APH Flashcards
(14 cards)
Define APH
Defined as bleeding from or in to the genital tract, occurring from 24 weeks of pregnancy and prior to the birth of the baby.
How many of preterm babies are born in asssociation with APH
one fifth
the known association of APH w/ cerebral palsy is d.t preterm delivery
APH complicates how many pregnancies ?
Complicates 3-5%
APH is a leading cause of perinatal and maternal mortality worldwide.
Causes of APH
Placenta praevia
Placental abruption
Local causes (bleeding from the vulva, vagina or cervix)
Unexplained APH
Indicators of blood volume depletion d.t. APH
Maternal - clinical shock
Fetal - compromise or demise
Define -
Minor haemorrhage
Major haemorrhage
Massive haemorrhage
Recurrent APH
Spotting
Minor – < 50 ml
Major – 50–1000 ml, with no signs of clinical shock
Massive – > 1000 ml and/or signs of clinical shock.
Risks and complication of APH
Maternal:
* anaemia
* infection
* maternal shock
* renal tubular necrosis
* consumptive coagulopathy
* PPH
* prolonged hospital stay
* psychological sequelae
* complications of blood transfusion.
Fetal:
* fetal hypoxia
* SGA
* FGR
* prematurity (iatrogenic and spontaneous)
* death.
Can we predict APH
no
it has heterogenous pathophysiology
Risk of recurrence with previous 1 and previous 2 abruption
Prev 1 - 4.4%
Prev 2 - 19-25%
Which thrombophilia associated with increased risk of abruption ?
Heterozygous factor V Leiden
Risk factors for placenta praevia ?
Previous previa
Previous lscs
Previous termination of pregnancy
Multiparty
Multiple pregnancy
Advance maternal age>40
Smoking
Assisted conception
Deficent endometrium
How many cases of placental abruption occur in low risk pregnancies ?
70%
What should be asked for in history if a female presents with repeated APH ?
Domestic violence
USG fails to detect how many cases of abruption
3/4
