Separation of the normally located placenta after the 20th week of gestation and prior to the birth of the fetus. Caused by bleeding into the decidua basalis.
Occurs in about 1% of pregnancies.
15% foetal mortality.
- Woody hard large for dates tender uterus
- Constant pain
- FH present or absent
- Concealed or revealed haemorrhage
- Immediate abdominal palpation
- Auscultate FH
- Call Obstetric SpR
- Two 16G cannulae
- Hb, X-match 4 units, clotting
- VE by Obstetrician
- Vaginal delivery vs. C section
Implantation of the placenta over or near the internal os of the cervix. Varies from total to partial to low lying placenta.
- Higher incidence in older women.
- Occurs in 0.5% of pregnancies.
- Foetal mortality low.
- Bright red blood
- High presenting part
- Bleeding may be profuse
- Mx depends on degree of bleeding
- IV infusion.
- Contact Obs Registrar for advice
- Conservative vs. Delivery. Grade / Gestation / Amount
Other causes of APH
- Cervical erosion
- Cervical neoplasia
- Vaginal tears
- Undefined bleeding
- Marginal abruption
- Marginal sinus haemorrhage