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.

 

Author: PINKY CHOUDHARY