Antepartum haemorrhage
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| ICD-10 | O46 |
|---|
In obstetrics, antepartum haemorrhage (APH), also antepartum hemorrhage, is bleeding from the vagina during pregnancy from twenty weeks gestational age to term.
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 frequency placental abruption.
[edit] Differential diagnosis of APH
- Bloody show (benign) - most common cause of APH
- Placental abruption - most common pathological cause
- Placenta previa - second most common pathological cause
- Vasa previa - often difficult to diagnose, frequently leads to fetal demise
- Uterine rupture
- 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
