Often attributed to marginal sinus rupture or "show". 2. Major Etiologies Placenta Praevia
APH is traditionally classified into two main pathological causes, plus a third miscellaneous category. Antepartum haemorrhage APH.ppt
| Feature | Placenta Praevia | Abruptio Placentae | | :--- | :--- | :--- | | | Painless, fresh red blood. | Painful, often dark venous blood. | | Onset | Often recurrent, mild episodes. | Sudden, acute, often single episode. | | Uterine Tenderness | Absent. Uterus is soft and relaxed. | Present. Uterus is tense, tender, and "woody." | | Fetal Presentation | Often malpresentation (breech/transverse) due to placenta occupying lower segment. | Usually normal presentation. | | Fetal Heart Rate | Usually normal unless massive bleed. | Often distressed or absent (fetal demise is common in severe cases). | | Relation to Contractions | Bleeding may follow contractions. | Bleeding may precede contractions. | | Risk of PPH | High (due to poor retraction of lower segment). | High (due to coagulopathy or Couvelaire uterus). | Often attributed to marginal sinus rupture or "show"
The initial management of APH is a simultaneous process of assessment and stabilization. This section is the "meat" of the presentation and should be emphasized in the slide deck. | Feature | Placenta Praevia | Abruptio Placentae
Blood loss greater than 1000 mL or the presence of clinical signs of hypovolaemic shock. Primary Causes of APH