Antepartum haemorrhage
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Antepartum Haemorrhage. Definition :- bleeding from the genital tract after 24 th week of preg .and before birth of the child. classification. 1) pp 2) abruptio p 3) vasa p 4)show 5) rupture uterus 6) cervical polyp. Placenta praevia.

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Antepartum Haemorrhage

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Antepartum haemorrhage

AntepartumHaemorrhage

Definition :- bleeding from the genital tract after 24th week of preg .and before birth of the child


Classification

classification

  • 1) pp

  • 2)abruptio p

  • 3)vasa p

  • 4)show

  • 5) rupture uterus

  • 6) cervical polyp


Placenta praevia

Placenta praevia

  • Def :- placenta partialy or totally attached to the lower uterine segment .

  • CAUSES :-

  • Multiparous – previous c\s & D C - ^ Age

  • TYPES :-

  • 1)first degree (Low- lying placenta) lateralis

  • 2)2nd degree :- marginalis

  • 3)3rd degree :- incomplete centralis

  • 4)4th degree :- complete centralis


Symptoms

Symptoms : -

  • Causless , painless, recurrent bleeding

  • Signs :- shock in acute severe blood loss

  • Uterus not tender

  • Malpresentations

  • FHS detected

  • Speculum EX(local lesions)

  • PV : -should not be done excep certain conditions (what are?)

  • Investigations :- U/S


D d what

D/D (WHAT)

  • Treatment :-

  • 1)resuscitation

  • 2)If not in labour

  • a/bleeding is severe immediate c/s

  • b/ bleeding is slight :-1/ if complete 37 wks termination by c/s 2/ less than 37 wks conservative treatment (hospitalization – anaemia – anti –D If needed )


Antepartum haemorrhage

3) if in labour :- bleeding c/s

Complications :-( matrenal & fetal)


Abruptio placenta

Abruptio placenta

  • Definition:- premature separation of normally situated placenta after 24 wks and before delivery.

  • Aetiology:- 1) hypertensive disorders

  • 2) trauma.

  • 3)folate deficiency

  • 4) smoking

    Pathology:-


Antepartum haemorrhage

  • 1) concealed

  • 2) revealed

  • 3) mixed

  • 4)couvelaires uterus

  • 5) DIC.

  • 6)acute renal failure

  • SYMPTOMS :- severe abdominal pain – vaginal bleeding – fetal distress or death

  • SIGNS ;- shock – BP (subnormal 0r normal ?) – tachycardia – tender uterus


D d what1

D/D (what)

INVESTIGATIONS: - u/s – test for DIC

  • Treatment : -

  • 1)resuscitations

  • 2)delivery (mode & time) depend on severity and GA

  • A/ Amniotomy and oxytocin (bleeding not severe, CX dilated,vertex)

  • B) C/S (severe hge if fetus dead or alive )


Antepartum haemorrhage

  • C) oxytocin continued after delivery ( post partum heamorrhage liable )


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