DEFINITION– Ante partum hemorrhage is defined as bleeding from the genital tract after 28th week of pregnancy and before the birth of the baby.
TYPES OF ANTEPARTUM HEMORRHAGE-
1] PLACENTAL BLEEDING
Placenta previa
Abruptio placentae
2] EXTRA PLACENTAL BLEEDING
Due to local cervicovaginal lesions
CAUSES-
Causes are not found of this disease is about 40 to 47%.
Vasa praevia and placenta praevia are causes to Ante partum Hemorrhage.
Bleeding from cervical tumor may cause to infiltrating carcinoma.
Blood which comes from the surface if cervix because of contact bleeding is cause to this Ante partum Hemorrhage.
Dilated cervix with bulging membranes.
SIGN AND SYMPTOMS-
Painless vaginal bleeding is the common symptom of Ante partum Hemorrhage.
Lower uterine segments develop at 28 week after which bleeding get start.
Dizziness is the commonest symptom and Tender abdomen is also a signs of this disease.
Mal presentation is the symptom of ante partum hemorrhage Bleeding may occur by intercourse.
At the time of Ante partum Hemorrhage blood pressure may be low and pulse rate may be fast.
Patient may feel cold and clammy to the touch.
Patient starts sweating and her skin becomes pale.
MANAGEMENT-
Firstly patient must be hospitalized and the treatment will be based on the examination of the patient.
If case is severe resuscitation is the first prerequisite.
Asses monitor fetal heart and uterine activity to treat the patient.
Check fundel height
Vaginal examination should be done until placenta praevia is not excluded.
Patient must have bed rest.
Hydrallazine is commonly used to treat the patient.
COMPLICATIONS-
Premature labor.
Disseminated intravascular coagulopathy.
Acute kidney injury.
Postpartum hemorrhage.
Placenta accreta: this may complicate cases of placenta praevia but is rare in the absence of placenta praevia or previous caesarean section. See separate Placenta and Placental Problems article.
Anemia.
Infection.
Prolonged hospital stay.
Psychological squeal.
Fetal complications:-
• Fetal hypoxia.
• Fetal growth restriction.
• Prematurity, both iatrogenic and spontaneous.
• Fetal death.
