ANTE-PARTUM HAEMORRAGE (APH)

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Presentation transcript:

ANTE-PARTUM HAEMORRAGE (APH) WONGANI ZGAMBO ARNOLD MKANDAWIRE DANIEL LEVITICUS

OBJECTIVES By the end of this session participant should be able to Define the term APH. Explain the causes of APH. Describe the clinical presentation of APH Outline the management of APH

DEFINITION OF APH .Bleeding from vagina at least at 22 weeks or more of pregnancy.

CAUSES Many causes the major causes are 1– placenta previa 2-Abruptionlplacenta

EXAMPLES OF PLACENTA ABRUPTUAL

CLINICAL PRESENTAION PLACENTA ABRAPTUAL Uterus is tender and hard(couvelaire uterus) Heavy bleeding lead to hypovolemic shock. PLACENTA PREVIA Painless vaginal bleeding.

RISK FACTORS Previous C/s scar Uterine abnormality Previous curettage Multiparity Multiple pregnancy

MANAGEMENT OF APH Admit the patient Management follow the ABC principle If severe bleeding Iv line ringers lactate or N/S Grouping and X-match Delivery irrespective of the gestation age usually c/s.

MANAGEMENT CONT…… LIGHT BLEEDING/ BABY PREMATURE Keep the woman in hospital until delivery Correct anaemia Ensure blood is available for transfusion if required

INVESTIGATIONS USS Haemoglobin level. Grouping and cross match.

COMPLICATION OF APH Disseminated intravascular coagulation Haemorrhagic shock which can lead to death. Convulaire uterus which can lead to hysterectomy Premature delivery/ FSB