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Antepartum Haemorrhage

Extracted from Survival Guide to Midwifery, 2nd Edition (2012) Diane M. Fraser and Margaret A. Cooper, Oxford; Churchill Livingstone: 2012. Courtesy Elsevier

Antepartum haemorrhage (APH) is bleeding from the genital tract after the 24th week of gestation and before the onset of labour.

Effect on fetus

Fetal mortality and morbidity are increased as a result of severe vaginal bleeding in pregnancy. Stillbirth or neonatal death may occur. Premature placental separation and consequent hypoxia may result in severe neurological damage to the baby.

Effect on the mother

If bleeding is severe, it may be accompanied by shock and disseminated intravascular coagulation (DIC). The mother may die or be left with permanent ill-health.

Types of APH

  • Bleeding from local lesions of the genital tract (incidental causes)
  • Placental separation due to placenta praevia or placental abruption

See also, Placenta praevia, Placental abruption

Resources

Royal College of Obstetricians and Gynaecologists (2011). Antepartum Haemorrhage. Green-top Guideline No 63. https://www.rcog.org.uk/globalassets/documents/guidelines/gtg63_05122011aph.pdf

National Institute for Health and Care Excellence. (2014) Intrapartum care for healthy women and babies. Clinical guideline 190. https://www.nice.org.uk/guidance/cg190/chapter/1-recommendations

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