Antepartum haemorrhage

In obstetrics, antepartum haemorrhage (APH), also prepartum hemorrhage, is genital bleeding during pregnancy from the ^[1] 28th week (sometimes defined as from the 20th week^[1][2]) gestational age to term.

It can be associated with reduced fetal birth weight.^[3]

In regard to 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.

Causes 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
  • Ruptured Uterus
    • Uterine rupture
• 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
    • GI bleed - haemorrhoids, inflammatory bowel disease
    • Urinary tract bleed - urinary tract infection

See also

• Obstetrical haemorrhage

References