleeding
What investigations should be considered in patients with antepartum haemorrhage?
Bedside:
Basic obs: Assess haemodynamic status
Abdominal examination
Speculum examination
Bloods:
FBC: Check anaemia
Group & save: If blood transfusion required]
Kleihauer test: If rhesus negative
Coagulation screen
Urea and electrolytes
LFTs
Imaging:
Ultrasound: Exclude placental praevia
Cardiotography: Monitor foetal status
