Antepartum haemorrhage
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Antepartum haemorrhage
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| Antepartum haemorrhage | |
|---|---|
| Classification and external resources | |
| ICD-10 | O46 |
| ICD-9 | 641 |
| DiseasesDB | 30077 |
In obstetrics, antepartum haemorrhage (APH), also prepartum hemorrhage, is bleeding from the vagina during pregnancy from the [1] 24th week (sometimes defined as from the 20th week[1][2]) gestational age to term.
It can be associated with reduced fetal birth weight.[3]
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Contents
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Treatment
It should be considered a medical emergency (regardless of whether there is pain) and medical attention should be sought immediately, as if it is left untreated it can lead to death of the mother and/or fetus.
Bleeding without pain is most frequently bloody show, which is benign; however, it may also be placenta previa (in which both the mother and fetus are in danger). Painful APH is most frequently placental abruption (which may also lead to adverse fetal and/or maternal outcomes).
As with other forms of hemorrhage, the patient may be at risk of hypovolemic shock, and volume restoration may be a priority.
Differential diagnosis of APH
- Obstetric
- Placenta
- Maternal blood
- Bloody show (benign) - most common cause of APH
- Placental abruption - most common pathological cause
- Placenta previa - second most common pathological cause
- Fetal blood (can be distinguished with Apt test)
- Vasa previa - often difficult to diagnose, frequently leads to fetal demise
- Maternal blood
- Uterus
- Placenta
avoid manual examination as it may lead to further damage and bleeding
- Nonobstetric
- Bleeding from the lower genital tract
- Cervical bleeding - cervicitis, cervical neoplasm, cervical polyp
- Bleeding from the vagina itself - trauma, neoplasm
- Bleeding that may be confused with vaginal bleeding
- Bleeding from the lower genital tract
See also
References
- ^ a b patient.co.uk » PatientPlus » Antepartum Haemorrhage Last Updated: 5 May 2009
- ^ The Royal Women’s Hospital > antepartum haemorrhage Retrieved on Jan 13, 2009
- ^ Lam CM, Wong SF, Chow KM, Ho LC (2000). "Women with placenta praevia and antepartum haemorrhage have a worse outcome than those who do not bleed before delivery". Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology 20 (1): 27–31. doi:10.1080/01443610063417. PMID 15512459.
External links
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