Antepartum Heamorrhage

Question 1

What are the key causes of antepartum haemorrhage?

Answer 1

Placental edge bleeding-painless
Placenta praevia-painless
Plancental abruption-painful
Preterm labour

Question 2

What is placental abruption?

Answer 2

Part of the uterus separates from the uterus before delivery

Question 3

What are the risk factors for placental abruption?

Answer 3

Previous abruption
Hypertension
Smoking
Multiple pregnancy

Question 4

What are the signs of placental abruption?

Answer 4

Pain and dark bleeding (not consistent with systemic signs as often hidden in uterus)
Tachycardia, low BP
Absent fetal heart
Hard uterus

Question 5

What are the signs of placenta previa?

Answer 5

Painless bleeding, bright red

Question 6

What is the first thing to rule out before doing a vaginal exam in antepartum haemorrhage?

Answer 6

Check if placenta previa-VE can cause bleeding

Question 7

Which investigations should be done for antepartum haemorrhage?

Answer 7

Group and hold
Rhesus status
FBC
Ultrasound
CTG

Question 8

How do we manage antepartum haemorrhage?

Answer 8

ABC
Iv line
Fluids
Analgesia if necessary
Blood transfusion if necessary
Rhesus antibodies
Admit
Steroids if <34 weeks
Abruption-emergency caesarean