Antepartum haemorrhage
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Antepartum hemorrhage; APH
Overview
In obstetrics, antepartum haemorrhage 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 frequently placental abruption.
Causes
- 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