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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
See also, Placenta praevia, Placental abruption
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